Craniofacial Vasculature I Flashcards
Layers of dura
Periosteal layer attaches to periosteum of bone.
Meningeal layer is deeper.
When do the dural layers fuse?
They fuse usually, except for when they form dural venous sinuses.
What is arachnoid made of?
Arachnoid trabeculae which is made of collagen and elastin.
Which layers are the subdural space and subarachnoid spaces between?
Subdural space - dura and arachnoid.
Subarachnoid space - arachnoid and pia mater.
What is pia mater made of?
What is it adhered to?
Made of delicate CT and adheres to entire brain and follows all contours.
What creates the cranial dural septa?
Extensions of meningeal layer of the dura.
4 cranial dural septa
What exists in these septa?
Falx cerebri
Tentorum cerebelli
Falx cerebelli
Diaphragma sellae
Sinuses.
Arterial supply to the meninges
Middle meningeal a. (frontal and parietal branches)
Occipital a.
Vertebral a. branches
Innervation of the meninges (4)
CN V1 - ophthalmic n.
CN V2 - maxillary n.
CN V3 - mandibular n.
Cervical spinal ns. (C2-C3)
Which cranial nerves contribute to the C2-C3 cervical spinal ns.?
C2-C3 from CN XII
C2 from CN X
8 sinuses in the brain
Superior sagittal sinus Inferior sagittal sinus Transverse sinus Occipital sinus Sigmoid sinus Confluence of sinuses Cavernous sinus
Associated structures with the cavernous sinus (7)
Internal carotid a. CN V and its branches. CN III CN IV CN VI Hypophysial fossa Pituitary glands
Superior orbital fissure
4 parts of the ICA
Cervical
Petrous
Cavernous
Cerebral
Where does CSF circulate?
Ventricles and subarachnoid space
What makes CSF?
Ependymal cells of choroid plexus produce CSF from plasma.
What is in greater concentration in CSF than plasma? (2)
Lesser amount? (2)
Greater - Na+ and H+
Lesser - K+ and Ca2+
How does CSF drain from brain?
Fluid drains from subarachnoid space into arachnoid villi and then into the dural venous sinuses.
Venous drainage from the face is:
Venous drainage from the head is:
Superficial (face)
Head (deeper)
Tract of internal jugular v.
Goes thru jugular foramen as a continuation of sigmoid sinus and descends behind and lateral to ICA within the carotid sheath.
4 cervical LN regions
Submental and submandibular LNs
Deep cervical LNs (upper, middle, lower)
LNs of posterior cervical triangle
Anterior cervical LNs
2 sites in neck where lymph pathways intersect and what empties there?
Jugulofacial venous junction - lymphatics from head meet there and travel down neck.
Jugulosubclavian venous junction - lymph from head and neck meets with thoracic duct from the rest of the body (on left)/
What kind of disease process is expected when central lymph nodes affected?
Peripheral nodes?
Central - extensive disease –> bx
Peripheral - localized process
What are bulbs of the Internal Jugular V.?
Swellings of the lumen at the start and end of the vein.
Which bulb has a bicuspid valve above it?
Inferior bulb
What does the Inferior Petrosal Sinus drain?
Where does it leave the skull?
What vein does it join and where?
Helps drain the cavernous sinus.
Leaves via the anterior part of jugular foramen.
Drains into IJV just below the superior bulb.
What forms the facial v.?
Union of supraorbital v. and supratrochlear v. to form the angular v.
Angular v. and deep facial v. join to form facial v.
What does the facial v. communicate with?
Cavernous sinus
What is the tract of the facial v. and what does it join?
Travels posteroinferiorly down the face to lower border of mandible.
Joins the retromandibular v.
What does the superior ophthalmic v. drain?
Cavernous sinus
What does the deep facial v. drain?
Pterygoid plexus
Which 2 veins form the retromandibular v.?
Superficial temporal v. and Maxillary v.
Which 2 veins does the pterygoid plexus drain into?
Deep facial v. anteriorly
Maxillary v. posteriorly
What gland is near the retromandibular v.?
Parotid gland
Where does the anterior division of the retromandibular v. drain?
Where does the posterior division of the retromandibular v. drain?
Anterior - facial v.
Posterior - posterior auricular v. –> EJV
If maxillary v. is occluded, who drains the pterygoid plexus?
Deep facial v.
What is the function of the pterygoid plexus?
To act as a peripheral pump to allow venous return when the mouth opens.
What muscle does the pterygoid plexus surround?
Lateral pterygoid m.
What triggers yawning?
Which muscle is contracted when one yawns?
Triggered by venous stagnation.
Lateral pterygoid m.
Which veins can the pharyngeal vs. drain? (4)
IJV
Facial v.
Lingual v.
Superior thyroid v.
Where can the superior thyroid v. drain? (2)
Facial v. or IJV
Where does the middle thyroid v. drain?
IJV
Where can the occipital v. drain? (2)
Vertebral v. or posterior auricular v.
What is the tract of the anterior jugular v.?
Below the chin, passes under platysma m. down to the suprasternal notch.
What is the tract of the external jugular v.?
Starts at angle of mandible by union of posterior auricular v. and posterior division of retromandibular v. and drains into subclavian v.
