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BIO 115 - Head & Neck Anatomy > LO 6 > Flashcards

LO 6 Flashcards

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1
Q

The vascular system of the head and neck consists of __________

A
  1. an arterial blood supply
  2. a capillary network
  3. a venous drainage
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2
Q

A large network of blood vessels within the system is a ____________

A

vascular plexus

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3
Q

Blood vessels also may communicate with each other within the system by an __________-a connecting channel(s) among the vessels.

A

anastomosis (pl. anastomoses)

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4
Q

Describe arteries

A
  1. Part of the arterial blood supply
  2. Begins at the heart and carries blood from it
  3. Arteriole: smaller diameter artery
  4. The smaller diameter arteries + arterioles control the filling of capillaries and the arterial pressure
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5
Q

Describe capillaries

A
  1. Smaller diameter than an arteriole
  2. Can supply blood to a larger area
  3. Capillary network: present through out the body for: Exchange of O2, Metabolic waste products, CO2
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6
Q

Describe veins

A
  1. Part of the venous drainage
    (drains blood from an area)
  2. Travels to the heart and carries blood to it
  3. Larger diameter and more numerous than arteries
  4. Have valves to prevent to prevent backflow
  5. Venule drains the capillaries of the tissue area
  6. Venous sinuses: blood-filled spaces between two layers of tissue
  7. All these venous networks are connected by anastomoses.
  8. Blood vessels may not only spread cancer but can also spread dental (or odontogenic) infection.
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7
Q

What are the 3 layers of arteries and veins?

A
  1. Tunica externa - connective tissue layer
  2. Tunica media- smooth muscle layer+ elastic fibers
  3. Tunica interna : inner endothelium; lines the blood vessels
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8
Q

What are the major arteries that supply the head and neck?

A
  1. common carotid
  2. subclavian arteries.

The origins from the heart to the head and neck of these two major arteries are different depending on the side of the body; in contrast, the other branching arteries of the head and neck are usually symmetric in their coverage.

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9
Q

Left side of the body: the common carotid and subclavian arteries arise directly from the _________.

A

aorta

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10
Q

Right side of the body: the common carotid and subclavian arteries are both branches from the _________.

A

brachiocephalic artery

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11
Q

Describe the common carotid artery

A
  1. Branchless
  2. Travels superiorly along the neck, lateral to the trachea and larynx to the superior border of the thyroid cartilage
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12
Q

The common carotid artery ends by dividing into the ___________ carotid arteries at about the level of the larynx.

A

internal and external

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13
Q

What is the carotid sinus?

A

Before the bifurcation of the common carotid artery

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14
Q

What is the carotid pulse?

A
  1. Most reliable arterial pulse
  2. Felt when the common artery is palpated against the larynx
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15
Q

Describe the subclavian artery

A
  1. The subclavian artery arises lateral to the common carotid artery.
  2. Supplies intracranial and extracranial structures
  3. Upper extremity ( at the arm) is its major destination
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16
Q

Describe the internal carotid artery

A
  1. The internal carotid artery is a division that travels superiorly in a slightly lateral position to the external carotid artery after leaving the common carotid artery
  2. Supplies blood to the internal structures of the head
  3. Source of the ophthalmic artery- supplies the eye, orbit, lacrimal gland and much of the forehead
  4. Covered by the large SCM on each side
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17
Q

Describe the external carotid artery

A
  1. Begins at the superior border of the thyroid cartilage
  2. Arises from the common carotid artery
  3. Travels superiorly in a medial position to the internal carotid artery
  4. Supplies the extracranial tissue of the head and neck, including the oral cavity.
  5. Has four sets of branches - Anterior (3), Medial (1), Posterior (2), Terminal Branches (2)
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18
Q

What are the anterior 3 branches of the external carotid artery?

A
  1. Superior thyroid
  2. Lingual/sublingual
  3. Facial
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19
Q

What are the 4 branches of the superior thyroid artery and what do they supply?

A

4 Branches:
1. infrahyoid
2. SCM
3. superior laryngeal
4. cricothyroid

These branches supply the tissue inferior
to the hyoid bone including:
1. the infrahyoid muscles
2. sternocleidomastoid muscle
3. muscles of the larynx
4. thyroid gland.

