5. Venous Drainage of H/N Flashcards by J L

Veins draining the head and neck may be organized into ____ groups

three

How well did you know this?

Not at all

Perfectly

Veins of the brain have no no valves and their thin walls have no smooth muscular tissue

Like brain arteries, these veins lie in the ____

Bridging veins
pierce both the arachnoid mater and the inner dura in order to drain into the ____

subarachnoid spaces

dural venous sinuses

How well did you know this?

Not at all

Perfectly

Cerebral and cerebellar veins communicate in abundance with the dural sinuses via
____

Tearing of a ____ as it enters a dural venous sinus produces…

bridging veins

How well did you know this?

Not at all

Perfectly

SUBDURAL HEMATOMA (Dural border hemorrhage)
Subdural hemorrhages may cause an increase in \_\_\_\_, which can cause compression of, and damage to, brain tissue.

____, usually of traumatic origin, has a high mortality rate and is a severe medical emergency.

____, common in the elderly, may often be managed successfully

intracranial pressure (ICP)
acute subdural hematoma (ASDH)
chronic subdural hematoma

How well did you know this?

Not at all

Perfectly

Changes in ICP resulting from intracranial bleeds may produce ____, ____ and ____ of brain tissue

ischemia
crushing
swelling

How well did you know this?

Not at all

Perfectly

Venous drainage
of the brainstem is
directed primarily toward the ____ (Great Vein of Galen)

…Drains into the ____

Great cerebral vein

straight (rectus) sinus

How well did you know this?

Not at all

Perfectly

____ are dilated channels between the two layers of the cranial dura

They are lined by
____
continuous with that in veins, but lack ____ and ____

venous dural sinuses
endothelium
valves
muscle

How well did you know this?

Not at all

Perfectly

DURAL
VENOUS
SINUSES
drain deoxygenated blood from the ____ and ____ and communicate with more ____ of the diploe, scalp and face

brain
endocranial cavity
superficial veins

How well did you know this?

Not at all

Perfectly

The Internal Jugular

Vein (IJV) arises at the jugular foramen where the ____ and ____ sinuses empty into its dilated ____

sigmoid
inferior petrosal
superior bulb

How well did you know this?

Not at all

Perfectly

Abundant valveless EMISSARY VEINS communicate between veins of the ____ and ____ and the endocranial network of ____

face
scalp
venous dural sinuses

How well did you know this?

Not at all

Perfectly

While flow in emissary veins is usually from ____ to ____, any increase in thoracic cavity pressure, as in coughing or straining, may ____ the flow since neither these veins nor the dural venous sinuses have valves

So hematogenous infections may spread from extracranial veins to the sinuses via the ____

intracranial
extracranial
reverse
emissary veins

How well did you know this?

Not at all

Perfectly

Emissary veins may also anastomose with the network of ____ located within the calvarial bones

diploic veins

How well did you know this?

Not at all

Perfectly

Not all venous blood leaving the cranial cavity exits
through the
IJVs

Occipital sinus
to the ____

Inferior vertebral venous plexus
(____)

____

marginal sinus

epidural

basilar plexus

How well did you know this?

Not at all

Perfectly

BASILAR PLEXUS

Anastomoses between the ____ and ____ are part of the Cerebrospinal Venous System (CSVS), contributing to pressure homeostasis of the intracranial venous system

Some studies have suggested that during expiration, more cranial venous blood exits the cranium via the ____ than the ____

basilar
vertebral venous plexus

CSVS
IJV’s

How well did you know this?

Not at all

Perfectly

The VERTEBRAL
VENOUS PLEXUS
communicates freely between the veins of the body wall and the
\_\_\_\_
draining the brain and endocranium

The clinical significance of the IVVP was first recognized at Penn by Oscar Batson in 1940 – ____

So the vertebral venous plexus is an important route for the spread of ____ & ____ as well as ____ to the endocranium

dural venous sinuses

batson’s plexus

infection
metastases
emboli

How well did you know this?

