Blood Vessels And Lymphatics

Question 1

Describe subclavian steal syndrome

Answer 1

Caused by obstruction of subclavian artery proximal to vertebral artery
Usually during physical work or exercise, episodic increase in peripheral circulatory demand in associated extermity
Shunting of blood from vertebro-basilar circulation into distal subclavian artery

Question 2

Describe vertebro-basilar insufficiency

Answer 2

Decrease in blood flow to brain
Type of ishemia. Episodic may result in transient or permanent neurological dysfunction
Clinical signs/symptoms: dizziness, cranial nerve dysfunction, paralysis, loss of consciouness
Can result in coma and quadiplegia

Question 3

Describe internal carotid arteries

Answer 3

No branches in neck
Supply 80% of blood to brain via anterior circle of Willis
Within cranial vault, ICA bifurcates into anterior and middle cerebral arteries

Question 4

What happens if blood shunts from one circulation to another (anterior and posterior)?

Answer 4

Can result in hyperfusion and cerebral edema

Question 5

What are the branches of the external carotid artery?

Answer 5

Superior thyroid artery (superior laryngeal artery as a branch)
Ascending pharyngeal artery
Lingual a
Facial a
Occipital a
Posterior auricular a
Superficial temporal a
Maxillary a

Question 6

Where is the superior thyroid artery located?

Answer 6

Inferior to tip of greater horn of hyoid

Question 7

Where is the superior bulb of internal jugular vein?

Answer 7

In jugular fossa

Does not have a valve

Question 8

Where is the inferior bulb of internal jugular vein?

Answer 8

Posterior to interval between sternoclavicular heads of sternocleidomastoid muscle
Has a valve

Question 9

Describe pericervical lymph nodes

Answer 9

Form a collar of superficial lymph nodes around base of head
Include occipital, mastoid, parotid, submandibular, buccal, and submental groups of lymph nodes
Drain directly/indirectly into deep cervical lymph nodes

Question 10

Describe superficial cervical lymph nodes

Answer 10

Clustered into two groups (posterior and anterior) adjacent to external jugular vein in posterior (lateral) triangle and anterior jugular vein in anterior triangle
Drain into deep cervical lymph nodes

Question 11

Describe deep cervical lymph nodes

Answer 11

Located along length of internal jugular vein

2 most important: jugulo-digastric (tonsillar) nodes and jugulo-omohyoid nodes

Question 12

Describe thoracic duct

Answer 12

Runs in front of anterior scalene and behind left carotid sheath
Located only on left side of root of neck
Receives left jugular trunk and ends in front of first part of subclavian artery
Receives lymph from left side of head and all of body except right upper extremity and head
Drains into IJV, IJV/subclavian v junction

Question 13

Describe right lymphatic duct

Answer 13

Receives lymph from right half of head and right upper extremity

Question 14

Describe what the vertebral artery supplies

Answer 14

20% supply to brain
Supplies posterior circulation
Brainstem, cerebellum, and upper spinal cord
Merges to form basilar artery