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Anatomy > Blood supply to the head & neck (A14) > Flashcards

Blood supply to the head & neck (A14) Flashcards

1
Q

endocarditis

A
  • endo= inner lining of heart
  • itis= inflammation/infection
  • infection of the heart (specifically cardiac valves for this lecture)
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2
Q

bacteraemia

A

bacteria in the bloodstream

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3
Q

dental origin of bacteraemia/ endocarditis

A
  • abscess
  • periodontal disease
  • dental manipulations
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4
Q

branches of arch of aorta (from right to left)

A
  • brachiocephalic trunk
  • left common carotid artery
  • left subclavian artery
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5
Q

visible structures of the heart anteriorly

A
  • superior vena cava
  • inferior vena cava
  • arch of aorta (+ branches)
  • left pulmonary artery (passes horizontally in front of the descending aorta and left bronchus to the root of the left lung, where it divides into two branches)
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6
Q

which area(s) of the body does the brachiocephalic trunk supply

A
  • right arm

- right side of head + neck

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7
Q

which area(s) of the body are supplied by the left common carotid artery

A

-left side of head + neck

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8
Q

what area(s) of the body does the left subclavian artery supply

A

left arm

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9
Q

which structure divides the subclavian artery and vein

A
  • scalenus anterior muscle (attached to scalene tubercle of rib 1)
  • subclavian artery sits more posterior to subclavian vein
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10
Q

significance of root of neck

A

at point where clavicle attaches to sternum, structures within the left and right sides now differ

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11
Q

thoracic duct

A

drains 3/4 of body into left venous angle (remaining 1/4 is the right arm which is drained into the right venous angle via the right lymphatic duct)

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12
Q

location phrenic nerve within root of neck

A

runs on scalenus anterior (to supply diaphragm, C3/4/5 keep diaphragm alive)

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13
Q

ascending aorta

A

leads to arch of aorta

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14
Q

azygous vein

A

drains right side of thorax/chest wall (left side is drained by the hemiazygous vein which eventually drains into the azygous vein) and azygous vein drains into right atrium via superior/inferior vena cava (also links the two therefore if one of the vena cava is blocked, there is another route of blood into the heart)

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15
Q

divisions of subclavian artery within root of neck

A

1-before scalenus anterior muscle
2-lies posterior to scalenus anterior muscle
3-after scalenus anterior muscle

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16
Q

what does the subclavian artery become after passing lateral border of first rib

A

axillary artery (axilla = armpit)

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17
Q

branches of 1st part of subclavian artery (before passing scalenus anterior muscle)

A
  • vertebral artery (passes into transverse foraminae in vertebrae round about the area of C6, in about 5% comes straight off arch of aorta, usually comes off subclavian artery)
  • thyrocervical trunk (supplies thyroid region and neck, inferior thyroid artery is a branch of this)
  • internal thoracic artery
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18
Q

vertebral artery

A

passes into transverse foraminae in vertebrae round about the area of C6, in about 5% comes straight off arch of aorta, usually comes off subclavian artery

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19
Q

thyrocervical trunk

A

branch of 1st part of subclavian artery, supplies thyroid region and neck

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20
Q

internal thoracic artery

A

a branch of the subclavian artery of each side that runs down along the anterior wall of the thorax and rests against the costal cartilages—called also internal mammary artery

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21
Q

carotid arteries

A

begin as common carotid arteries from arch of aorta (brachiocephalic trunk on right side), and travel on outside/ posterior to thyroid gland, before branching into internal carotid artery (in carotid sheath) and external carotid artery (leaves carotid sheath) - external is medial/anterior to internal, and superior thyroid artery branches from external carotid artery

