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Head and Neck > Major Blood Vessels of Head and Neck > Flashcards

Major Blood Vessels of Head and Neck Flashcards

1
Q

Describe the Right Side of the Aortic Arch.

A

The Brachiocephalic trunk is given off. This gives rise to the Right Subclavian Artery and Right Common Carotid Artery.

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2
Q

Describe the Left Side of the Aortic Arch.

A

The Left Subclavian and Left Common Carotid Artery are given directly off the Aortic Arch.

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3
Q

What does the Subclavian Artery at the base of the neck give rise to?

A

The Vertebral, Internal Thoracic and Thyrocervical Arteries.

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4
Q

Describe the Thyrocervical Trunk (given off from the Subclavian artery on either side).

A

The Thyrocervical Trunk gives off the Ascending Cervical, Transverse Cervical, Suprascapula and Inferior Thyroid Arteries.

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5
Q

What does the Ascending Cervical and Transverse Cervical Arteries Supply?

A

The Neck.

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6
Q

What does the Suprascpaularis Supply?

A

The Shoulder.

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7
Q

What does the Inferior Thyroid Supply?

A

Lower pole of thyroid gland.

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8
Q

What is the Path of the Vertebral Artery?

A

Arise from the Subclavian Arteries, ascend in the neck through transverse foramina in C1-C6 and pass through the foramen Magnum. Help supply the brain.

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9
Q

Does the Internal Carotid Artery give off any branches in the neck?

A

No.

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10
Q

How does the Internal Carotid Artery enter the skull?

A

Through the Carotid Canal.

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11
Q

Where does Bifurcation of the Common Carotid Artery Occur?

A

Superior border of the thyroid cartilage.

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12
Q

Where does the Internal Jugular Vein lie in respect to the Common Carotid Artery?

A

IJV lies lateral to the CCA and mostly under the sternocleidomastoid.

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13
Q

Describe a Carotid Artery Atheroma.

A

The most common site of a carotid artery atheroma is in the bifurcation area. The symptoms are visible at a 70% narrowing of the artery. A rupture of the clot can cause an embolus which reaches the brain causing a TIA or stroke.

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14
Q

Describe the Carotid Sinus.

A

It is a swelling in the Internal Carotid Artery near the bifurcation of the CCA. It is a baroreceptor that detects changes in the aBP.

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15
Q

Describe the Carotid Body.

A

On the outside of the bifurcation of the CCA. It is a peripheral chemoreceptor which detects changes in aO2.

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16
Q

Describe the Clinical Relevance of the Carotid Triangle.

A

The triangle is where the most appropriate access of the CA or IJV or hypoglossal nerve or vagus nerve can be found.
This area is where Carotid Sinus Massage can be formed to elevate a supra ventricular tachycardia, by increasing vagal tone via the baroreceptors.

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17
Q

Where can the Carotid Pulse be Palpated?

A

Found in the carotid triangle just below the bifurcation or palpated inferiorly.

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18
Q

Describe the pathway of the Internal Carotid Artery.

A

Enters the skull through the carotid canal (petrous part of temporal bone), turns medially and horizontally, enters the cranial cavity (S shaped bend) then to the cavernous sinus.

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19
Q

What is the Cavernous Sinus?

A

A plexus of extremely thin-walled veins on the upper surface of the sphenoid.

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20
Q

What is found in the Cavernous Sinus?

A
  1. Extremely thin-walled veins.
  2. Internal Carotid Artery.
  3. Oculomotor Nerve (CNIII).
  4. Trochlear Nerve (CNIV).
  5. Abducent Nerve (CNVI).
  6. Ophthalmic Nerve (branch of trigeminal) (CNVI).
  7. Maxillary (branch of trigeminal) (CNV2).
21
Q

Describe the Ophthalmic Artery.

A

The Ophthalmic Artery is a branch of the Internal Carotid Artery. It gives off the Supratrochlear Artery and the Supraorbital Artery.

22
Q

Describe the Distribution of the External Carotid Artery.

A

There are 8 branches (2 terminal):

  1. Superior Thyroid Artery (SomeTimes).
  2. Lingual (Loveable).
  3. Facial (Francescas).
  4. Ascending Pharyngeal (Are Potentially).
  5. Occipital (Okay).
  6. Posterior Auricular (People And).
  7. Superficial Temporal (SomeTimes)-Terminal.
  8. Maxillary (Meh)- Terminal.
23
Q

List the Arteries that Supply Blood to the Scalp.

A
  1. Supraorbital Artery (ICA).
  2. Supratrochlear Artery (ICA).
  3. Superficial Temporal Artery (ECA).
  4. Posterior Auricular Artery (ECA).
  5. Occipital Artery (ECA).
24
Q

Describe the Blood Supply to the Scalp.

A

Rich blood supply, lots of anastomoses. Mainly from the external carotid artery.

25
Q

Describe the Layers of the Scalp.

A
  1. Skin.
  2. Connective Tissue (Dense- blood vessels are here (subcutaneous)).
  3. Aponeurosis.
  4. Loose Connective Tissue.
  5. Preriosteum (CT on bone).
26
Q

What is the Clinical Relevance of the Blood Supply to the Scalp?

