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BS III, Module II > 5. Venous Drainage of H/N > Flashcards

5. Venous Drainage of H/N Flashcards

1
Q

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

A

three

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2
Q

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 ____

A

subarachnoid spaces

dural venous sinuses

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3
Q

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

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

A

bridging veins

bridging veins

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4
Q 
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

A

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

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5
Q

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

A

ischemia
crushing
swelling

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6
Q

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

…Drains into the ____

A

Great cerebral vein

straight (rectus) sinus

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7
Q

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

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

A

venous dural sinuses
endothelium
valves
muscle

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8
Q

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

A

brain
endocranial cavity
superficial veins

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9
Q

The Internal Jugular

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

A

sigmoid
inferior petrosal
superior bulb

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10
Q

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

A

face
scalp
venous dural sinuses

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11
Q

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 ____

A

intracranial
extracranial
reverse
emissary veins

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12
Q

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

A

diploic veins

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13
Q

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

Occipital sinus
to the ____

Inferior vertebral venous plexus
(____)

____

A

marginal sinus

epidural

basilar plexus

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14
Q

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 ____

A

basilar
vertebral venous plexus

CSVS
IJV’s

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15
Q 
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

A

dural venous sinuses

batson’s plexus

infection
metastases
emboli

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16
Q

SUPERFICIAL VEINS of the face

  • ____
  • Facial
  • ____
  • Posterior auricular
A

Superficial temporal

occipital

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17
Q

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
A

scalp
external ear
stylomastoid

scalp
suboccipital
emissary
deep cervical
vertebral
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18
Q

DEEP
CERVICAL VEIN normally drains into the
____ VEIN

The vertebral vein normally drains to the ____ vein

A

vertebral

brachiocephalic

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19
Q

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

A

tortuous
facial
masseteric
parotid

parotid
anterior auricular
middle temporal

supratochlear
supraorbital
ophtalmic

20
Q

The ophthalmic veins

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

They are commonly situated above and below the ____ respectively

A

superior
inferior

optic nerve

21
Q

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.

A

central retinal veins
vortex veins
ophthalmic artery’s

22
Q

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 \_\_\_\_
A

angular branch
superior orbital fissure
inferior orbital fissure

23
Q

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

A

facial

pterygoid venous plexus

24
Q

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 ____

A

maxillary artery
hematoma
noticeable swelling

25
Q

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

A

temporalis
lateral pterygoid
medial
lateral pterygoid

26
Q

The pterygoid plexus receives venous tributaries corresponding to branches of the maxillary artery including:
____, ____, ____, ____ and ____

As well as veins from the ____

A 
sphenopalatine
buccal
infraorbital
palatine
alveolar

muscles of mastication

27
Q

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

A

superior

inferior alveolar

28
Q

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 \_\_\_\_
A

superior sagittal sinus
cavernous sinus
facial vein
pterygoid venous plexus

29
Q

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

A

cavernous sinus
emissary
foramina of vesalius
foramen ovale

30
Q

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

A

opthalmic veins
cavernous sinus
cavernous sinus thrombosis

death triangle

pimples

31
Q

Veins of the PTERYGOID VENOUS PLEXUS usually converge to form a short ____

Associated with the 1st part of the maxillary artery

A

maxillary vein

32
Q

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

A

superficial temporal
maxillary

external carotid artery

33
Q

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 ____

A

lingual

angina pectoris

34
Q

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

A

internal jugular vein

35
Q

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 ____)

A

parotid gland
common facial vein
external jugular vein

IJV
variation

36
Q

We can distinguish SUPERFICIAL and DEEP cervical veins

The superficial veins, generally tributaries
of the ____, drain a much smaller volume of tissue

A

EJV

37
Q

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…

A

carotid artery
external carotid

superior jugular
IJVs
internal jugular

superior
middle

38
Q

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

A

left brachiocephalic vein

39
Q

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

A

jugular foramen
sigmoid
inferior petrosal

toward

valve
brain
right

TGA
transient global amnesia
CPR

40
Q

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

A

right IJV

IJV puncture

41
Q

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

A

posterior auricular

posterior division of the retromandibular

42
Q

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

A

SCM

subclavian

43
Q

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.

A

right
cor pulmonale
SVC

EJV

44
Q

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
____

A

suprahyoid
manubrium of the sternum

SCM
external jugular vein

45
Q

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

A

jugular venous arch
tracheostomy
SCM

BS III, Module II (9 decks)

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