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22
Q

superior and inferior thyroid arteries

A
  • inferior thyroid artery branches from thyrocervical trunk which is a branch of the subclavian artery, and goes to supply inferior part of thyroid gland
  • superior thyroid artery branches from the external carotid artery which is a branch of the common carotid artery, and goes to supply superior part of thyroid gland
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23
Q

internal and external carotid arteries

A
  • both branches of common carotid artery
  • external carotid artery leaves carotid sheath to supply outside
  • internal carotid artery stays inside carotid sheath and goes straight to the cranial cavity, heads through carotid canal and along with vertebral artery, forms circle of wilis that supplies all the blood to the brain
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24
Q

structures present at bifurcation of the common carotid artery

A
  • common carotid artery in carotid sheath
  • INternal carotid artery IN carotid sheath
  • external carotid artery leaves carotid sheath
  • carotid body present at point of bifurcation
  • carotid sinus (dilation at first part of internal carotid artery)
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25
Q

carotid sinus

A
  • dilation at first part of internal carotid artery after common carotid artery bifurcates
  • contains baroreceptors for monitoring blood pressure and sends signals to the brain to regulate blood pressure
  • mainly supplied by cranial nerve IX/9/glossopharyngeal and a little bit of vagus
26
Q

carotid body

A
  • about 1mm in diameter
  • peripheral chemoreceptor (detects changes in chemicals in blood, mainly oxygen but also carbon dioxide)
  • mainly supplied by cranial nerve IX/9/glossopharyngeal and a little bit of vagus
27
Q

nerve supply to carotid sinus/body

A

mainly cranial nerve IX/9/glossopharyngeal, but also a little bit of vagus (CNX/10)

28
Q

branches of external carotid arterty (from inferior to superior)

A

-Superior thyroid
-Ascending pharyngeal
-Lingual
-Facial
-Occipital
-Posterior auricular
-Maxillary
-Superficial temporal
(Some Anatomists Like Fries, Others Prefer Mashed Spuds)

29
Q

occipital artery

A

branch of external carotid, supplies occiptal part of skull

30
Q

posterior auricular artery

A

branch of external carotid, supplies posterior part of ear

31
Q

ascending pharyngeal artery

A

branch of external carotid, hard to see as it is more posterior/medial to external carotid, ascends up to supply pharynx

32
Q

lingual artery

A

branch of external carotid, supplies tongue

33
Q

facial artery

A
  • branch of external carotid
  • CURLY as it has to be able to move for muscles of facial expression
  • supplies face
  • crosses over anterior border of the mandible at anterior border of masseter muscle
34
Q

inferior alveolar artery

A
  • The inferior alveolar artery is one of five branches of the first part of the maxillary artery (maxillary artery is a branch of external carotid). After branching, it descends downwards and forwards to join the inferior alveolar nerve
  • runs through mandibular foramen
35
Q

general route of veins and arteries

A

veins generally accompany arteries

36
Q

how can a dental abscess (gum boil) or bacteria enter the blood stream (from lower right second premolar specifically)

A

passes back in inferior alveolar vein

37
Q

mandibular teeth blood supply

A

inferior alveolar artery and vein(vein sits just superior to artery)

38
Q

venous drainage of the head and neck

A
  • inferior alveolar vein drains into maxillary vein
  • the superficial temporal vein and maxillary vein join to form the retromandibular vein
  • the retromandibular vein splits into anterior and posterior divisions
  • the posterior division of retromandibular vein joins with the posterior auricular vein to form external jugular vein which drains into subclavian vein (usually)
  • the anterior division of the retromandibular vein joins with the facial vein to form the common facial vein which drains into the internal jugular vein
  • internal jugular vein is more anterior/ medial to external jugular vein
39
Q

clinical significance of facial vein

A
  • has connections to internal cranial cavity (mainly through pterygoid plexus)
  • there are NO VALVES in the facial vein therefore blood/ and infections can travel backwards into dural venous sinuses
40
Q

intra-cranial dural venous sinuses

A

veins within cranial cavity, venous drainage of the brain and meninges

41
Q

venous drainage of the scalp and face

A

drained by veins closely associated with the arteries of the face and scalp, these drain into the internal and external jugular veins

42
Q

venous drainage of the neck

A

carried out by the anterior jugular veins

43
Q

jugular veins

A
  • three main jugular veins – external, internal and anterior.
  • they are ultimately responsible for the venous drainage of the whole head and neck
44
Q

external jugular veins (long study card include everything you know from face to root of neck where it drains)