A

The walls of the arteries are closely attached to the CT, which means if the CT is damaged the arteries will also pull apart causing profuse bleeding. There are also numerous anastomoses increasing the bleeding. Deep lacerations involving the epicranial aponeurosis will cause profuse bleeding due to the opposed pull of the occiptofrontalis.

27
Q

Will a deep Laceration of the Skull cause bone Necrosis?

A

Unlikely as the main blood supply of the skull is via the Middle Meningeal Artery (a branch of the ECA).

28
Q

Name the Superficial Arteries of the Face.

A
  1. Supraorbital Artery (ICA).
  2. Supratrochlear Artery (ICA).
  3. Transverse Facial Artery (ECA).
  4. Angular Artery (ECA).
  5. Lateral Nasal Artery (ECA).
  6. Maxillary Artery (ECA).
  7. Superior and Inferior Labial Artery (ECA).
  8. Facial Artery (ECA).
29
Q

Where can the Facial Artery Pulse be Felt?

A

Inferior border of the mandible, anterior to the masseter muscle.

30
Q

What are the Branches of the Maxillary Artery?

A
  1. Sphenopalatine Artery- nasal septum.

2. Middle Meningeal Artery- skull and dura.

31
Q

Describe the Blood Supply to the Nasal Septum.

A

There is an anastomosis of arteries at the Kiesselbach area. This is a combination of Sphenopalatine and Anterior ethmoidal arteries from the ophthalmic artery.

32
Q

Describe the Blood Supply to the Dura and Skull.

A

At the Pterion (where the bones of the skull join together, creating a thinner layer) there is an increased risk of damage. The Meningeal Artery and its branches supply the dura and skull. TheAnterior branch of the Middle Meningeal Artery creates a foramen Spinosum which is a groove in the skull. The brain is covered by a double layer of dura mater.

33
Q

What would happen in a Rupture of the Middle Meningeal Artery?

A

The Middle Meningeal Artery supplies the skull and dura and thus a fracture of the skull at period can rupture it and cause an extradural haemorrhage. The dura of the skull can peal the skull.

34
Q

What is a Craniotomy?

A

Involves removing the dura mater and the bone flap to gain access to the cranial cavity. The bone and scalp flap is reflected inferiorly to preserve blood supply.

35
Q

Which Superficial Veins accompany their Arteries?

A

Most superficial veins accompany their arteries. Examples include:

  1. Superficial Temporal Veins.
  2. Occipital Veins.
  3. Posterior Auricular Veins.
36
Q

Describe the Supraorbital and Supratrochlear Veins Pathway?

A

The Supraorbital and Supratrochlear veins untie at the medial angle of the eye to form the Angular Vein which Drains into the Facial Vein.

37
Q

Describe the potential pathway of some deep parts of scalp veins.

A

In the temporal region some veins drain into the pterygoid venous plexus.

38
Q

What is the Connection between the Venous Drainage of the Scalp and the Dural Venous Sinuses?

A

Veins of the scalp connect to Diploic veins through several emissary veins (valveless and thus to the dural venous sinuses.

39
Q

What is the Clinical Relevance of the Connection between the Venous Drainage of the Scalp and the Dural Venous Sinuses?

A

Infection from the scalp can thus spread to the cranial cavity and affect the meninges.

40
Q

Describe the Venous Drainage of the Face.

A

Supraorbital vein + Supratrochlear vein + Angular vein +Superior and Inferior Labial Veins-> Facial Vein-> Common Facial vein-> Internal Jugular Vein. External Jugular Vein.

41
Q

What is the Connection between the Facial Veins and the Cavernous Sinus and Pterygoid Venous Plexus?

A

The facial veins are valveless. At the medial angle of the eye the facial vein communicates with the Superior Ophthalmic and drains into the Cavernous Sinus.
Deep Facial Veins drain into the Pterygoid Venous Plexus.

42
Q

What is the Clinical Relevance of the Connection between the facial veins with the Cavernous Sinus and Pterygoid Venous Plexus?

A

Infection from the facial vein can spread to dural venous sinuses. Thrombophlebitis of the facial vein is where an infected clot can travel to the intracranial venous system.

43
Q

Describe the Danger Triangle of the Face.

A

Infections in a triangle in the middle of the face can spread through the venous system to the dural venous sinuses.

44
Q

What do the Sigmoid Sinuses Continue As?

A

Internal Jugular Veins, leaving the skull through the Jugular Foramina.

45
Q

Describe the External and Internal Jugular Veins.

A

The EJV is much easier to see as IJV is under the sternocleidomastoid.

46
Q

Which Jugular Vein gives a better indication of pressure in the RA?

A

IJV.

47
Q

How do you measure Jugular Venous Pressure?

A

Use the Right Internal Jugular Vein as it is effectively a direct connection to the RA. Put the patient at a 45 degree angle with the head slightly to the left. Pulsations can be observed through the scm. It is measured in cmH20. It is the height from the sternal angle + 5cm.

48
Q

Name the holes in the base of the skull and which blood vessels go through them?

A

Carotid Canal- Internal Cartoid Artery
Jugular Foramen- Internal Jugular Vein.
Foramen Spinosum- Middle Meningeal Artery.
Foramen Magnum- Vertebral Artery.

Head and Neck (6 decks)

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