5 - Head & Neck - Blood Vessels + Lymphatics Flashcards
The vertebral arteries are branches of which arteries?
Subclavian arteries
Describe the route of the vertebral arteries from their origin to the formation of the basilar artery:
- Branch from subclavian arteries
- Ascend through transverse foramina of c-spine (except C7)
- Enter subarachnoid space between atlas and occipital bone
- Passes through foramen magnum
- Curves around medulla to join other vertebral artery = basilar artery
Beneath which anatomical landmark does the right common carotid branch from the brachiocephalic artery?
Behind the right sternoclavicular joint
Where do the common carotid arteries terminate?
- Upper border of the Thyroid Cartilage level, deep to SCM
~ C4
How can you locate the site of the carotid sinus? Why may this be helpful?
- Upper border of the Thyroid Cartilage level, deep to SCM
~ C4 level - Carotid massage: Rubbing this area can alleviate a supra-ventricular tachycardia
When measuring the JVP, are you looking for the external or internal jugular vein?
Internal Jugular Vein
Which of the internal and external carotid arteries give branches during its ascent through the neck?
External carotid artery
Name the 8 branches of the external carotid artery:
1) Superior Thyroid
2) Lingual
3) Facial
4) Ascending pharyngeal
5) Occipital
6) Posterior auricular
7) Superficial Temporal
8) Maxillary
Which 2 branches does the external carotid give within the parotid gland?
1) Superficial Temporal
2) Maxillary
Which vein drains most of the structures of the face?
Facial vein
- drains into internal jugular vein
Why is it important to remember that the facial vein recieves blood from the sup. and inf. ophthalmic veins?
Sup. and Inf. ophthalmic veins are directly connected to the Pterygoid venous plexus and the Cavernous sinus
= Potential route for infection or clot into the intracranial system
Where is the danger triangle of the face?
From corners of mouth to bridge of nose
- Incl. nose + maxilla
Which veins provide a potential route for infection from the scalp into the cranial cavity?
Emissary veins
List some structures which do not contain lymphatic vessels:
- Cornea
- Lens
- Inner ear
- Cartilage
What cells are found in lymph nodes?
- B cells
- T cells
- Macrophages
Which deep cervical lymph node is most frequently enlarged?
Jugulo-digastric node
- drains palatine tonsil
Where is the jugulo-digastric lymph node located, and what structures does it drain?
- Below and behind the angle of the mandible
- Oral cavity, pharynx, larynx, palatine tonsil, tongue
Which lymph node is often swollen in tonsillitis?
Jugulo-digastric node
Which deep cervical lymph node drains the trachea, oesophagus and thyroid gland?
Jugulo-omohyoid node
What is the name often given to an enlarged left supraclavicular lymph node?
Virchow’s node
What is Trosier’s sign?
A hard, enlarged left supraclavicular lymph node, a sign of metastatic abdominal malignancy
Which superficial lymph node drains the lips and chin?
Submental node
Which superficial lymph node drains the face (except the lips and chin)?
Submandibular node
Which superficial lymph nodes drain the back and sides of the head (including the auricle)?
Pre- and Post Auricular nodes
Occipital node
Which superficial lymph nodes drain the neck?
- Anterior cervical
- Posterior cervical
- Superficial cervical
Name the superficial lymph nodes of the head + neck region:
- Submental
- Submandibular
- Pre-auricular
- Post-auricular
- Occipital
- Anterior cervical
- Posterior cervical
- Superficial cervical
Into which vessel do the deep cervical lymph nodes drain?
Thoracic duct
- Into the left subclavian vein
Into which vessel does the thoracic duct drain into?
Left subclavian vein
Lymph may contain:
- Tissue fluid
- Small proteins
- Lipids (chylomicrons from gut lymphatics)
- Damaged cells
- Bacteria
- Cancer cells
How many litres of lymph is produced on average per day?
~ 3-4 L
The lymphatic system has no central pump, so how does it ensure one-directional flow?
- Valves
- Uses artery pulsation or muscle contraction to keep up flow
What structures does the Thoracic duct drain?
- Entire L side of body
- Right side of pelvis
- Right lower limb
What structures does the right lymphatic duct drain?
- Right side of head + neck
- Right arm
- Right side of torso
Define lymphoedema:
Abnormal collection of protein-rich fluid, causing tissue swelling, due to compromised lymphatic system
List some causes of lymphoedema:
- Infection (parasites)
- Removal of lymph nodes
- Damage to lymphatic system (ie chemotherapy)
- Lack of limb movement
- Congenital (ie Milroy’s syndrome)
Which tonsils form the Waldeyer’s tonsillar ring?
- Pharyngeal tonsils (adenoids)
- Tubal/Eustachian/Gerlach’s tonsils
- Palatine tonsils
- Lingual tonsils
Where is the Waldeyer’s tonsillar ring?
Within the naso- and oro-pharynx
Before performing a carotid massage, what would a doctor do to minimise the risk of causing a TIA/stroke?
Listen with stethoscope over the carotid artery for bruits, which may indicate atheroma formation
