CAROTID ARTERY PULSE POINTS Temporal pulse - ____ artery - anterior branch of ____ artery Carotid pulse Facial pulse

superficial temporal superficial temporal

4. Blood Supply of H/N, Pt. 2 Flashcards by J L

Occipital arter

Muscular
- Digastric
- Stylohyoid
— ____

Posterior cervical branches anastomose with branches of ____ near C1 and C2

…and may add blood to the____ system if the ____ are occluded in the neck

posterior cervical
vertebral arteries

vertebrobasilar system
vertebrals

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Occipital artery

Muscular

Digastric
Stylohyoid
Posterior cervical

____

____
mastoid air cells

____
Dura of PCF via multiple foramina

____

occipitalis
posterior scalp

SCM
auricular
meningeal
terminal

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Posterior auricular artery

Occipital Branches Supplies the ____

Multiple Auricular
branches Supply the deep surface of the ____

scalp

external ear

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Posterior auricular artery
Parotid branch
brings blood to the ____

Stylomastoid artery
rising toward the ____, which is the exit point for the trunk of the facial nerve, containing fibers that innervate ____ muscles including muscles of facial expression.

parotid gland
stylomastoid foramen
second arch

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Stylomastoid artery ascends the stylomastoid foramen to the ____, ____ and ____

Gives rise to the
____ artery

Which in turn gives rise to the ____ artery

facial canal
tympanic cavity
mastoid antrum

posterior tympanic

stapedial artery

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Internal auditory (labyrinthine) artery

A branch of the ____ system, this artery enters the petrous temporal through the ____ with both CN ____ and CN ____

Because this artery is yet
another example of an
____ lacking peripheral anastomoses, both the vestibular and the auditory structures are especially vulnerable to ____.

vertebrobasilar
internal acoustic meatus
VII
VIII

end artery
ischemic events

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Maxillary and Superficial Temporal

The External Carotid
has two terminal branches arising within the substance of the
____

Small branches of both will supply the ____

parotid gland

TMJ

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ANTERIOR AURICULAR arteries

ZYGOMATICO-ORBITAL a.
____

TRANSVERSE 
FACIAL a.
• \_\_\_\_
• \_\_\_\_
• \_\_\_\_

MIDDLE TEMPORAL a
____

SUPERFICIAL TEMPORAL

orbicularis oculi
facial skin
parotid
masseter
temporalis

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The scalp receives a rich blood supply from branches of both the ____ and ____ which anastomose freely in the ____ layer

ECA
ICA
second (dense connective tissue)

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CAROTID ARTERY PULSE POINTS

Temporal pulse

____ artery
anterior branch of ____ artery

Carotid pulse

Facial pulse

superficial temporal

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Maxillary artery

Arising from the ____ at the level of the neck of the ____ of the mandible, the maxillary artery may be divided into ____ parts

On the basis of its relationship to the ____

ECA
condylar process
three

lateral pterygoid

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The relationship between lateral pterygoid

and the MAXILLARY ARTERY is ____!

variable

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The maxillary artery is divided into three distinct parts…

____
____
____

pterygoid-palatine
pterygoid
mandibular

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Mandibular (of Maxillary)

MIDDLE MENINGEAL
DEEP AURICULAR
ANTERIOR TYMPANIC
INFERIOR ALVEOLAR

A 5th branch
____ ascends through Foramen Ovale when present

accessory meningeal

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anterior tympanic

deep auricular
Supplies the
____

external auditory canal

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The anterior tympanic artery passes through the ____ after supplying the ____

Contributes to the blood supply of the ____ membrane and the anterior ____

petrotympanic fissure
TMJ

tympanic
tympanic cavity

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Numerous branches of the ECA form a rich arterial anastomotic network in the middle ear cavity

SUPERIOR TYMPANIC from ____

ANTERIOR TYMPANIC from ____

POSTERIOR TYMPANIC
from ____ from
____

DEEP AURICULAR from ____

INFERIOR TYMPANIC
from ____

middle meningeal
maxillary
stylomastoid
posterior auricular

maxillary

ascending pharyngeal

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Inferior Alveolar

Descends and enters the the ____

Courses thru the ____, supplying the mandibular teeth

Terminates as____ and ____ arteries

The mental artery anastomoses with the ____ branch of ____

mandibular foramen

mandibular canal

incisive
mental

inferior labial

facial

Recall that the
Middle Meningeal Artery enters the cranial cavity
thru ____ and ramifies within deep grooves in the inner table of cranial bone

To ____ nerve and
____
(superior tympanic)

foramen spinosum

facial
tympanic cavity

Middle Meningeal Artery

These vessels lie between the ____ and the ____ of cranial bone in a potential epidural space

They supply both
____ and overlying ____

dura mater
inner table

meninges
calvaria

A radiating fracture line passing thru the thin bone at ____ may lead to tearing of the ____ of the middle meningeal artery

pterion

frontal branch

Bleeding from a torn middle meningeal artery produces an ____

Produces a cerebral compression after a period of ____

epidural hematoma

“lucid interval”

In contrast…
SUBARACHNOID
HEMORRHAGE may result from ____ or the rupture of either an aneurysm or an AVM near the ____

Start as the ____
Half are fatal even with immediate medical attention

head trauma
circle of willis

“worst headache ever”

