test 4 Flashcards
1
Q
The vascular system of the head and neck, as is the case in the rest of the body, consists of
A
an arterial blood supply, a capillary network, and venous drainage.
2
Q
An artery is
A
the component of the vascular system that arises from the heart, carrying blood away from it.
3
Q
Each artery starts as a large vessel and branches into smaller vessels called?
A
arteriole
4
Q
Each arteriole branches into even smaller vessels until it becomes
A
a network of capillaries.
5
Q
each capillary is smaller than an arteriole but can supply blood to a larger tissue are area bc
A
there are so many of them
6
Q
A vein is
A
another component of the vascular system.
7
Q
a vein travels
A
to the heart and carries blood
8
Q
valves are in the veins are
A
mostly absent in the head and neck area, unlike in the rest of the body
9
Q
smaller veins are called?
A
venule
10
Q
venules drain?
A
capillaries of the tissue area
11
Q
venules coalesce to become?
A
larger veins
12
Q
superficial veins found ?
A
immediately deep to the skin
13
Q
deeper veins usually accompany
A
larger arteries in a more protected location within the tissue
14
Q
larger network of blood vessels called?
A
plexus
15
Q
head and neck are contain what type of important plexuses?
A
venous plexuses
16
Q
blood vessels communicate with each other by a connecting channels among vessels by
A
anastomosis
17
Q
what are venous sinuses?
A
blood filled spaces between two layers of tissue
18
Q
venous networks connected by?
A
anastomoses
19
Q
For the left side of the body, the common carotid and subclavian arteries arise
A
directly from the aorta
20
Q
For the right side of the body, the common carotid and subclavian arteries are both branches from
A
the brachiocephalic artery
21
Q
The brachiocephalic artery is a direct branch of the
A
aorta
22
Q
does the common carotid artery have branches?
A
no it is branchless
23
Q
how does the common carotid artery end?
A
by dividing into the internal and external carotid arteries at about the level of the laryn
24
Q
Just before the common carotid artery bifurcates into the internal and external carotid arteries
A
it exhibits a swelling, the carotid sinus
25
subclavian artery arises?
lateral to the common carotid artery
26
The internal carotid artery is a division that travels
superiorly in a slightly lateral position (in relationship to the external carotid artery) after leaving the common carotid artery
27
internal carotid artery supplies?
intracranial structures and is the source of ophthalmic artery which supplies eye, orbit, and lacrimal gland
28
external carotid artery begins?
superior border of the thyroid cartilage, at the termination of the common carotid artery and the carotid sheath.
29
external carotid artery travels
ls superiorly in a more medial position (in relationship to the internal carotid artery) after arising from the common carotid artery
30
external carotid artery supplies?
extracranial tissue of the head and neck, including the oral cavity.
31
sets of branches of the external carotid artery?
anterior, medial, posterior, and terminal (named bc of location)
32
how many branches does the anterior branch from the external carotid artery have? name them..
3: superior thyroid, lingual, and facial branches
33
branches of the superior thyroid artery (anterior branch of the external carotid artery)
four branches: the infrahyoid artery, the sternocleidomastoid branch, the superior laryngeal artery, and the cricothyroid branch
34
lingual artery arises from? (anterior branch from the external carotid artery)
superior to the superior thyroid artery at the level of the hyoid bone
35
lingual artery travels (anterior branch of the external carotid artery)
anteriorly to the apex of the tongue by the way of its inferior surface
36
lingual artery supplies?
the tissue superior to the hyoid bone including the suprahyoid muscles and floor of the mouth
37
sublingual artery supplies?
the mylohyoid muscle, sublingual salivary gland, and mucous membranes of the floor of the mouth.
38
facial artery/external maxillary artery belongs to which branch?
final anterior branch from the external carotid artery
39
facial artery arises?
slightly superior to the lingual artery as it branches off anteriorly; however, sometimes the facial and lingual arteries share a common trunk
40
path of the facial artery
complicated path as it runs medial to the mandible, over the submandibular salivary gland, and then around the mandible’s inferior border to its lateral side
41
from the inferior border of the mandible facial artery runs
anteriorly and superiorly near the angle of the mouth and along the side of the nose.
