Blood Vessels of Head and Neck Flashcards
(124 cards)
1
Q
What type of blood do arteries carry?
A
Oxygenated
2
Q
Arteries have a smaller diameter than veins. True or false?
A
True
3
Q
Why do arteries have a paler colour?
A
Because it has a thicker wall. The dark colour of veins is due to contained blood being partly visible through thin walls.
4
Q
How does blood flow in the arteries?
A
Under pressure from the heart
5
Q
In which cases do arteries have valves?
A
Origins of aorta and pulmonary artery
6
Q
Arteries are usually accompanied by veins. True or false?
A
True
7
Q
Why are veins usually more superficial?
A
So that slow venous return is not compressed by overlying artery.
8
Q
What are the two types of nerves associated with arteries?
A
- Muscle contraction (vasomotor)
2. Hitchhikers
9
Q
What are the characteristics of vasomotor nerves?
A
- Penetrate wall
2. Sympathetic (accompanied by sensory fibres)
10
Q
What are the characteristics of hitchhikers?
A
- Remain outside adventitia
2. Can be parasympathetic, sympathetic, sensory or a combination
11
Q
How do lymph plexuses arise? Where do they sit?
A
Small lymph vessels form a plexus on the walls of many large arteries.
12
Q
What is an arterial anastomosis?
A
Connection between 2 arteries rather than the usual pattern of arteries of decreasing size emptying into a network of capillaries and from there into a network of veins of increasing size.
13
Q
What does an arterial anastomosis mean they can do?
A
They can influence/feed into each others territories
14
Q
What are the 3 types of arterial anastomoses?
A
1) One artery opening directly into another (e.g. L and R superior labial arteries)
2) Two arteries coming together to form a single artery (e.g. vertebral arteries forming the basilar artery inside the skull)
3) Two arteries linked by a small connecting artery
15
Q
What is the endothelium?
A
A single layer of flattened epithelial cells that forms the innermost lining of all vessels - blood and lymph
16
Q
At what level is the arch of aorta?
A
Manubriosternal joint
17
Q
Where does the brachiocephalic trunk, left common carotid and left subclavian artery rise from?
A
Rise from arch of aorta behind manubrium.
18
Q
Where does the brachiocephalic trunk divide?
A
Divides at the level of the right sternoclavicular joint
19
Q
What does the braciocephalic trunk divide into?
A
Right common carotid and subclavian
20
Q
At what level does the common carotid divide?
A
At the top of the thyroid cartilage of larynx.
21
Q
What does the common carotid divide into?
A
Internal and external carotids
22
Q
Where are the carotids located?
A
On either side of trachea, thyroid gland, larynx, pharynx and deep to sternocleidomastoid
23
Q
What does the carotid sheath enclose? (3)
A
- Common and internal carotids (medial)
- internal jugular (lateral)
- Vagus (posterior)
24
Q
What is the ansa cervicalis? What does it supply?
A
- A nerve loop arising from cervical spinal nerves
2. Supplies muscles of the anterolateral neck.
25
Where is the ansa cervicalis located?
Anterior to the carotid sheath.
26
Where does the sympathetic trunk lie in relation to the carotid sheath?
Posterior
27
What is the carotid sheath made of?
Thin sheet of dense fascia enclosed in looser adjacent fascia.
28
What does the superior thyroid artery pass? Where is it located?
1. Passes inferiorly to THYROID GLAND
| 2. Deep to infrahyoid strap muscles of neck (flat muscles superficial to larynx and thyroid gland)
29
What does the superior thyroid artery supply?
Thyroid
30
What else is the thyroid supplied by?
Pair of inferior thyroid arteries from thyrocervical trunk (branch of the subclavian artery)
31
Where does the lingual artery pass?
1. Passes deep to intermediate tendon of digastric and submandibular gland.
2. To side of tongue.
32
Where does the facial artery run? (2) What type of course does it have?
1. Loops posterior to submandibular gland
2. Passes over body of mandible
Wavy course and superficial
33
What are the branches of the facial artery?
