S3) Major Blood Vessels of the Head and Neck Flashcards

1
Q

What is the anatomical surface landmark that relates to the dotted line A-B in the image below?

A

Angle of Louis (manubrio-sternal angle)

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2
Q

Name the components of the aorta illustrated as H, I and J

A
  • H – ascending aorta
  • I – aortic arch
  • J – descending aorta
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3
Q

Name the blood vessels labelled C, D, E, F and G

A
  • C – Brachiocephalic trunk
  • D – Right common carotid artery
  • E – Right subclavian artery
  • F – Left common carotid artery
  • G – Left subclavian artery
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4
Q

Which arteries arise from the brachiocephalic trunk on the right hand side?

A

Subclavian and common carotid arteries

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5
Q

Which arteries arise from subclavian artery in the base of the neck?

A
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6
Q

What are the branches of the thyrocervical trunk?

A
  • Suprascapular artery
  • Ascending cervical artery
  • Inferior thyroid artery
  • Transverse cervical artery
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7
Q

Which region does the suprascapular artery supply?

A

Suprascapular artery supplies the shoulder

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8
Q

Which region do the ascending and transverse cervical arteries supply?

A

Ascending cervical and transverse cervical arteries supply the neck

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9
Q

Which region does the inferior thyroid artery supply?

A

Inferior thyroid artery supplies lower pole of the thyroid gland

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10
Q

Where do vertebral arteries arise from?

A

Vertebral arteries arise from the subclavian arteries on left & right

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11
Q

Describe the course of the vertebral arteries through the brain

A
  • Ascend in the neck through transverse foramina in C1-6
  • They pass through the foramen magnum
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12
Q

Describe how the vertebral arteries supply the brain

A

The vertebral arteries supply the brain along with the internal carotid arteries which enter the skull through the carotid canal

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13
Q

Which arteries arise from the common carotid artery?

A

Common carotid artery bifurcates to give external and internal carotid arteries

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14
Q

Where does the common carotid bifurcate?

A

The common carotid bifurcates at about the level of the superior border of the thyroid cartilage

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15
Q

Describe the anatomical position of the internal jugular vein

A

The internal jugular lies lateral to the common carotid mostly under sternocleidomastoid

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16
Q

Bifurcation of the carotid artery is a common site for atheroma formation.

What are the consequences of this?

A
  • Causes stenosis of the artery
  • Rupture of the clot can cause an embolus to travel to brain (TIA or stroke)
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17
Q

What is the carotid sinus and what does it do?

A
  • Carotid sinus is a swelling at region of bifurcation
  • Location of baroreceptors for detecting changes in aBP
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18
Q

What is the carotid body?

A

Carotid body is a group of peripheral chemoreceptors which detect arterial O2

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19
Q

Which neurovascular structures can be accessed through the carotid triangle?

A
  • Carotid arteries
  • Internal jugular vein
  • Vagus nerves
  • Hypoglossal nerves
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20
Q

Which pulse can be felt in the carotid triangle?

A

Carotid pulse can be felt in carotid triangle just below bifurcation

21
Q

What is the carotid sinus massage and what does it do?

A
  • The carotid massage involves gently massaging the carotid artery
  • Pressure in the area of carotid sinus quickly reduces heart rate (alleviates supra-ventricular tachycardias)
22
Q

Describe the course of the internal carotid artery through the head and neck

A
  • Enters skull through carotid canal
  • Turns medially and horizontally
  • Enters the cranial cavity then bends (S-shaped) to course through the cavernous sinus
23
Q

What is the cavernous sinus?

A

Cavernous sinus is a plexus of extremely thin-walled veins on upper surface of sphenoid

24
Q

Identify 6 neurovascular structures in the cavernous sinus

A
25
Q

The ophthalmic artery branches from the internal carotid artery.