42
where does facial artery terminate?
medial canthus
43
major branches of facial artery?
the ascending palatine, the glandular branches, the submental, the inferior labial, the superior labial, and the angular
44
1st branch of the facial artery? (anterior branch of external carotid artery)
ascending palatine
45
what is the terminal branch of the facial artery
angular artery
46
how many branches does the medial branch of external carotid artery have? name them
just one; the small ascending pharyngeal artery
47
ascending pharyngeal artery arises?
arises close to the origin of the external carotid artery and cannot be seen in most lateral views of the head and neck
48
branches of the ascending pharyngeal artery
many small branches that include the pharyngeal branch and meningeal branch
49
what are the posterior branches of the external carotid artery?
occipital and posterior auricular
50
terminal branches of the external carotid artery?
superficial temporal and maxillary
51
which branch is the smallest of the terminal branches?
superficial temporal artery is the smaller of the 2
52
branches of the superficial temporal artery
several branches including the transverse facial artery, the middle temporal artery, the frontal branch, and the parietal branch
53
maxillary artery also called>
internal maxillary artery
54
what is the first part of the maxillary artery
mandibular part
55
first part of maxillary artery begins? (mandibular part)
begins at the neck of the mandibular condyle within the parotid salivary gland
56
second party of maxillary artery runs?
between the mandible and the sphenomandibular ligament anteriorly and superiorly through the infratemporal foss
57
middle meningeal artery supplies? Passes thru?
the meninges of the brain by way of the foramen spinosum, located on the inferior surface of the skull, as well as the skull bones
58
inferior alveolar artery arises from? And where?
arises from the maxillary artery in the infratemporal fossa
59
inferior alveolar artery gives rise to? and where?
dental and alveolar branches in mandibular canal
60
mylohyoid artery arises?
from the inferior alveolar artery before the main artery enters the mandibular canal by way of the mandibular foramen
61
mental artery arises?
from the inferior alveolar artery and exits the mandibular canal by way of the mental foramen
62
incisive artery branches off what artery? and then does what?
inferior alveolar artery, remaining within the mandibular canal to divide into dental and alveolar branches
63
deep temporal arteries supplies
the anterior and posterior parts of the temporalis muscle
64
pterygoid arteries supplies?
the lateral and medial pterygoid muscles
65
masseteric artery supplies
masseter muscle
66
buccal artery supplies
the buccinator muscle and other soft tissues of the cheek
67
After traversing the infratemporal fossa, the maxillary artery enters
the pterygopalatine fossa, which is deep and inferior to the eye
68
Just as the maxillary artery leaves the infratemporal fossa and enters the pterygopalatine fossa as the third part (or pterygopalatine part), it gives rise to
it gives rise to the posterior superior alveolar artery.
69
posterior superior alveolar artery enters where to give rise to dental and alveolar branches?
the posterior superior alveolar foramina on the maxillary tuberosity
70
what artery also branches from the third part of the maxillary artery in the pterygopalatine fossa and may share a common trunk with the posterior superior alveolar artery
infraorbital artery
71
after infraorbital artery gives off branches in infraorbital canal it then does what?
,the infraorbital artery emerges onto the face from the infraorbital foramen
72
anterior superior alveolar artery arise
from the infraorbital artery and gives rise to dental and alveolar branches
73
pterygopalatine fossa, the third part of the maxillary artery gives rise to
descending palatine artery
74
descending palatine artery travels?
to the palate through the pterygopalatine canal
75
descending palatine artery supplies?
hard and soft palates
76
descending palatine artery terminates?
in both the greater palatine and lesser palatine artery
77
maxillary artery ends?
by becoming the sphenopalatine artery, its main terminal branch
78
sphenopalatine artery 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
79
wing-like projections off side of nose
ala
80
external nose consist of ?
soft tissue and cartilage
81
Nostrils, lateral border is ala
nares
82
tip of nose
apex
83
Part of it is cartilage which connects to bony nasal septum
nasal septum
84
(AKA nasal aperature)-pear-shaped anterior opening of nasal caviity
piriform aperature
85
3 “shelves” that project inward toward the nasal septum
nasal conchae (superior, middle, and inferior)
86
inside lining of nose has hair like projection that move together in a beating pattern called?
cilia
87
purpose of cilia
trap contaminants as they enter the nasal cavity & to move them forward so that they can be blown out
88
why is nasal conchae important to cilia
conchae are an important part of this process because they provide a large surface area on which to trap the foreign matter
89
nasal septum bony part made of
vomer and ethmoid bone (perpendicular plate)
90
Small projection of the maxilla at the bottom of the piriform aperature
anterior nasal spine
91
Cribiform plate of the Ethmoid located
on superior border of nasal cavity
92
cribiform plate of ethmoid bone has small holes that?
open into anterior cranial fossa
93
posterior nasal aperature is
(choana) opening at back of nasal cavity
94
posterior nasal spine is
pointy bony projection at posterior end of hard palate
95
nasolacrimal duct is
an opening into the nasal cavity from the eye; excess tears drain thru the lacrimal fossa through this duct & into nose-that’s why nose runs when you cry
96
opening from auditory tube
opens into the nasal part of the pharynx; that is how you can “pop” your ears by holding your nose & blowing
97
paranasal sinuses are
air-filled cavities in bone; paired
98
purpose of paranasal sinuses?