1) Tonsilar artery
2) Submental artery
3) Inferior and superior labial arteries
34
What does the facial artery supply? (5)
1. Soft palate
2. Tonsils
3. Submandibular and sublingual glands
4. Adjacent muscles
5. Superficial face
35
What are the possible variations for the facial artery?
1. Lingual and facial arteries often arise as a common trunk
| 2. They arise as a common trunk with the superior thyroid artery
36
Where does the ascending pharyngeal artery arise?
It is a small posteior branch arising near the origin of the external carotid.
37
Where does the ascending pharyngeal artery pass?
1. Arises well below posterior belly of digastric and close to origin of external carotid.
2. It passes deep to the styloid muscles
38
What does the extracranial branch of the ascending pharyngeal artery supply?
Supplies outside cranium (extra cranial):
1. Upper pharynx
2. TMJ
3. Tymapnic cavity
4. Meninges
39
Where does the intracranial branch pass and what does it supply?
It passes through the foramen magnum and supplies the meninges.
40
Where does the occipital artery run?
It runs deep to the posterior belly of the digastric muscles and it passes behind the mastoid
41
What does the occipital artery supply? Where does it sit?
1. SCM
2. Muscles and skin of occiput
It sits medial to the mastoid groove.
42
Where does the posterior auricular artery arise? What does it supply?
It is a posterior branch which arises above the posterior belly of digastric
It supplies part of the parotid, auricle and occipital region.
43
Where does the occipital artery arise in relation to the posterior belly of the digastric muscle? What does it have a branch to? Where does that run?
Passes deep to posterior belly and usually has a branch to the SCM (stump) and passes posterior to the external ear and across occiput.
44
Where does the posterior auricular artery arise in relation to the posterior belly of the digastric muscle?
Above level of posterior belly of digastric.
45
What are the two terminal branches of the external carotid?
It divides in the parotid to form:
1. Superficial temporal artery
2. Maxillary artery
46
What other structures passes through the parotid?
1. Retromandibular vein
| 2. Facial nerve
47
What are the important branches of the superficial temporal artery?
1. Transverse facial artery
| 2. Zygomatico-orbital artery
48
Where does the transverse facial artery arise? What does it supply?
It arises from the superficial temporal artery within the parotid below the zygomatic arch.
It passes anteriorly to supply part of the parotid and inferior part of the orbicularis oculi.
49
Where does the zygomatico-orbital artery arise and what does it supply?
It arises just above the zygomatic arch and supplies the superior orbicularis oculi.
50
What other branches does the superficial temporal artery have? What do they supply?
1. Anterior(frontal)
2. Posterior (parietal)
They supply the scalp, ear, orbicularis oculi and temporalis muscle.
51
What is the temporalis supplied by?
Deep temporal arteries.
52
Where does the maxillary artery pass? What does it supply?
1. Passes deep to condyle of mandible
2. Between pterygoid muscles to pterygopalatine fossa
Maxillary teeth, muscles of mastication, skin of face between eye and mouth
53
What are the branches of the maxillary artery prior to pytergoid palatine fossa? Where is it located?
1. Deep auricular artery (external ear, external tympanic membrane, TMJ)
2. Anterior tympanic artery (Internal tympanic membrane and middle ear)
3. Middle meningeal artery
4. Inferior alveolar artery to mandible
5. Medial and lateral pyterogoid
6. Masseteric
7. Buccinator
8. Posterior superior alveolar
9. Infraorbital
54
What are the branches of mastication?
1. Medial and lateral pyterygoid
2. Masseteric
3. Buccinator
55
Where does the infraorbital artery enter? What branches does it gives rise to?
Enters orbit through interior orbital fissure and gives rise to branches including superior alveolar/dental arteries (anterior and middle)
56
What branches come off the maxillary artery in the pterygopalatine fossa? What do they supply?
Small branches accompanying nerves arising from the pterygopalatine ganglion. (Nose, orbit, maxilla)
57
What are the features of the internal carotid in the neck?
1. Unbranched in the neck (usually - superior thyroid artery may arise from upper common carotid)
2. Carotid sinus and carotid body
58
Where does the dilation of the carotid sinus occur?