A
  • external jugular vein and its tributaries supply the majority of the external face
  • it is formed by combining of posterior auricular vein and posterior division of retromandibular vein
  • these two veins combine immediately posterior to the angle of mandible, and inferior to the outer ear, forming the external jugular vein
  • the external jugular vein descends down the neck within the superficial fascia. It runs anteriorly to the sternocleidomastoid muscle, crossing it in an oblique, posterior and inferior direction.
  • In the root of the neck, the vein passes underneath the clavicle, and terminates by draining into the subclavian vein. Along its route down the neck, the EJV receives tributary veins – posterior external jugular, transverse cervical and suprascapular veins
45
Q

posterior auricular vein

A

drains the area of scalp superior and posterior to the outer ear

46
Q

anterior jugular veins

A
  • drain the anterior aspect of the neck.
  • often they will communicate via a jugular venous arch.
  • the anterior jugular veins descend down the midline of the neck, emptying into the subclavian vein
47
Q

internal jugular vein

A
  • begins in cranial cavity (as continuation of sigmoid sinus)
  • exits skull via jugular foramen
  • In the neck, the internal jugular vein descends within the carotid sheath, deep to the sternocleidomastoid, and lateral to the common carotid artery.
  • At the bottom of the neck, posteriorly to the sternal end of the clavicle, it combines with the subclavian vein to form the brachiocephalic vein.
  • It has a valve that stops back-flow of blood.
  • During its descent down the neck, the internal jugular vein receives blood from the facial, lingual, occipital, superior and middle thyroid veins. These veins drain blood from the anterior face, trachea, thyroid, oesophagus, larynx, and muscles of the neck.
48
Q

danger triangle of the face

A
  • where superficial veins can carry infection into cranial cavity
  • facial vein has no valves therefore can travel backwards into dural venous sinuses instead of going straight to heart
49
Q

brachiocephalic vein

A
  • subclavian vein joins with internal jugular vein to form/drain into the brachiocephalic vein (therefore whether the retromandibular vein goes anteriorly or posteriorly, it eventually drains into the subclavian)
  • both brachiocephalic veins form to give superior vena cava
50
Q

which veins form to make up superior vena cava

A

brachiocephalic veins

51
Q

effect of bacteria on heart valves

A

bacteria attacks the valves causing damage, if not corrected can cause heart murmer, stroke etc

52
Q

muscles of heart

A
  • papillary muscles (attached to chordae tendinae)

- serve to anchor the valves

53
Q

chordae tendinae

A

Thread-like bands of fibrous tissue which attach on one end to the edges of the tricuspid and mitral valves of the heart and on the other end to the papillary muscles

54
Q

tricuspid valve

A

on right between atrium and ventricle

55
Q

mitral/bicuspid valve

A

on left between atrium and ventricle

56
Q

2 semilunar valves

A

(semilunar=shaped like a half-moon or crescent)

  • pulmonary valve between right ventricle and pulmonary artery
  • aortic valve between left ventricle and aorta
57
Q

how can bacteria with a dental origin cause bacterial endocarditis

A
  • travels through the bloodtream, reaches susceptible heart valve and causes bacterial endocarditis
  • can cause death if not treated
58
Q

contents of carotid sheath

A
  • internal jugular vein
  • common carotid artery (then internal carotid)
  • vagus nerve
  • deep cerical lymph nodes
  • the carotid artery lies medial to the internal jugular vein, and the vagus nerve is situated posteriorly between the two vessels
59
Q

location of ansa cervicalis

A
  • embedded in anterior wall of carotid sheath

- formed by “descendens hypoglossi” (C1) and “descendens cervicalis” (C2-C3)

60
Q

at which point in the root of the neck does the common carotid split

A

at the level of the superior border of thyroid gland

61
Q

laryngeal prominence of thyroid cartilage

A
  • adam’s apple

- lump or protrusion that is formed by the angle of the thyroid cartilage surrounding the larynx

Anatomy (21 decks)

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