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20
Q

Describe the lingual artery (anterior branch #2)

A
  1. branches off the external carotid artery below the facial artery
  2. supplies the tissue superior to the hyoid bone including the
  3. suprahyoid muscles and
    floor of the mouth (FOM)
  4. well-developed blood supply to the tongue
  5. Ends in 3 branches: dorsal lingual artery, deep lingual artery, sublingual artery
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21
Q

Describe the terminal branches of the lingual artery

A
  1. dorsal lingual artery- deep posterior part of the tongue
  2. deep lingual artery-deep anterior part of the tongue
  3. sublingual artery-mylohyoid muscle / ventral surface of the tongue / FOM
  4. Some sources suggest there are 2 more branches: the suprahyoid and the tonsillary branches
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22
Q

Describe the Facial Artery (external maxillary artery) - Anterior Branch #3

A
  1. serves components of the face; final anterior branch
  2. ascends the side of the neck
  3. runs deep to the submandibular gland to supply the gland
  4. crosses the lower border of the mandible just in front of the angle of the mandible
  5. From the inferior border of the mandible, the facial artery runs anteriorly and superiorly near the angle of the mouth and along the side of the nose.
  6. terminates at the medial canthus.
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23
Q

What are the branches of the facial artery

A
  1. angular
  2. superior labial
  3. inferior labial
  4. ascending palatine
  5. submental
  6. glandular branches
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24
Q

Describe the ascending palatine artery (cervical branch)

A
  1. first branch off the facial artery
  2. supplies the soft palate, palatine muscles, and
  3. palatine tonsils
  4. can be the source of serious blood loss or
    hemorrhage if it is injured during a tonsillectomy
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25
Q

Describe the submental artery (branch of the facial artery)

A

Supply:
1. submandibular lymph nodes
2. submandibular salivary gland, and
3. mylohyoid and digastric muscles

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26
Q

Describe the Inferior Labial Artery (branch of the facial artery)

A

supplies the lower lip area including some of the muscles of facial expression

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27
Q

Describe the Superior Labial Artery (branch of the facial artery)

A

supplies the tissue of the upper lip

28
Q

Describe the Angular Artery (branch of the facial artery)

A
  1. terminal branch
  2. supplies the lateral side of the naris
29
Q

Describe the Ascending Pharyngeal Artery – Only Medial Branch

A
  1. only one medial branch from the external carotid artery
  2. arises close to the origin of the external carotid and cannot be seen in most lateral views of the head and neck
  3. has many small branches, including the pharyngeal,meningeal and tonsillar branches
30
Q

Describe the Occipital Artery (1/2 Posterior Branches of the External Carotid)

A
  1. Arises from the ECA as it passes superiorly just deep to the ascending ramus of the mandible and then travels to the posterior part of the scalp
  2. At its origin, the occipital artery is adjacent to the
    hypoglossal nerve (12th cranial nerve).

Branches
1. sternocleidomastoid – SCM mucle
2. auricular – scalp in the occipital region
3. meningeal – meninges in the occipital area
4. muscular – suprahyoid muscles

31
Q

Describe the Postauricular Artery (1/2 Posterior Branches of the External Carotid)

A
  1. auricular branch – inner ear
  2. stylomastoid branch – mastoid air cells
32
Q

What terminal branches does the external carotid split into within the parotid salivary gland?

A
  1. Superficial Temporal Artery
  2. Maxillary Artery
33
Q

Describe the Superficial Temporal Artery

A
  1. Smaller terminal branch (compared to maxillary artery)
  2. can sometimes be visible under the skin in the temporal region

Branches:
1. transverse facial
2. middle temporal artery
3. frontal branch
4. parietal branch

34
Q

Describe the maxillary artery

A
  1. The larger terminal branch of the ECA
  2. 3 parts defined by location: First part (mandibular part); Second part (pterygoid part); Third part (or pterygopalatine part)
35
Q

Describe the 3 parts of the maxillary artery defined by location

A
  1. First part (mandibular part) begins at the neck of the mandibular condyle within the parotid salivary gland
  2. Second part (pterygoid part) runs between the mandible and the sphenomandibular ligament anteriorly and superiorly through the infratemporal fossa
  3. Third part (or pterygopalatine part): after traversing the infratemporal fossa, the maxillary artery enters the pterygopalatine fossa, which is deep and inferior to the eye
36
Q

What are the branches of the mandibular part of the maxillary artery?