At the origin of the internal carotid
59
Where are the nerve endings of the carotid sinus?
In wall - pressure receptors
60
Where does the carotid body lie? What type of receptors and what do they detect?
Outside artery wall.
Chemoreceptors
Oxygen levels
61
What are the carotid body and sinus innervated by?
Branches of glossopharyngeal, vagus and sympathetic trunk
62
What does the internal carotid pass through in the skull?
1. Carotid canal and foramen lacerum
63
What is the internal carotid responsible for within the skull?
Supplies arterial Circle of Willis which supplies brain. Circle also receives blood from vertebral arteries.
64
Where does the opthalmic artery arise? What does it accompany? What does it supply?
Near cranial opening of optic canal.
It accompanies optic nerve through optic canal.
Supplies orbit, eye and forehead - including supraorbital and supratrochlear arteries.
65
What are the branches of the subclavian artery?
1. Vertebral (first branch, deep, from posterior side of subclavian artery and ascending)
2. Internal thoracic artery (from inferior side of subclavian and descending)
3. Thyrocervical trunk (from anterior side of the SA and opposite to origin of vertebral artery)
4. Costocervical trunk (just lateral to thyrocervical trunk,)
66
What does the vertebral artery pass through?
Foramen transversaria of cervial vertebra 1-6.
| It passes through the foramen magnum to form a single basilar artery
67
What does the internal thoracic artery supply?
Thorax
68
What are the branches of the thyrocervical trunk?
Branches include inferior thyroid artery to thyroid and neck
69
Where do the branches of the costocervical trunk go?
Branches to thorax and neck.
70
What are the general features of veins? (4)
1. Deoxygenated blood
2. Low pressure
3. Contain 80% of body's blood
4. Venous return
71
What is venous return assisted by?
1. Gravity
2. Muscle in vein walls
3. External pressure
4. Valves
72
How can external pressure be applied to veins?
1. From contraction of adjacent viscera
2. Movement of adjacent viscera
3. Suction (e.g. blood pulled into thorax during inspiration)
73
What are the brachiocephalic veins formed by?
Formed from subclavian and internal jugular veins.
74
What are the tributaries of the brachiocephalic veins?
1. Inferior thyroid veins
2. Vertebral veins
3. Internal thoracic veins
75
What do the inferior thyroid veins drian?
Small vessels within the thyroid as well as some of the vessels in the adjacent larynx, trachea and oesophagus.
76
What do the vertebral veins start as?
Internal vertebral venous plexus wihin the vertebral canal.
77
Where does the vertebral plexus travel?
Leave the vetebral canal above the atlas and form a vein on either side which passes down through the trasverse foramina of the first 6 cervical vertebra.
78
What is the function of the vertebral plexus?
Collect some of the blood from dural sinuses
79
What is special about the internal thoracic veins?
They are directed inferiorly unlike the other tributaries of the braciocephalic vein.
80
What does the internal jugular collect blood from?
Cranial dural sinuses.
1. Facial
2. Lingual
3. Pharyngeal
4. Superior and middle thyroid vein
81
Where does the internal jugular pass?
Passes tthrough jugular foramen into carotid sheath.
82
What and where does the subclavian vein cross?
The superior surface of rib 1, anterior to the attachment for the scalenus anterior.
83
What are the tributaries of the subclavian vein?
1. External jugular
| 2. Anterior jugular
84
What is the external jugular formed by?
Confluence of posterior branch of retromandibular vein with posterior auricular vein.
85
Where does the external jugular cross?
Crosses superficial/lateral surface of SCM to drain into subclavian vein
86
Where do the anterior jugulars arise? Where does it pass?
Arise near hyoid from confluence of small veins in the submandibular region.
It passes deep to the SCM to join the subclavian vein or external jugular.
87
What is the scalp drained by?
Tributaries of the superficial temporal vein
88
What does the superficial temporal vein end up joining with?
Maxillary vein
89
What does the maxillary vein drain?
Pterygoid venous plexus
90
Where is the pytergoid venous plexus initially?