Recall that cerebral vessels above the circle of Willis are ____, with either hemorrhagic or ischemic stroke leading to death of brain tissue

end arteries

PTERYGOID supplies the ____ as well as the ____ Buccal Deep temporal Masseteric

muscles of mastication | buccinator

The maxillary a. may sweep across the infratemporal fossa EITHER superficial OR deep to the ____ muscle While there is NO significance to this variation from a functional perspective... There may be significance in terms of the success of distribution of ____

lateral pterygoid anesthesia

BUCCAL artery Supplies ____ and ____ Anastomoses with branches of ____ and ____ arteries

buccinator cheek mucosa facial infraorbital

PTERYGOPALATINE 1. Posterior Superior Alveolar 2. Infraorbital 3. Descending palatine 4. Artery of the pterygoid canal 5. Pharyngeal 6. Sphenopalatine

YAY

Pharyngeal branch Enters the cranium thru the ____ canal to ____, ____ sinus and ____ ``` ARTERY OF PTERYGOID CANAL recall that it anastomoses with a branch of the ____ ```

pharyngeal (palatovaginal) canal nasopharynx sphenoid auditory tube petrous ICA

INFRAORBITAL artery enters the orbit thru the ____ and enters the ____ canal POSTERIOR SUPERIOR ALVEOLAR arteries Supply maxillary ____, maxillary ____ and ____

inferior orbital fissure infraorbital canal molars sinus gingivae

Within the infraorbital canal, the artery gives rise to ____ and ____ arteries To the maxillary teeth and maxillary sinus After emerging through the infraorbital foramen... the artery gives rise to branches supplying the ____, lateral ____, part of ____ and the ____

anterior middle superior alveolar lower eyelid nose cheek upper lip

Descending Palatine artery The vessel descends and divides with the ____

pterygopalatine canal

``` Greater palatine supplies: ____ Hard palate ____ —A branch will ascend the ____ towards KIESSELBACH’S AREA ``` Lesser Palatine arteries supply the ____

inferior nasal meatus palatal gingiva of the maxillary teeth incisive foramen soft palate

LESSER PALATINE arteries also contribute to an ____.. ...that underlies the ____

arterial plexus | palatine tonsil

Achieving complete ____ | after tonsillectomy has been regarded traditionally as a challenge

hemostasis

____ artery supplies the lateral wall of the nasal cavity... ...and provides blood to the posterior aspect of the ____ via ____ branches

sphenopalatine nasal septum posterior septal

____ - the most common site of nosebleed OPHTHALMIC (from ____) - Posterior ethmoidal - Anterior ethmoidal - Anterior septal branches MAXILLARY (from ____) - Sphenopalatine - Posterior Septal branches - Branch of greater palatine - Septal branch of superior labial (from facial a.) ____ = chronic nosebleed

kiesselbach's area epistaxis ICA ECA

Branches of the SUBCLAVIAN ARTERY AXILLARY artery COSTOCERVICAL TRUNK* THYROCERVICAL TRUNK This ____ pathway at the root of the neck is the principal pathway for blood to reach the upper extremity.

subclavian-axillary

Branches of the thyrocervical trunk (of the subclavian) TRANSVERSE CERVICAL artery To ____ SUPRASCAPULAR artery to muscles of the ____ INFERIOR THYROID artery to ____ and ____ ASCENDING CERVICAL artery to ____muscles Before we leave this slide, let’s go back to ascending cervical artery which is paralleling the course of the vertebral artery lying in close proximity to it • not surprisingly, there will be anastomoses between these 2 blood vessels (Between the ____ arising from subclavian, and the ____ which are part of the vertebrobasilar system supplying posterior contents of the cranial cavity) • **If vertebral artery is occluded near its base or if blood flow is interrupted by some sort of degenerative cervical condition that interrupts the course of the vertebral artery through transverse foramina and reduces the blood flow to places like brainstem and cerebellum, we can, above the points of STENOSIS (narrowing/obstruction), get collateral flow from ____ system into ____ system.**

``` trapezius rotator cuff thyroid gland larynx prevertebral ``` ascending cervical branch vertebral arteries subclavian vertebrobasilar

Branches of Costocervical Trunk (from subclavian) DEEP CERVICAL artery This artery will give blood supply to the ____ muscles (i.e. semispinalis capitis and the sub-occipital muscles). SUPREME INTERCOSTAL artery Here, we have an opportunity for anastomoses that can fill the ____ system if flow is interrupted either through atherosclerotic plaque accumulation at the base or constriction of the artery associated with cervical spinal pathology.

deep posterior cervical vertebrobasilar

SEGMENTAL SPINAL arteries also arise from the ____ arteries in the neck and the ____ and ____ arteries of the trunk

vertebral posterior intercostals lumbar

Spinal cord is supplied and drained by blood vessels which also course through the ____ These include: 1. ____ and ____ arteries 2. ____ arteries which enter the vertebral canal through the ____ foramina We see anastomoses here in the same plane as we found in the cranial cavity. These spinal vessels are all lying and anastomosing in the ____ b/t the arachnoid and the pia in the space normally filled with cerebral spinal fluid. That’s where we find the vasculature of the cord and the roots of the spinal nerves.

sub-arachnoid space anterior posterior segmental spinal arteries IV sub-arachnoid space

There is an extensive ____ of these vessels within the sub-arachnoid space Again, lots of opportunities along the vertebral canal for anastomoses of the sort that we found at the base of the brain in the cranial cavity when we looked at the ____, but once you start to get blood vessels that supply ____ (gray or white matter), these are END ARTERIES and if you lose any of these vessels you will lose a significant chunk of neural tissue with the expected neurological deficits.

anastomosis circle of willis brain tissue