Not at all

Perfectly

SUPERFICIAL VEINS of the face

____
Facial
____
Posterior auricular

Superficial temporal

occipital

How well did you know this?

Not at all

Perfectly

POSTERIOR AURICULAR
- Drains posterior ____ and the deep surface of the ____
- Receives a ____
vein

OCCIPITAL

Drains the posterior ____, the ____ region, and cranial cavity via ____ veins
Joins the ____ and ____ veins

scalp
external ear
stylomastoid

scalp
suboccipital
emissary
deep cervical
vertebral

How well did you know this?

Not at all

Perfectly

DEEP
CERVICAL VEIN normally drains into the
____ VEIN

The vertebral vein normally drains to the ____ vein

vertebral

brachiocephalic

How well did you know this?

Not at all

Perfectly

FACIAL VEIN Less ____
than the artery, the vein receives tributaries akin to the branches of the ____ artery plus ____ and ____ veins

SUPERFICIAL TEMPORAL
Drains the scalp plus:
- \_\_\_\_ veins
- TMJ
- \_\_\_\_ 
- Transverse facial 
- \_\_\_\_

The angular vein receives drainage of the ____ and the ____ veins and anastomoses with the ____ veins

tortuous
facial
masseteric
parotid

parotid
anterior auricular
middle temporal

supratochlear
supraorbital
ophtalmic

The ophthalmic veins

The ____ ophthalmic vein is usually larger than the ____ ophthalmic vein

They are commonly situated above and below the ____ respectively

superior
inferior

optic nerve

The ophthalmic veins receive the venous drainage of the eye through both the ____, which drain much of the retina, and the ____ which drain the vascular (choroid) layer of the eyeball.

The other tributaries of the ophthalmic veins are similar to the ____ branches.

central retinal veins
vortex veins
ophthalmic artery’s

The ophthalmic veins communicate with:

1. The \_\_\_\_ of the facial vein anteriorly
2. The cavernous sinus through the \_\_\_\_
3. The pterygoid venous plexus through the \_\_\_\_

angular branch
superior orbital fissure
inferior orbital fissure

The DEEP
FACIAL vein also communicates between
the ____ vein and the ____

facial

pterygoid venous plexus

PTERYGOID VENOUS PLEXUS
An extensive network of veins paralleling the 2nd and 3rd parts of the ____

Improper administration of dental anaesthesia may puncture the plexus resulting in ____ and ____

maxillary artery
hematoma
noticeable swelling

The pterygoid plexus is found partly between the ____ and ____, and partly between the ____ and ____ muscles