A
  1. Middle Meningeal Artery - Supplies the meninges of the brain and the skull bones
  2. Inferior Alveolar Artery - Turns inferiorly to enter the mandibular foramen and then the mandibular canal, along with the inferior alveolar nerve - gives rise to dental and alveolar branches to supply the mandibular posterior teeth and gingiva
  3. Mylohyoid Artery - arises from the inferior alveolar artery before the main artery enters the mandibular canal by way of the mandibular foramen; Supplies the mylohyoid muscle and FOM
  4. Mental Artery - arises from the inferior alveolar artery and exits the mandibular canal by way of the mental foramen; supplies the tissue of the chin; anastomoses with the inferior labial artery
  5. Incisive Artery - Remains within the mandibular canal to divide into dental and alveolar branches.; supplies the pulp of the mandibular anterior teeth by way of each tooth’s apical foramen; the periodontium (including the gingiva) of the mandibular anterior teeth
37
Q

What are the branches of the Pterygoid Part of the maxillary artery?

A
  1. The second part of the maxillary artery also has branches that are located near the muscle they supply.
  2. These arteries all accompany branches of the mandibular division of the trigeminal nerve (5th)
  3. deep temporal arteries: supply the temporalis muscle
  4. pterygoid arteries: supply the lateral and medial pterygoid muscles
  5. masseteric artery: supplies the masseter muscle
  6. buccal artery: supplies the buccinator muscle and other soft tissues of the cheek
38
Q

What are the branches of the Pterygopalatine Part of the maxillary artery?

A
  1. Just as the maxillary artery leaves the infratemporal fossa and enters the pterygopalatine fossa, it gives rise to the
    Posterior Superior Alveolar Artery (PSA)
  2. Then enters the posterior superior alveolar foramina on the maxillary tuberosity, giving rise dental branches and alveolar branches

Supply:
1. the pulp of the maxillary posterior teeth by way of each tooth’s apical foramen
2. the periodontium (including the gingiva) of the maxillary posterior teeth
3. maxillary sinus

39
Q

Describe the Infraorbital Artery

A
  1. May share a common trunk with the posterior superior alveolar artery
  2. After giving off branches in the infraorbital canal, the infraorbital artery travels in the infraorbital canal and emerges onto the face from the infraorbital foramen
  3. Gives rise to the anterior superior alveolar artery
40
Q

Describe the Anterior Superior Alveolar (ASA) Artery

A
  1. arises from the infraorbital artery and gives rise to dental and alveolar branches
  2. anastomoses with the posterior superior alveolar artery.

Supplies:
1. the pulp of the maxillary anterior teeth via each tooth’s apical foramen
2. the periodontium (including the gingiva) of the maxillary anterior teeth

41
Q

Describe the Middle Superior Alveolar Artery( MSA)

A
  1. Supplies the buccal periodontium and gingiva of the maxillary premolars
  2. Anastomoses with ASA and PSA arteries
42
Q

Describe the Descending Palatine Artery

A
  1. Also in the pterygopalatine fossa, the third part of the maxillary artery gives rise to the descending palatine artery
  2. travels to the palate through the pterygopalatine canal which then terminates in:
    1. Greater Palatine Artery - via the greater palatine foramina; supplies the hard palate
    2. Lesser Palatine Artery - via the lesser palatine foramina; supplies the soft palate
43
Q

Describe the Sphenopalatine Artery

A
  1. terminal branch of the maxillary artery
  2. gives rise to the posterior lateral nasal branches and septal branches, including a nasopalatine branch that accompanies the nasopalatine nerve through the incisive foramen on the maxillae
  3. supplies the nasal cavity via the sphenopalatine foramen
44
Q

Describe venous drainage of the head and neck

A
  1. Drainage starts out as small, freely anastomosing venules in the brain and get bigger as they near the neck and descend toward the heart.
  2. All the venous drainage from the head
    and neck terminates in the internal jugular vein, which then joins the subclavian vein to form the brachiocephalic vein behind the medial end of the clavicle.
  3. In general, veins follow the same pathways as arteries and, in most instances, have the same names
45
Q

Describe the facial vein

A
  1. formed by the union of the supratrochlear and the supraorbital veins at the medial canthus
  2. drains into the internal jugular
  3. supraorbital vein anastomoses with the ophthalmic veins that drain the tissue of the orbit
  4. This anastomosis provides a communication
  5. the cavernous sinus, which may become
    fatally infected through the spread of dental infection – this is significant because there are no one-way valves, so infection may back flow.
  6. Receives blood from the same areas of the face that are supplied by the facial artery.
  7. Anastomoses with the pterygoid plexus in the infratemporal fossa and with the large retromandibular vein before joining the internal jugular vein at the level of the hyoid bone.
46
Q

What are the tributaries in the oral region that flow to the facial vein?