–To lighten the bones of the skull
–Act as sound resonators when speaking
–Provide mucous for the nasal cavity
99
names of paranasal sinuses are derived from
bones in which they are located
100
Ostia is
the openings from the paranasal sinuses into the nasal cavity
101
is cilia found in lining of paranasal sinuses
yes
102
cilia in paranasal sinuses beat in direction of
ostia; promoting drainage of the accumulating fluids; location of the ostia do not favor drainage in the upright position (except for frontal sinus
103
why can paranasal sinuses become easily infected
due to their openings into the nasal cavity-bacteria from the nasal cavity multiply rapidly because of the warm, moist mucosa in these sinuses& causes “sinus infection
104
Sinusitis is
the mucosa of the sinuses become inflamed as a result of sinus infection; this blocks normal drainage of fluid causing infection to worsen; this accumulation of fluid in the sinuses is what causes feeling of pressure with sinus infection. Sinusitis is also what blocks breathing
105
Maxillary Sinus occupies
s much of the interior of the maxilla
106
largest paranasal sinuses
maxillary sinus
107
if one side of maxillary sinus is block you may be able to
lay down on opposite side to promote drainage from blocked side
108
ostia of maxillary sinus located?
near the top, which makes it difficult to drain
109
maxillary sinus important in dentistry bc
its close proximity to maxillary teeth
110
If infections occur frequently in maxillary sinus, an ear, nose, & throat specialist
an make an opening near base of sinus to promote better drainage
111
ASA, MSA, and PSA innervate
maxillary teeth and maxillary sinus
112
why does often sinus infection feels like toothache
. Normally, the maxillary sinus does not send out any PPTT info. to the brain; usually these sensations traveling along these nerves come from the max. teeth (during eating or whatever); When there is a sinus infection, the sinus sends a message of pain & pressure along these same nerves to the brain. However, since the brain normally only gets messages from the teeth, it assumes this message is also from the teeth, & the patient thinks he/she has a toothache. An x-ray will help rule toothache out; review medical history-frequent sinus infection
113
Relationship of floor of maxillary sinus to roots of maxillary teeth
often, the floor of the max. sinus dips down around the tips of max. posterior roots. Therefore, periapical infection of a max. post. tooth may involve the max. sinus
114
dilacerated roots means
curved
115
maxillary sinus may also
dip between roots of a maxillary molar`
116
when maxillary posterior teeth are extracted what happens to maxillary sinuses
they tend to enlarger and fill in space where roots were
117
Blood supply to max. sinus
anterior , middle, & posterior superior alveolar branches of max. artery
118
Nerve supply to maxillary sinus
anterior, middle, & posterior superior alveolar nerves of max. division of trigeminal
119
Frontal sinus located
in frontal bone just above the orbital cavity; infections here cause pressure & pain just above the eye
120
Ethmoid air cells is
numerous, small sinus compartments located in the ethmoid bone
121
infection in ethmoid air cells difficult to treat bc
so many small compartments; when infected, pain & pressure in nasal are
122
Sphenoid sinus (another paranasal sinus) located
in sphenoid bon
123
infection in sphenoid sinus causes
s pressure that is hard to localize but is deep in midline of head
124
Infections in ethmoid air cells or sphenoid sinus can be dangerous due to close proximity to:
Cavernous sinus-one of the venous dural sinuses that are located in brain tissue (will discuss these in next unit)
2.Optic nerve-cranial nerve responsible for sig
125
The veins of the head and neck start out as small venules and become
larger as they near the base of the neck on their way to the heart
126
The veins of the head and upper neck are usually
symmetric in their coverage on each side of the body but have a greater variability in location than do the arteries, anastomosing freely
127
Veins are also generally larger and
more numerous than arteries in the same tissue area
128
internal jugular vein drains
the brain as well as most of the other tissue of the head and neck
129
external jugular vein drains
only a small part of the extracranial structures
130
internal jugular vein and external jugular vein have many
anastomoses
131
facial vein drains
into the internal jugular vein.
132
facial vein begins? With junction with?
at the medial canthus of the eye with the junction of two veins from the frontal region, the supratrochlear vein and supraorbital vein.
