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BS III, Module II > 4. Blood Supply of H/N, Pt. 2 > Flashcards

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

1
Q

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

A

posterior cervical
vertebral arteries

vertebrobasilar system
vertebrals

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2
Q

Occipital artery

Muscular

  • Digastric
  • Stylohyoid
  • Posterior cervical

____

____
mastoid air cells

____
Dura of PCF via multiple foramina

____

  • occipitalis
  • posterior scalp
A

SCM
auricular
meningeal
terminal

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3
Q

Posterior auricular artery

Occipital Branches Supplies the ____

Multiple Auricular
branches Supply the deep surface of the ____

A

scalp

external ear

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4
Q

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.

A

parotid gland
stylomastoid foramen
second arch

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5
Q

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

Gives rise to the
____ artery

Which in turn gives rise to the ____ artery

A

facial canal
tympanic cavity
mastoid antrum

posterior tympanic

stapedial artery

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6
Q

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 ____.

A

vertebrobasilar
internal acoustic meatus
VII
VIII

end artery
ischemic events

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7
Q

Maxillary and Superficial Temporal

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

Small branches of both will supply the ____

A

parotid gland

TMJ

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8
Q

ANTERIOR AURICULAR arteries

ZYGOMATICO-ORBITAL a.
____

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

MIDDLE TEMPORAL a
____

SUPERFICIAL TEMPORAL

A 
orbicularis oculi
facial skin
parotid
masseter
temporalis
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9
Q

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

A

ECA
ICA
second (dense connective tissue)

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10
Q

CAROTID ARTERY PULSE POINTS

Temporal pulse

  • ____ artery
  • anterior branch of ____ artery

Carotid pulse

Facial pulse

A

superficial temporal

superficial temporal

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11
Q

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 ____

A

ECA
condylar process
three

lateral pterygoid

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12
Q

The relationship between lateral pterygoid

and the MAXILLARY ARTERY is ____!

A

variable

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13
Q

The maxillary artery is divided into three distinct parts…

____
____
____

A

pterygoid-palatine
pterygoid
mandibular

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14
Q

Mandibular (of Maxillary)

MIDDLE MENINGEAL
DEEP AURICULAR
ANTERIOR TYMPANIC
INFERIOR ALVEOLAR

A 5th branch
____ ascends through Foramen Ovale when present

A

accessory meningeal

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15
Q

anterior tympanic

deep auricular
Supplies the
____

A

external auditory canal

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16
Q

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

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

A

petrotympanic fissure
TMJ

tympanic
tympanic cavity

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17
Q

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 ____

A

middle meningeal
maxillary
stylomastoid
posterior auricular

maxillary

ascending pharyngeal

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18
Q

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 ____

A

mandibular foramen

mandibular canal

incisive
mental

inferior labial

facial

19
Q

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)

A

foramen spinosum

facial
tympanic cavity

20
Q

Middle Meningeal Artery

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

They supply both
____ and overlying ____

A

dura mater
inner table

meninges
calvaria

21
Q

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

A

pterion

frontal branch

22
Q

Bleeding from a torn middle meningeal artery produces an ____

Produces a cerebral compression after a period of ____

A

epidural hematoma

“lucid interval”

23
Q

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

A

head trauma
circle of willis

“worst headache ever”

24
Q

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

A

end arteries

25
Q

PTERYGOID
supplies the ____
as well as the ____

Buccal
Deep temporal
Masseteric

A

muscles of mastication

buccinator

26
Q

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 ____

A

lateral pterygoid

anesthesia

27
Q

BUCCAL
artery
Supplies ____ and ____

Anastomoses with branches of ____ and ____ arteries

A

buccinator
cheek mucosa

facial
infraorbital

28
Q

PTERYGOPALATINE

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

YAY

29
Q

Pharyngeal branch

Enters the cranium thru the
____ canal to ____, ____ sinus and ____

ARTERY OF PTERYGOID CANAL
recall that it
anastomoses
with a branch
of the
\_\_\_\_
A

pharyngeal (palatovaginal) canal

nasopharynx
sphenoid
auditory tube

petrous ICA

30
Q

INFRAORBITAL artery enters the orbit thru the ____ and enters the ____
canal

POSTERIOR SUPERIOR ALVEOLAR arteries

Supply maxillary ____, maxillary ____ and ____

A

inferior orbital fissure
infraorbital canal

molars
sinus
gingivae

31
Q

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 ____

A

anterior
middle superior alveolar

lower eyelid
nose
cheek
upper lip

32
Q

Descending Palatine artery

The vessel descends and divides with the ____

A

pterygopalatine canal

33
Q 
Greater palatine supplies:
\_\_\_\_
Hard palate 
\_\_\_\_
—A branch will ascend the \_\_\_\_ towards KIESSELBACH’S AREA

Lesser Palatine arteries supply the ____

A

inferior nasal meatus
palatal gingiva of the maxillary teeth

incisive foramen

soft palate

34
Q

LESSER PALATINE
arteries also contribute to an ____..

…that underlies the ____

A

arterial plexus

palatine tonsil

35
Q

Achieving complete ____

after tonsillectomy has been regarded traditionally as a challenge

A

hemostasis

36
Q

____
artery supplies the lateral wall of the nasal cavity…

…and provides blood to the posterior aspect of the ____ via ____ branches

A

sphenopalatine

nasal septum
posterior septal

37
Q

____ - 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

A

kiesselbach’s area
epistaxis

ICA
ECA

38
Q

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.

A

subclavian-axillary

39
Q

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.

A 
trapezius
rotator cuff
thyroid gland
larynx
prevertebral

ascending cervical branch
vertebral arteries

subclavian
vertebrobasilar

40
Q

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.

A

deep posterior cervical

vertebrobasilar

41
Q

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

A

vertebral
posterior intercostals
lumbar

42
Q

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.

A

sub-arachnoid space

anterior
posterior
segmental spinal arteries
IV

sub-arachnoid space

43
Q

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.

A

anastomosis

circle of willis
brain tissue

BS III, Module II (9 decks)

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