A
  1. Superior Labial Vein - drains the upper lip
  2. Inferior Labial Vein - drains the lower lip
  3. Submental Vein - drains the tissue of the chin and the submandibular region.
47
Q

Describe the lingual veins

A
  1. May drain indirectly into the facial veins or directly into the internal jugular.
  2. Dorsal Lingual Veins - drain the dorsum of the tongue
  3. Deeper Lingual Veins - drain the ventral surface of the tongue
  4. Sublingual Veins - drain the floor of the mouth
48
Q

Describe the retromandibular vein

A
  1. Formed by the merger of the temporal (drains the lateral tissues of the scalp) and the maxillary veins
  2. Divides into an anterior and posterior retromandibular vein.
  3. The posterior division joins with the posterior auricular vein to form the external jugular vein.
49
Q

Describe the Maxillary (internal maxillary) Vein

A
  1. Deeper than the superficial temporal vein
  2. formed by the pterygoid plexus of veins
  3. Through the pterygoid plexus, the maxillary vein receives the middle meningeal, posterior superior alveolar, inferior alveolar, and other veins (e.g., those from the nasal cavity and palate - those areas served by the maxillary artery).
  4. After receiving these veins, it merges with the superficial temporal vein to drain into and form the retromandibular vein.
50
Q

Describe the Pterygoid Plexus of Veins

A
  1. A collection of small anastomosing vessels
  2. Also anastomoses with the facial and retromandibular veins
  3. Located within the infratemporal fossa, and around the pterygoid muscles and the second part (i.e., pterygoid part) of the maxillary artery
  4. Drains: the middle meningeal vein, the posterior superior alveolar vein, other veins from the deep parts of the face, and then drains into the maxillary vein
  5. also drains dental tissues
  6. The veins of the plexus are so close to the maxillary tuberosity that there is a risk of piercing them if the needle is incorrectly overinserted during a posterior superior alveolar nerve block.
51
Q

What happens if the pterygoid Plexus of Veins is pierced during a posterior superior alveolar nerve block?

A
  1. When this happens, blood escapes into the tissue spaces and a hematoma occurs
    – and this tends to upset clients.
  2. Hematoma: A swelling and discoloration of the area that results when a blood vessel is injured and a small amount of blood escapes into the surrounding tissue and clots
52
Q

Describe the Posterior Superior Alveolar Vein

A
  1. Formed by the merging of its dental and alveolar branches
  2. Drain:
    1. the pulp of the maxillary teeth by way of each tooth’s apical foramen
    2. the periodontium (including the gingiva) of the maxillary teeth
53
Q

Describe the Inferior Alveolar Vein

A

Formed by the merging of its dental and alveolar branches, and the mental branches

Drain:
1. in the pterygoid plexus
2. the pulp of the mandibular teeth by way of each tooth’s apical foramen
3. the periodontium (including the gingiva) of the mandibular teeth
4. The mental branches of the inferior alveolar vein enter the mental foramen after draining the chin area on the outer surface of the mandible, where they anastomose with branches of the facial vein.

54
Q

What happens if the Inferior Alveolar Vein is pierced?

A
  1. When a needle goes through soft tissue, there are small blood vessels in the area.
  2. A needle contacting a blood vessel ruptures it and blood flows into the area.
  3. Blood contacting the nerve irritates it …….and can produce paresthesia.
  4. The area of the IA nerve block is quite vascular so this is a possible cause of paresthesia.
  5. What normally happens when the hematoma is the cause of paresthesia is that the client will report a gradual return
    of sensation over about 10-14 days (the avg. length a hematoma lasts)
55
Q

Describe the venous sinuses

A
  1. blood-filled spaces between two layers of tissue
  2. Include: inferior, straight, transverse, sigmoid, cavernous

Drains:
1. the cerebral veins into the internal jugular
2. The venous sinus most important to dental care is the cavernous sinus located on the lateral surface of the body of the sphenoid bone.
3. May be involved with the spread of dental infection (which can be fatal).