133
The supraorbital vein also anastomoses with
the ophthalmic veins
134
ophthalmic veins drain
the orbit
135
anastomosis of ophthalmic veins provides direct communication with
cavernous sinus
136
anastomosis and one-way direction of blood flow may allow cavernous sinus to become..
fatally infected through the spread of dental infection
137
the facial vein receives branches from
the same areas of the face that are supplied by the facial artery
138
The facial vein anastomoses with
the deep veins such as the pterygoid plexus of veins in the infratemporal fossa and with the large retromandibular vein before joining the internal jugular vein at the level of the hyoid bone
139
submental vein drains
the tissue of the chin as well as the submandibular region
140
superior labial vein drains
the upper lip
141
inferior labial vein drains
lower lip
142
sublingual vein that drains
the floor of the mouth
143
dorsal lingual veins drains
dorsal surface of the tongue
144
describe deep lingual vein; drains?
highly visible branching blue; noted during an intraoral examination ; drains ventral surface of the tongue
145
lingual veins drain into?
indirectly into the facial vein or directly into the internal jugular vein
146
lingual veins may join to form
single vessel or may empty into larger vessels separately
147
lingual veins are important clinically bc
they are capable of rapid and direct topical drug absorption
148
retromandibular vein forms
the external jugular vein from a part of its route
149
The retromandibular vein is formed from
from the merger of the superficial temporal vein and maxillary vein
150
The retromandibular vein emerges from
the parotid salivary gland and courses inferiorly
151
retromandibular vein and its beginning venules drain
areas similar to those supplied by the superficial temporal and maxillary arteries
152
retromandibular vein usually divides into 2 parts where?
Anterior and posterior. Divides inferior to the parotid salivary gland
153
anterior division of retromandibular vein joins
facial vein
154
posterior division of retromandibular vein continues its inferior course
on the surface of the SCM muscle
155
posterior auricular vein drains
the lateral scalp posterior to the ear
156
posterior retromandibular veins joins posterior auricular vein and becomes?
external jugular vein
157
superficial temporal vein drains
lateral scalp
158
superficial temporal vein is located
superficially in skin covering the temporal region and can sometimes be noted on a patient during an extraoral examination.
159
superficial temporal vein goes on to drain into and form the
retromandibular vein, along with the deeper maxillary vein
160
maxillary vein is deeper than
superficial temporal vein
161
maxillary vein begins within
infratemporal fossa by collecting blood from the pterygoid plexus of veins, while accompanying the maxillary artery
162
Through the pterygoid plexus, the maxillary vein receives
middle meningeal, posterior superior alveolar, inferior alveolar veins, and other veins such as those from the nasal cavity and palate, which are served by the maxillary artery
163
after receiving middle meningeal, posterior superior alveolar, inferior alveolar veins, maxillary vein merges with?
merges with the superficial temporal vein
164
after maxillary vein merges with the superficial temporal vein it drains into and forms?
retromandibular vein
165
The pterygoid plexus of veins is? located?
a collection of small anastomosing vessels located around the pterygoid muscles and surrounding the second part (or pterygoid part) of the maxillary artery on each side of the face within the infratemporal fossa
166
pterygoid plexus anastomoses with ?
facial and retromandibular veins
167
pterygoid plexus of veins protects?
protects the maxillary artery from being compressed during mastication; by either filling or emptying, the pterygoid plexus can accommodate changes in volume within the infratemporal fossa that occur when the mandible undergoes movement
168
the pterygoid plexus of veins drains
the veins from the deep parts of the face and then drains into the maxillary vein.
169
The middle meningeal vein drains
blood from both the dura mater of the meninges (not the arachnoid or pia mater) and the bones of the cranial vault into the pterygoid plexus of veins
170
if posterior superior alveolar block is incorrectly administered its a possibility of piercing?
pterygoid plexus of veins or possibly the nearby maxillary artery
171
Some parts of the pterygoid plexus of veins are near
maxillary tuberosity, reflecting the drainage of dental tissue into the vascular plexus.
172
pterygoid plexus draiins which alveolar vein
posterior superior alveolar vein
173
posterior superior alveolar vein formed by
merging of its dental and alveolar branches
174
inferior alveolar vein forms from?
merging of its dental branches, alveolar branches, and mental branches in the mandible
175
inferior alveolar vein drains into
the pterygoid plexus of veins
176
The mental branches of the inferior alveolar vein enter
mental foramen
177
before inferior alveolar vein enters mental foramen it does what?
drains the chin area on the outer surface of the mandible, where they anastomose with branches of the facial vein.
