S2 blood vessels

Question 1

superior border of carotid triangle?

importance of the triangle?

Answer 1

posterior belly of digastric muscle

access site for carotid artery which is an important central pulse

Question 2

medial/inferior border of carotid triangle?

Answer 2

superior belly od omohyoid muscle

Question 3

lateral border of carotid triangle?

Answer 3

medial border of sternocleidomastoid

Question 4

what level does bifurcation of common carotid occur?

Answer 4

C4

within carotid triangle

Question 5

what is carotid endarterectomy?

Answer 5

Removal of plaque tissue in the carotid artery
> common site is the bifurcation

make incision in neck and carotid

Question 6

what is carotid sinus massage? when is it performed?

Answer 6

performed if patient is tachycardic>trigger baroreceptors

massage/ put pressure on the site of the carotid bodies (within carotid sinus)

Question 7

importance of internal jugular vein?

Answer 7

• large central vein
• superficial (easy to access)
• good site for central venous line > IV/ theatre
  canulation

Question 8

route of internal carotid arteries

Answer 8

give off no branches in neck
enter base of skull via carotid canal
supplies intracranial structures

Question 9

vertebral arteries arise from? route?

Answer 9

L and R subclavian
ascend up cervical vertebrae (C6-C1) through transverse foramina
enter base of skull via foramen magnum

supply brain with blood

Question 10

internal carotid artery route

Answer 10

passes through carotid canal (temporal bone) through the base and enter skull
enters cranium and makes an S shaped bend
moves through cavernous sinus

Question 11

where is cavernous sinus found

which structures run through?

Answer 11

upper surface of sphenoid bone

• carotid artery
• CN 3 oculomotor
• CN 4 trochlear
• CN 6 abducens
• 2 branches of CN 5 (trigeminal > ophthalmic and maxillary branches)

O TOM CAT

Question 12

branch of internal carotid artery that supplies the scalp?

Answer 12

ophthalmic artery

its branches > supratrocheal artery AND supra-orbital artery

Question 13

branch of internal carotid that supplies optic nerve/ retina

Answer 13

ophthalmic artery
branch>central retinal artery

embolus can lodge here and cause sight loss

Question 14

main branches of internal carotid artery

Answer 14

ophthalmic artery
anterior cerebral artery
middle cerebral artery
posterior communicating artery

Question 15

distribution of external carotid

Answer 15

superior thyroid
ascending pharyngeal
lingual
facial
occipital
posterior auricular
maxillary
superficial temporal

(remember Some Anatomists Like Freaking Out Poor Medical Students)

Question 16

clinical importance of superficial temporal artery

Answer 16

clinical condition:
giant cell arteritis OR temporal arteritis
- frequent headaches
- scalp tenderness over temple (hurt when brushing hair)
- jaw pain when eating
- loss/ vision change

> can lose eyesight if not treated

Question 17

what supplies blood to scalp

Answer 17

internal carotid
>supra-orbital and supratrocheal art

external carotid
> superficial temporal
> posterior auricular
> occipital art

Question 18

layers of scalp

Answer 18

Skin
Connective tissue
Aponeurosis
Loose areolar tissue
Periosteum

(remember S.C.A.L.P)

Question 19

why does scalp bleed a lot?

Answer 19

• artery walls held open by connective tissue so can’t constrict>no elastic recoil
• lots of anastomoses
• deep laceration to occipito frontal muscle can pull cuts open

Question 20

what does maxillary artery supply and its key branches?

Answer 20

maxillary artery is a branch of external carotid. supplies deeper facial structures

its branches:
middle meningeal > supply dura mater (enters via foramen spinosum)
sphenopalatine art> supplies nasal septum (important in nose bleeds)

Question 21

what happens with middle meningeal artery rupture?

Answer 21

occur from blow to side of head
fracture occur in pterion> rupture artery
blood leak into area below
ripping dura mater away from bone wall
> extradural hematoma
- requires craniotomy (open cranium relieve pressure)

Question 22

drainage of scalp?

Answer 22

into dural venous sinus through emissary veins

Question 23

facial vein drains to?

clinical importance?

Answer 23

cavernous sinus

> infection can spread via facial vein and end up in the dural venous sinuses (deep veins)

Question 24

how to test jugular venous pressure?

Answer 24

using R internal jugular vein
- patient at 45 degrees
- head tilt to left
- look for pulsations through SCM muscle
> measure hight from sternal angle and add 5cm to give estimate of right atrial pressure in cmH20

Question 25

what is Amaurosis Fugax?

Answer 25

affects ophthalmic artery (internal carotid)

vision loss from a clot