56
Q

Describe the Cavernous Sinus

A
  1. Each cavernous sinus communicates by anastomoses with the contralateral sinus and also with the pterygoid plexus of veins and superior ophthalmic vein, which anastomoses with the facial vein.
  2. The internal carotid artery and certain cranial nerves or their branches (III, IV, V1, V2 and VI) pass through this blood-filled space
  3. it is the only anatomic location in which an artery travels completely through a venous structure
57
Q

Describe the internal jugular vein

A
  1. Originates in the cranial cavity
  2. Emerges from the skull through the jugular foramen
  3. Runs with the common carotid artery and its branches as well as the vagus nerve in the carotid sheath
  4. Within the carotid sheath, the deep cervical lymph nodes form a chain along the internal jugular vein.
  5. Descends in the neck to merge with the subclavian vein.
  6. Drains the entire brain area and most of the tissue of the head and neck
  7. receives many tributaries (e.g., the veins from the lingual, sublingual, and pharyngeal areas as well as the facial vein)
58
Q

Veins of the head and neck ________ one-way valves so the internal jugular may become involved in the spread of infection since ________ to prevent the backward flow of blood

A
  1. do not have any
  2. it does not have any valves
59
Q

Describe the external jugular vein

A
  1. The posterior division of the retromandibular vein becomes the external jugular vein
  2. Descends inferiorly along the neck, terminating in the subclavian vein
  3. Drains: anterior jugular (begins inferior to the chin)
  4. usually visible as it crosses the SCM muscle
60
Q

Describe the pathways to the heart from the head and neck

A
  1. On each side of the body, the external jugular vein joins the subclavian vein from the arm
  2. then the internal jugular vein merges with the subclavian vein to form the brachiocephalic vein
  3. then the brachiocephalic veins unity to form the superior vena cava to travel to the heart
  4. The supply to and from the head and neck is then complete, and the blood can flow out of the heart to the lungs again.
61
Q

What occurs when arteries are narrowed or blocked?

A
  1. The narrowing and blockage of the arteries can cause pathologic changes that impact the head and neck or dental care.
  2. This can be by a buildup of fatty plaque, which consists of mainly cholesterol, as well as calcium, clotting proteins, and other substances, resulting in atherosclerosis.
  3. The fatty plaque buildup in the walls of arteries with atherosclerosis results in cardiovascular disease due to partially blocked artery.
62
Q

Describe Atherosclerosis

A
  1. thickening or hardening of the arteries
  2. The process of atherosclerosis is now known to begin as early as childhood. However, even late in adulthood, lifestyle changes can reduce the onset or severity of coronary artery disease.
  3. Lifestyle changes, such as eating a healthy diet and exercising, are often the best treatment for atherosclerosis. But in more serious cases, medication or surgical procedures may be recommended as well.
63
Q

What is a thrombus?

A
  1. thrombus (plural, thrombi) that forms on the inner vessel wall.
  2. partially and completely blocks blood vessels.
  3. A thrombus (or thrombi) may dislodge from the inner vessel wall and travel as an embolus (pl.emboli).
64
Q

Describe bacteremia theory

A
  1. occlusion of the blood vessel can hamper blood circulation and cause further complications such as stroke (cerebrovascular accident), heart attack (myocardial infarction), or tissue destruction (gangrene), depending on the lesion’s location. These thrombi may also be infected and spread infection by way of embolus formation, travelling to such areas as the cavernous sinuses.
  2. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries and contributing to clot formation. Another possibility is that the inflammation caused by periodontal disease increases fatty plaque buildup, which may contribute to swelling of the arteries.
  3. Finally, patients at risk for infective endocarditis may require antibiotics before dental procedures
65
Q

What can happen when a blood vessel is seriously traumatized?

A
  1. When a blood vessel is seriously traumatized, large amounts of blood can escape into surrounding tissue without clotting, causing a hemorrhage
  2. This is a serious, life-threatening vascular lesion.
  3. Usually a healthy person can endure a loss of 10% to 15% of the total blood volume without serious medical difficulties. Blood donation usually takes 8% to 10% of the donor’s blood volume.
66
Q

Describe hematomas

A
  1. This escaped blood causes tissue tenderness, swelling, and discoloration that will last until the blood is broken down by the body.
  2. Blocks such as an infraorbital block or inferior alveolar block may result in hematomas even when administered correctly. These hematomas can vary in extent from minor bruising to major disfiguring lesions.
  3. Dental professionals need to be aware of the location of larger blood vessels to prevent major injury during dental treatment such as with the posterior superior alveolar block.
67
Q

What is the link between Periodontal Disease and Cardiovascular Disease?

A
  1. Studies now show a link between periodontal disease and CVD; several theories exist to explain this link.
  2. People with periodontal disease are almost twice as likely to suffer from CVD as those without periodontal disease; in addition, periodontal disease can also exacerbate existing heart conditions.

BIO 115 - Head & Neck Anatomy (6 decks)

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