178
The venous sinuses in the brain are located
in the meninges (within dura mater)
179
meninges are
Connective tissue coverings which enclose the brain and spinal cord; filled with cerebrospinal fluid & therefore, provide a shock absorber between the CNS & bone
180
dura mater is
outer layer-dense connective tissue that lines the inside of the cranium
181
arachnoid membrane
between dura& cerebrospinal fluid (Between the arachnoid membrane and pia mater there is a space filled with cerebrospinal fluid called the Subarachnoid space.
182
pia mater
closely adhere to surface of brain, across gyri& into sulci and fissures
183
Dura mater is further divided into
fibrous dura(periosteal dura) on outside & meningeal layer, the inner layer of dura
184
In most places the 2 layers of dura mater are
side by side with no spaces in between.
185
areas with spaces in between 2 layers of dura mater are?
venous dural sinuses
186
dural sinuses are channels
by which blood is conveyed from the cerebral veins into the veins of the neck, particularly the internal jugular vein
187
The venous sinus most important to dental care is? located?
the paired cavernous sinus located on the lateral surface of the body of the sphenoid bone
188
Each cavernous sinus communicates by
anastomoses with its contralateral sinus and also with the pterygoid plexus of veins and superior ophthalmic vein, which anastomoses with the facial vein as discussed earlier
189
paired intercavernous sinuses, with an anterior and a posterior position, connect
the two cavernous sinuses across the midline
190
what cranial nerves and artery pass through the blood-filled space of the cavernous sinus
The internal carotid artery and certain cranial nerves (III, IV, V1, V2, and VI)
191
cavernous sinus important to dental professionals why?
cavernous sinus may be involved with the spread of dental (or odontogenic) infection
192
fatal results of cavernous sinus can include?
cavernous sinus thrombosis
193
internal jugular vein drains most of
the structures of the head and neck
194
internal jugular vein originates in? leaves through?
the cranial cavity and leaves the skull through the jugular foramen
195
internal jugular vein receives many tributaries including veins from?
the lingual, sublingual, and pharyngeal areas as well as the facial vein.
196
internal jugular vein runs
with the common carotid artery and its branches as well as the vagus nerve in the carotid sheath
197
Within the carotid sheath, the deep cervical group of lymph nodes forms
a chain along the internal jugular vein
198
The internal jugular vein descends in
the neck to merge with the subclavian vein.
199
The posterior division of the retromandibular vein becomes
the external jugular vein
200
The external jugular vein continues the descent _____ along the neck
inferiorly
201
external jugular vein terminates in the
subclavian vein
202
The anterior jugular vein drains into? before it joins?
the external jugular vein (or directly into the subclavian vein) before it joins the subclavian vein
203
The anterior jugular vein begins
inferior to the chin
204
anterior jugular vein descends near
the midline within the superficial fascia, receiving branches from the superficial cervical structures
205
Only one anterior jugular vein may be present, but
usually two veins are present, anastomosing with each other through a jugular venous arch
206
Usually the external jugular vein is visible as it crosses
the large SCM muscle
207
On each side of the body, the external jugular vein joins
the subclavian vein from the arm, and then the internal jugular vein merges with the subclavian vein to form the brachiocephalic vein
208
he brachiocephalic veins unite to form
the superior vena cava and then travel to the heart
209
Because the superior vena cava is on the right side of the heart, the brachiocephalic veins are
asymmetric
210
The right brachiocephalic vein is short and
vertical in placement
211
the left brachiocephalic vein is long and
horizontal in placement
212
route of blood from heart to teeth and back (right maxillary central)
Blood travels from heart-Ascending aorta-Brachiocephalic trunk-Common carotid artery-External carotid artery-Maxillary artery-Infraorbital artery-Anterior Superior Alveolar branch-Thru apical foramen to pulp of right maxillary central
213
Route of Blood from Heart to Teeth (Right Max Central) and Back
Dental branches of the Posterior Superior Alveolar Vein-Pterygoid plexus of veins-Maxillary vein-Retromandibular vein-Internal jugular vein-Jugular foramen-Internal jugular vein descends the neck in the carotid sheath -Blood goes through brachiocephalic vein and then back to heart
214
The narrowing and blockage of the arteries can cause
pathologic changes that impact the head and neck with dental care
215
what is atherosclerosis
a buildup of fatty arterial plaque, which consists of mainly cholesterol, as well as calcium, clotting proteins, and other substances
216
when atherosclerosis happens in arteries leading to heart the result is
cardiovascular disease
217
Blood vessels may also become compromised in certain disease processes such as? and may lead to?
high blood pressure, infection, trauma, or endocrine pathology; leading to vascular lesions
218
one of lesions leading from blood vessels being compromised?
a clot or thrombus that forms on the inner vessel wall
219
a thrombus may dislodge from
the inner vessel wall and travel as an embolus