temporalis lateral pterygoid medial lateral pterygoid

The pterygoid plexus receives venous tributaries corresponding to branches of the maxillary artery including: ____, ____, ____, ____ and ____ As well as veins from the ____

``` sphenopalatine buccal infraorbital palatine alveolar ``` muscles of mastication

Venous return from both maxillary and mandibular dentitions drains to the pterygoid plexus via the ____ and ____ veins

superior | inferior alveolar

The nasal cavity may be drained along four distinct venous pathways: 1. To the ____ via foramen cecum 2. To the ____ via ethmoidal veins 3. To the ____ 4. To the ____

superior sagittal sinus cavernous sinus facial vein pterygoid venous plexus

The PTERYGOID VENOUS PLEXUS anastomoses with the ____ via abundant ____ VEINS Some of these pass through the ____ and ____ Recall that CN III, IV, VI, V1 and V2 as well as the ICA pass through the low flow trabeculated cavernous sinus

cavernous sinus emissary foramina of vesalius foramen ovale

The angular branch of the facial vein anastomoses with the ____ of the orbit which in turn communicate with the ____. This provides the principal pathway for spreading infection from the face into the cranial cavity to cause a possible ____. The facial area which can potentially drain into the cavernous sinus is the triangular area defined by the midline and by lines drawn from the external auditory meatus to the lateral corners of the eye and mouth. The preantibiotic era this was somewhat dramatically called: the ____ Since picking ____ in this area could causes pathogens to enter the venous system and cause a cavernous sinus thrombosis with its resultant high incident of mortality

opthalmic veins cavernous sinus cavernous sinus thrombosis death triangle pimples

Veins of the PTERYGOID VENOUS PLEXUS usually converge to form a short ____ Associated with the 1st part of the maxillary artery

maxillary vein

The RETROMANDIBULAR VEIN is formed posterior to the neck of the mandible by the junction of the ____ and ____ veins The vein descends within the parotid gland between the ____ and the facial nerve

superficial temporal maxillary external carotid artery

Venous drainage of the tongue and oral floor ____ veins are important clinically as they are capable of rapid absorption of drugs E.g. nitroglycerine taken as a vasodilator to relieve the pain of ____

lingual | angina pectoris

Venous drainage of the tongue is directed towards the ____, but there is significant variation in the specific pathway

internal jugular vein

The RETROMANDIBULAR VEIN usually terminates by dividing into anterior and posterior branches near the inferior pole of the ____ The anterior division joins the facial vein to form the ____ The posterior division is joined by the posterior auricular vein to form the ____ Note the direct drainage of the lingual vein into the ____ (but there is ____)

parotid gland common facial vein external jugular vein IJV variation

We can distinguish SUPERFICIAL and DEEP cervical veins The superficial veins, generally tributaries of the ____, drain a much smaller volume of tissue

EJV

Most individuals present with three jugular veins on each side of the head and neck INTERNAL descends through the neck in the carotid sheath, just lateral to the ____, receives tributaries comparable to many of the branches of the ____ ____ Bulb The pharyngeal venous plexus - Usually drains directly into the ____… ____ Vein ... as do the ____ and ____ thyroid veins...

carotid artery external carotid superior jugular IJVs internal jugular superior middle

But the INFERIOR THYROID VEIN drains to the ____ in the superior mediastinum

left brachiocephalic vein

Recall that the IJV arises at the ____ where the ____ and ____ dural venous sinuses empty into its dilated superior bulb This valve prevents retrograde blood flow ____ the brain when intrathoracic pressure increases acutely IJV terminates by joining the subclavian vein to form the Brachiocephalic vein The inferior end of the IJV features a venous ____, the only venous valve between the ____ and the ____atrium IJV valve incompetence may lead to neurologic symptoms (e.g. ____) upon elevation of intrathoracic pressure, as during ____ compressions

jugular foramen sigmoid inferior petrosal toward valve brain right TGA transient global amnesia CPR

The ____ is used clinically to evaluate venous pulsations and to estimate venous pressure ____ may be performed for diagnostic or therapeutic purposes Placement of central venous catheters and venous ports Placement of vena cava filters and stents

right IJV | IJV puncture

The EXTERNAL JUGULAR VEIN is formed by a variable junction of the ____ vein and the ____ vein at the angle of the mandible

posterior auricular | posterior division of the retromandibular

After descending vertically across the ____, the EJV empties into the ____ vein at the base of the posterior triangle

SCM | subclavian

The EJV will become engorged as the result of ____ side heart failure (____), which produces ____ constriction and increased right atrial pressure The extent of the venous congestion is indicated by is indicated by the level of pulsations in the ____. The higher the level of jugular pulsation, the greater the backup of blood into the vein.

right cor pulmonale SVC EJV

The ANTERIOR JUGULAR VEINS drain from the ____ region toward the ____ Communicating vein from the facial vein The anterior jugular veins then turn laterally deep to the origin of the ____ to empty into the ____

suprahyoid manubrium of the sternum SCM external jugular vein

Occasionally, the anterior jugular veins may unite above the sternum, to form a ____ across the midline It may be encountered during a ____ With ____ reflected, the drainage of all the jugular veins may be fully appreciated

jugular venous arch tracheostomy SCM