Craniofacial Vasculature I

Question 1

Arterial supply to the cranial meninges, not brain, and travels through the foramen spinosum.

This artery lies behind the ____.

Answer 1

Middle meningeal A (from maxillary A)

Pterion

Question 2

Little lacunae in the back of the skull called ____ drain cerebral spinal fluid into venous sinuses.

Answer 2

Arachnoid granulations

Question 3

The cranial meninges are three dense regular CT layers separate the soft tissue of the _____ from the ____ of the cranium.

They enclose and protect _____ that supply the brain. Parts of the cranial meninges form some ____ that drain blood from the brain. They also contain and circulate _____.

What is the order from superficial to deep?

Answer 3

Brain; bones

Blood vessels; veins; CSF

Dura mater, arachnoid mater, pia mater

Question 4

What are the two layers of the dura mater and where are they?

The ____ layer is fused to the periosteal layer except where the two layers separate to form large blood filled spaces called _____.

Answer 4

Periosteal layer: superficial and attaches to periosteum of cranial bones

Meningeal layer: deep to periosteal

Meningeal; dural venous sinuses

Question 5

____ is composed of a web of collagen and elastic fibers called arachnoid trabeculae. Between this layer and the overlying dura mater is the ____. Underneath this layer is the ___.

Answer 5

Arachnoid mater

Subdural space

Subarachnoid space

Question 6

____ is the innermost layer of the cranial meninges. It is a thin layer of delicate CT that adheres to the brain and follows every contour of the brain surface.

Answer 6

Pia mater

Question 7

The meningeal layer of the ____ extends as flat septa deep into the cranial cavity at four locations called ____.

What are they called what what do they separate?

Answer 7

Dura mater; cranial dural septa

Falx cerebri: separates the two hemispheres of the cerebrum superficially to the corpus callosum

Tentorium cerebelli: separates the cerebrum form the cerebellum

Falx cerebelli: separates the two hemispheres of the cerebellum

Diaphragma sellae: overlays the cavernous sinus

Question 8

CSF is a colorless liquid that circulates in the ____ and _____.

Has three fx?

Formed by _____ in each ventricle and produced by secretion of a fluid from _____ that originate from blood plasma.

How does it compare to plasma?

Answer 8

Ventricles; subarachnoid space

Buoyancy, protection, environmental stability

Choroid plexus; ependymal cells

Greater Na, H, Ca; less K

Question 9

____ drain CSF from the subarachnoid space into the dural venous sinus. There is a lower pressure in the ____ allowing for this drainage of fluid.

Answer 9

Arachnoid villus

Dural venous sinus

Question 10

What is found in the cranial dural septa?

The transverse sinus drains into the ____ that drains out of the jugular foramen.

____ is where the sinuses join together.

____ runs longitudinally on the caverium.

Answer 10

Dural venous sinuses: superior and inferior sagittal sinuses, straight sinus, sigmoid sinus and transverse sinus

Sigmoid dural venous sinous

Confluence of sinus

Superior sagittal dural sinus

Question 11

Branches off of what nerves innervate the meninges?

Answer 11

Ophthalmic (V1)

Maxillary (V2)

Mandibular (V3)

Hypoglossal XII

Vagus X

Cervical spinal nerves C2, C3

Question 12

____ delivers blood to the face; ____ drains blood from the face.

Answer 12

External carotid A

Internal jugular V -> subclavian V -> brachiocephalic V

Question 13

____ in the neck are potential sites of metastasis from head and neck tumors.

Answer 13

Deep lymph nodes

Question 14

Deep cervical lymph nodes are found in zones II-IV and are distributed along the _____; what are their names?

Superficial cervical lymph nodes are in zones I, V, and VI. What are their names?

Answer 14

Internal jugular V

II: upper lateral group
III: middle lateral group
IV: lower lateral group

I: submental submandibular LN
V: LN in posterior cervical triangle
VI: anterior cervical LN

Question 15

The superficial LN of the head and neck receive lymph from the ____. They are arranged in a ring and extend from the inferior chin to the posterior aspect of the head. They drain into the ____.

