Head and neck: Venous drainage

Question 1

three layers of meninges:

Answer 1

• dura mater
• arachnoid mater
• pia mater

Question 2

dura mater: features

Answer 2

• adhered to internal layer of skull

layers:

• external periosteal
• internal meningeal

Question 3

list meningeal spaces:

Answer 3

• epidural (extradural): potential
• subdural: potential
• subarachnoid (leptomeningeal): fluid-filled, arachnoid trabeculae

Question 4

arachnoid trabeculae: features

Answer 4

• flattened irregularly shaped fibroblasts

Question 5

pia mater: features

Answer 5

• highly vascular

- shiny appearance to the brain

Question 6

list meningeal folds:

Answer 6

• tentorium cerebelli
• falx cerebri
• falx cerebelli
• diaphragma selli

Question 7

nerve supply to dura: general

Answer 7

• opthalmic div of trigeminal (CN V)
• mandibular div of trigeminal (CN V)
• maxillary div of trigeminal (CN V)
• cranial nerves

Question 8

dural venous sinus: define

Answer 8

spaces btw two layers of dura mater

Question 9

dural venous sinus: drainage

Answer 9

• large cerebral veins empty into these sinuses -> internal jugular v

Question 10

name dural venous sinuses: (11)

Answer 10

• inf sagittal
• sup sagittal
• straight
• occipital
• confluence of sinus
• sphenoparietal sinus
• cavernous
• superior petrosal
• transverse
• inf petrosal
• sigmoid

Question 11

inferior sagittal sinus drains to:

Answer 11

straight sinus

Question 12

sup sagittal sinus drains to:

Answer 12

typically R transverse (or confluence)

Question 13

straight sinus drains to:

Answer 13

typically L transverse (or confluence)

Question 14

occipital sinus drains to:

Answer 14

confluence

Question 15

confluence of sinuses drains to:

Answer 15

R and L transverse sinuses

Question 16

sphenoparietal sinuses drains to:

Answer 16

cavernous

Question 17

cavernous drains to:

Answer 17

sup/ inf petrosal sinuses

Question 18

transverse sinuses drains to:

Answer 18

sigmoid

Question 19

inf petrosal sinus drains to:

Answer 19

internal jugular v

Question 20

sigmoid sinus drains to:

Answer 20

internal jugular v

Question 21

eg. subdural heamatoma

Answer 21

• tearing of small bridging veins crossing subdural space
• from cerebral v to meningeal c draining into venous dural sinuses
• haemorrhage causes separation of arachnoid - dura, opening space
• chronic or acute

Question 22

main veins of the face:

Answer 22

• superficial temporal v
• transverse facial v
• retromandibular v
• internal jugular
• pterygoid plexus
• facial v
• deep facial v

Question 23

danger triangle of face:

Answer 23

• retrograde infections may cause cavernous sinus thrombosis, meningitis, brain abscess
• highly anastomotic venous system in region
• incl nose and mouth

Question 24

what drains directly into internal jugular v:

Answer 24

• sigmoid sinus
• facial v
• ant div

Question 25

what drains directly into external jugular v:

Answer 25

- suprascapular - post ext jugular - post div + post auricular - ant jugular - transverse cervical

Question 26

what drains directly into external superior vena cava:

Answer 26

- ext jugular + axillary into subclavian - internal jugular - vetebral v

Question 27

eg. SVC obstruction:

Answer 27

- increase jugular venous pressure - increase capillary pressure - fluid moves out into interstitial spaces - oedema

Question 28

jugular venous pressure comparison:

Answer 28

- observed as palpation not distended v is bad | - vs during exertion not sign of congestive heart failure