Identify its two main branches

A
  • Supratrochlear artery
  • Supraorbital artery
26
Q

Identify the 6 branches of the external carotid artery

A
  • Facial
  • Lingual
  • Occipital
  • Ascending pharyngeal
  • Posterior auricular
  • Superior thyroid
27
Q

Identify the two terminal branches of the external carotid artery

A
  • Superficial temporal
  • Maxillary
28
Q

Describe the nature of the blood supply to the scalp

A
  • Rich blood supply with many anastomoses
  • Largely branches of external carotid artery
29
Q

Describe the anatomical position of scalp blood vessels

A

Vessels of the scalp lie in the subcutaneous connective tissue layer

30
Q

Where does the skull get its blood supply from?

Why is this significant?

A
  • Mostly middle meningeal artery, the terminal branch of the maxillary artery
  • Hence, loss of blood from scalp does not lead to bone necrosis
31
Q

What are the consequences of a rupture to the skull?

A

Fracture of skull at pterion can cause the middle meningeal artery (supplies skull and dura) to rupture i.e. extradural haemorrhage

32
Q

Where do the superficial arteries of the face arise from?

A
  • All arise from the external carotid artery
  • Exception: supra-orbital and supratrochlear artery arise from internal carotid artery
33
Q

Where can the facial pulse be felt?

A

Facial artery pulse can be felt at inferior border of mandible, anterior to the masseter muscle

34
Q

Identify the two most important branches in the nasal septum

A
  • Septal branch of sphenopalatine artery (from maxillary artery)
  • Anterior ethmoidal arteries (from ophthalmic artery)
35
Q

Why is the Kiesselbach area in the nasal septum a common site for epistaxis?

A
  • Anastomosis of arteries in Kiesselbach area
  • Hence prone to nose bleeds
36
Q

What is a craniotomy and how is it performed?

A
  • Craniotomy is a procedure used to gain access to cranial cavity
  • The bone and scalp flap are reflected inferiorly to preserve blood supply
37
Q

Identify the 3 superficial veins draining the scalp

A
  • Superficial temporal veins
  • Occipital veins
  • Posterior auricular veins
38
Q

Describe the structures involved in the venous drainage of the scalp

A
  • Supraorbital and supratrochlear veins unite at medial angle of eye to form angular vein (drains into the facial vein)
  • Deep parts of scalp in temporal region have veins which drain into the pterygoid venous plexus
39
Q

What is unique attribute of facial veins?

A

Veins of the face are valveless

40
Q

Describe the drainage of the facial vein

A

At medial angle of eye the facial vein communicates with superior ophthalmic vein and drains into the cavernous sinus

41
Q

Describe the clinical significance of the deep facial veins draining into pterygoid venous plexus

A
  • Infection from facial vein can spread to dural venous sinuses
  • Infected clot can travel to intracranial venous system i.e. thrombophlebitis of facial vein
42
Q

What is the danger of the triangle of the face?

A

Infections in this region of the face can spread through the venous system to the dural venous sinuses

43
Q

The sigmoid sinus is a dural venous sinus.

Describe its anatomical course

A

The sigmoid sinuses continue as the internal jugular veins, leaving the skull through the jugular foramina

44
Q

Why is the external jugular vein easier to see?

A

The internal jugular vein lies under sternocleidomastoid

45
Q

The internal jugular vein is a better indication of pressure in the right atrium.

How is this measured?

A
  • Right IJV used
  • Pulsations observed through muscle
  • Measured in cmH2O
  • Height from sternal angle + 5cm
46
Q

Why might a doctor wish to listen over the carotid artery with a stethoscope?

A
  • Check for degree of stenosis
  • Listening for carotid bruit (systolic sound indicating turbulent blood flow)
47
Q

Why is it helpful for a patient to hold his/her breath during auscultation of the carotid arteries?

A

Noise of breathing disrupts transmittent sounds

48
Q

Name the holes in the base of the skull through which the following vessels travel:

  • Internal carotid artery
  • Internal jugular vein
  • Middle meningeal artery
  • Vertebral artery
A
  • Internal carotid artery: carotid canal

- Internal jugular vein: jugular foramen

  • Middle meningeal artery: foramen spinosum
  • Vertebral artery: foramen magnum