Medial to neck of mandible (accompanies maxillary artery)
91
What is the pterygoid venous plexus? Where does it span?
A deep network of fine veins between temporalis and pterygoid muscles.
92
What drains into the pterygoid venous plexus?
Larger deep veins:
1. Sphenopalatine
2. Deep temporal
3. Pyterygoid
4. Masseteric
5. Buccal
6. Dental
7. Palatine
8. Meningeal
93
What can the pterygoid venous plexus be a possible infection route of?
Face and inracranial structures.
94
How is the pterygoid venous plexus connected?
1. Connected to the facial veins via the deep facial vein.
2. Plexus also connected to cavernous sinus via emissary veins through the skull via the emissary foramen and/or foramen ovale.
95
What forms the retromandibular vein in the parotid?
Maxillary and superficial temporal veins
96
What are the divisions of the retromandibular vein?
Anterior and posterior
97
What does the anterior branch unite with and what does it drain into?
Facial, Internal jugular
98
What does the posterior branch join with and what does it drain into?
Posterior auricular vein
External jugular
Note: This is very superficial and often visible as an oblique ridge down the side of the neck lateral to the SCM.
99
What is the facial vein formed by?
Confluence of supraorbital and supratrochlear veins.
100
Where does the facial vein pass?
1. Passes from medial corner of eye obliquely across face.
2. Then lateral to mandible and submandibular gland
3. Joins anterior branch of retromandibular vein just posterior to mandible
101
Where does the facial vein receive blood from?
Anterior maxilla and anterior mandible (plus other tributaries).
102
What drains into pytergoid venous plexus?
Posterior maxilla and mandible
103
Where is the facial vein located?
1cm posterior to facial artery and more direct (less wavy)
104
What does the deep facial vein connect?
Connects pterygoid venous plexus with facial vein.
105
Where does the deep facial vein pass?
Passes deep to ramus of mandible and masseter, across the superficial surface of buccinator and joins the facial vein above the junction with the anterior branch of the retromandibular vein.
106
What does the deep facial vein drain?
Buccinator
Z. major
Z. masseter
107
Where does the occipital vein arise?
Posterior network of veins of the scalp
108
Where does the occipital vein drain into?
Vertebral or posterior auricular veins
109
What and where does the posterior auricular vein unite with? What does it form.
Unites with posterior branch of retromandibular vein near angle of mandible to form external jugular.
110
What are the external veins of head and face?
1. Pterygoid venous plexus
2. Retromandibular system
3. Facial vein
4. Deep facial vein
5. Posterior auricular and occipital vein
111
Where are the cranial dural venous sinuses located?
Venous spaces within dura. Includes cavernous sinuses.
112
What are the charateristics of cranial dural?
No valves
| No muscles
113
What is the function of cranial dural venous sinuses?
Collect blood from brain and cranial bones
114
Where do cranial sinuses mostly drain?
Internal jugular
115
Where does the superior sagittal sinus run?
Runs in dura beneath saggital suture
116
What are the cavernous sinuses?
A pair of venous plexus each about 2 cm long. It consists of interconnecting endothelial lined venous spaces
117
Where are the cavernous sinuses located?
Middle cranial fossa just lateral to the pituitary.
118
What are the cavernous sinuses connected to?
Dural sinuses, veins of the brain and ophthalmic veins as well as pterygoid venous plexus via emissary veins through the bone of skull.
119
What are the cavernous sinuses?
A pair of venous plexus each about 2 cm long. It consists of interconnecting endothelial lined venous spaces
120
Where are the cavernous sinuses located?
Middle cranial fossa just lateral to the pituitary.
121
What are the cavernous sinuses connected to?
Dural sinuses, veins of the brain and ophthalmic veins as well as pterygoid venous plexus via emissary veins through the bone of skull.
122
What passes through the sinus?
The internal carotid with its sympathetic nerve plexus
123
What passes through the lateral wall of the sinus?
Occulomotor
Trochlear
Abducens
Opthalmic and maxillary division of trigeminal
124
What are nerves separated from the blood by?
Endothelium