Answer 15

Scalp, face, and neck

Deep LN

Question 16

Lymphatics from the head pass obliquely downwards to the ____; this redirects lymph vertically downward in the neck.

The thoracic duct terminates at the ____ where lymph collected from the left side of the head and neck is combined with lymph draining from the rest of the body.

Answer 16

Jugulofacial venous junction

Jugulosubclavian venous junction (left)

Question 17

When ____ LN are affected, there is a localized disease process.

If ____ LN are affected, there is an extensive disease process. These LN can be obtained through a _____.

Answer 17

Peripheral LN

Central LN in the venous junctions

Prescalene biopsy

Question 18

The _____ receives blood form the brain, face, and neck.

It emerges from the jugular foramen as a continuation of the ____ and enters the carotid sheath.

Answer 18

Internal jugular V

Sigmoid sinus

Question 19

____ and ____ are dilations near the origin and termination of the vein.

____ are present in the internal jugular veins and prevent retrograde flow when coughing.

Answer 19

Superior and inferior bulbs

Valves

Question 20

____ assists in draining the cavernous sinus. It leaves through the anterior part of the jugular foramen and joins internal jugular V below the ____.

Answer 20

Inferior petrosal sinus

Superior bulb

Question 21

____ is formed by the union of the superficial temporal V and maxillary V from the pterygoid plexus.

It passes inferiorly to the ____ and divides into two parts; anterior division joins the ____ and the posterior division pierces the deep fascia and joins the ____ to form the external jugular V and empty into the subclavian V.

Answer 21

Retromandibular V

Parotid gland

Facial V

Posterior auricular V

Question 22

___ communicates with the cavernous sinus via the superior and inferior ophthalmic veins.

It’s initial tributaries are the ____ and ____ veins.

Answer 22

Angular V

Supraorbital V
Supratrochlear V

Question 23

The ____ is joined by the anterior division of the retromandibular V.

It joins the ____ through the deep facial V.

Answer 23

Facial V

Pterygoid plexus

Question 24

The danger triangle of the face contains the area from the corners of the mouth to the nose. This area can causes retrograde infections from the nasal area to spread to the brain causing ____, ______, or _____.

This is possible because of the venous communication via the ____ and between the _____ and ____.

Answer 24

Cavernous sinus thrombosis

Meningitis

Brain abscess

Ophthalmic veins

Facial V

Cavernous sinus

Question 25

The ____ drains from the pterygoid plexus and passes between the sphenomandibular L and neck of mandible; unite with the temporal V to form the _____.

Answer 25

Maxillary V

Retromandibular V

Question 26

The ____ descends deep to the platysma and pierces the deep fascia above the clavicle and drains into the subclavian V.

___ and ___ drain into this vein.

Answer 26

External jugular V

Posterior auricular and and posterior division of the retromandibular V

Question 27

This vein passes below the chin, beneath the platysma, pierces deep fascia, passes deep to the SCM, and opens into the external jugular V.

Answer 27

Anterior jugular V

Question 28

____ drain the dorsal and sides of the tongue.

____ drain the tip of the tongue and join the sublingual V.

All of these veins terminate in the ____.

Answer 28

Dorsal lingual V

Deep lingual V

Internal jugular V

Question 29

____ drain the pharyngeal plexus and terminate in the internal jugular V, facial V, lingual V, or the superior thyroid V.

Answer 29

Pharyngeal veins

Question 30

The ____ acts as a peripheral pump; it aids venous return by the pumping action of the muscle every time the mouth is opened.

____ triggers yawning reflex, a prolonged contraction of the lateral pterygoid to open the mouth, contract the diaphragm, and stretch the limbs

Answer 30

Pterygoid plexus

Venous stagnation

Question 31

____ is a network of small veins around and within the pterygoid muscle in the infratemporal region.

It receives blood from the ____ and _____ and drains into the maxillary V. If the maxillary V is occluded, the deep facial V will drain the plexus into the ____.

Answer 31

Pterygoid plexus

Inferior ophthalmic V and deep facial V

Facial V

Question 32

7 components of the cavernous sinus?

Answer 32

Maxillary N, ophthalmic N, internal carotid A, pituitary gland, oculomotor N, trochlear N, abducent N