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3 - HNN > Blood Vessels of Head and Neck > Flashcards

Blood Vessels of Head and Neck Flashcards

1
Q

Describe the route of IJV and EJV relative to SCM

A
  • External jugular vein runs above sternocleidomastoid

- Internal jugular vein and carotid artery covered by sternocleidomastoid

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2
Q

Where do subclavian and common carotid arteries arise from

A

brachiocephallic trunk

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3
Q

Name arteries that arise from subclavian artery

A

Vertebral, internal thoracic arteries and thyrocervical trunk

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4
Q

Name the branches off the thyrocervical trunk

A
  • Ascending cervical and transverse cervical supply the neck
  • Suprascapular artery supplies shoulder
  • Inferior thyroid supplies lower pole of thyroid gland
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5
Q

Describe the route of the vertebral arteries

A
  • Vertebral arteries arise from the subclavian arteries on left and right
  • Ascend in the neck through transverse foramina in cervical vertebrae C6-C1 and pass through the foramen magnum
  • Continues as the basilar artery in the skull
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6
Q

Distinguish between internal and external carotid arteries in the neck

A

Internal carotid artery gives no branches off in the neck

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7
Q

Describe the route of the internal carotid artery

A
  • Internal carotid artery gives no branches off in neck
  • Enter skull through carotid canal
  • Bother vertebral and internal carotid arteries supply the brain and enter circle of Willis
  • Anastomoses of arteries in case one gets blocked
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8
Q

State the arrangement of internal jugular vein relative to common carotid in the neck

A

Internal jugular lies lateral to the common carotid mostly under sternocleidomastoid

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9
Q

At what level does common carotid artery bifurcate

A
  • Bifurcates at about the level of the superior border of thyroid
  • At C4 level within carotid triangle
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10
Q

What complications occur at point of common carotid artery bifurcation

A
  • At point of bifurcation, common site of atheroma formation
  • Causes narrowing (stenosis) of the artery creating turbulence - can be heard from stethescope
  • Rupture of the clot can cause an embolus to travel to brain
  • Cause TIA or stroke
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11
Q

State the location and action of carotid sinus

A
  • Swelling at region of bifurcation - stretching of arterial wall
  • Location of baroreceptors for detecting changes in arterial blood pressure
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12
Q

State the location and action of carotid body

A
  • Peripheral chemoreceptors which detect arterial oxygen

- Located near the bifurcation of carotid artery

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13
Q

State the origin and branches of ophthalmic artery

A
  • Ophthalmic artery branches from internal carotid artery

- Supratrochlear and supra-orbital artery are branches of ophthalmic artery

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14
Q

State the branches of external carotid artery

A
  • 6 branches
    • superior thyroid
    • lingual
    • facial
    • ascending pharyngeal
    • occipital
    • posterior auricular
  • +2 terminal branches
    • superficial temporal
    • maxillary
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15
Q

State the blood supply to the scalp

A
  • From internal carotid:
    • supra-orbital
    • supratrochlear
  • From external carotid:
    • superficial temporal
    • posterior auricular
    • occipital
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16
Q

State the layers of the scalp

A
  • Skin
  • Connective tissue (dense)
  • Aponeurosis
  • Loose connective tissue
  • Periosteum
17
Q

State where blood vessels lie in the scalp

A
  • Mainly dense connective tissue layer
18
Q

Describe how injuries to the scalp can cause raccoon eyes

A
  • Blood may seep in the loose connective tissue layer below the aponeurosis
  • Occipitaofrontalis muscle is not inserted into bone, but into the orbit
  • Blood flows through the loose connective tissue to the orbit
19
Q

Name 2 branches of the maxillary artery

A
  • Middle meningeal

- Sphenopalatine (nasal septum)

20
Q

Describe the blood supply to the nasal septum

A
  • Anastomosis of arteries of Kiesselbach area
  • Most important branches are septal branch of sphenopalatine artery (from maxillary nerve) and anterior ethmoidal arteries (from ophthalmic artery)
  • Kiesselbach area common site for nose bleed (epistaxis)
    • Septal branch sources of severe bleeds
21
Q

What artery supplies the dura and skull

A

Middle meningeal artery - lies between inner table and dura matter

22
Q

State how the venous drainage of the eye occur

A

Supraorbital and supratrochlear veins unite at medial angle of eye to form angular vein which drains into the facial vein

23
Q

Explain diploic and emissary veins

A
  • Diploic veins drain the skull bone to the dural venous sinuses
  • Emissary veins connect the veins in the scalp to the dural venous sinuses within the skull
    • Emissary veins are valveless
  • Infection from scalp can spread to the cranial cavity and affect meninges
24
Q

Explain the venous drainage of the facial vein

A
  • Veins of the face are valveless
  • At medial angle of eye, facial vein communicates with superior ophthalmic
    • Drains into cavernous sinus
  • Deep facial veins drain into pterygoid venous plexus
    • Infection from facial vein can spread to dural venous sinuses
      • Thrombophlebitis of facial vein - infected clot can travel to intracranial venous system
25
Q

Explain the danger triangle of the face

A
  • Between the eyebrows down to the edge of the mouth

- Infections in this region of the face can spread through the venous system to the dural venous sinuses

26
Q

State the importance of the carotid triangle surgically

A
  • Important for surgical approach of the carotid arteries or internal jugular vein
  • Can also access vagus and hypoglossal nerves via carotid triangle
  • Carotid pulse can be felt in carotid triangle just below bifurcation
27
Q

State the borders of the carotid triangle

A
  • Superior border - posterior belly of digastric muscle
  • Lateral border - medial border of SCM
  • Inferior border - superior belly of omohyoid muscle
28
Q

Explain how and when a carotid sinus massage is used

A
  • Terminate supraventricular tachycardia
  • Massaging tricks peripheral receptors in thinking blood pressure has increased
  • Stimulates glossal pharyngeal nerve to activate parasympathetic system through brainstem
  • Stimulates vagus nerve to lower heart rate
29
Q

How is jugular venous pressure measured

A
  • Use right internal jugular vein
    • Direct connection to right atrium
  • Patient at 45˚ angle - head slightly to the left
  • IJV largely hidden by sternocleidomastoid
  • Pulsation observed through muscle
  • Height from sternal angle + 5cm
  • Do not palpate as that is carotid artery
30
Q

Explain the course of the internal carotid artery

A
  • Internal carotid artery enters skull through carotid canal at petrous part
  • Turns medially and horizontally
  • Enters the cranial cavity then makes S-shaped bend
  • Course through the cavernous sinus
  • Continues into circle of Willis
31
Q

Through which opening does the vertebral artery pass through in the skull

A
  • Vertebral artery pass through the foramen magnum

- Continues as basilar artery into circle of Willis

32
Q

Explain the passage of the middle meningeal artery through the skull

A
  • Middle meningeal artery runs alongside pterion area
    • Easily fractured so risk of rupture of middle meningeal artery
  • Passes through foramen spinosum
33
Q

Through which opening does the internal jugular vein pass through in the skull

A

Jugular foramina

3 - HNN (15 decks)

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