vascular and nervous system

Question 1

1. what classification of basic tissues is the vascular system
2. define arteries
3. define arterioles
4. define capillaries
5. define venules
6. define veins

Answer 1

1. connective tissue
2. blood vessels that ARISE from the heart and carry blood AWAY
3. Smaller than an artery, further away from the heart
4. smallest blood vessel; arterioles drain into them, blood then drains into venules
5. smaller veins that drain the capillaries, form larger veins
6. carry blood BACK to the heart

Question 2

describe veins in the head and neck (5)

Answer 2

• do not usually have valved
• can lead to two-way flow of blood that is dictated by blood pressure
• lack of valves allow dental infections to spread more readily
• veins are larger and more numerous than arteries
• veins anastomose/communicate and are variable from person to person

Question 3

1. define plexus
2. define anastomosis
3. define venous sinus
4. is blood vessel supply one-to-one or regional

Answer 3

1. large network of blood vessels
2. blood vessel communication
3. blood filled spaces between two layers of tissue
4. REGIONAL unlike the one-to-one relationship like nerves

Question 4

describe the arteries coming directly off of the heart and how they differ from left/right

Answer 4

• ON THE RIGHT: right common carotid and the right subclavian branch off the brachiocephalic
• ON THE LEFT: left common carotid and left subclavian arteries come directly off of the aorta

Question 5

describe the common carotid artery

Answer 5

• branchless and travels superiorly in neck
• travels in the carotid sheath deep to SCM WITH the internal jugular vein and the vagus nerve (CNX)
• divides into internal carotid (lateral) and external carotid (medial) at the level of the larynx
• before splitting, the swelling is called the carotid sinus

Question 6

1. does the internal carotid have branches in the head and neck
2. where does the internal carotid enter the skull
3. what does the internal carotid supply
4. what does the internal carotid artery SOURCE and where does it travel

Answer 6

1. NO, NO BRANCHES IN HEAD AND NECK
2. internal carotid artery enters the skull via the carotid canal
3. the internal carotid artery supplies INTRAcranial structures
4. the internal carotid canal branches into the ophthalmic artery/ is the SOURCE of the ophthalmic artery which travels through the optic canal

*ophthalmic artery supplies the eyes, lacrimal gland, forehead, and orbit

Question 7

1. what does the external carotid artery supply
2. how many branches does the external carotid artery have and what are they

Answer 7

1. the external carotid artery supplies EXTRAcranial tissues AND the oral cavity
2. 4 sets of branches (anterior, medial, posterior, terminal) they are grouped by location in relation to the main artery

Question 8

1. what are the ANTERIOR branches of the external carotid artery
2. what are the MEDIAL branches of the external carotid artery
3. what are the POSTERIOR branches of the external carotid artery
4. what are the TERMINAL branches of the external carotid artery

Answer 8

1. superior thyroid artery, lingual artery, and facial artery
2. ascending pharyngeal artery
3. occipital artery and posterior auricular artery
4. superficial temporal artery and maxillary artery

Question 9

1. what are the further branches of the SUPERIOR THYROID artery (4)
2. what does the superior thyroid artery supply (4)

Answer 9

1. infrahyoid artery, sternocleidomastoid artery, superior laryngeal artery, and cricothyroid artery
2. infrahyoid muscles, SCM muscle, larynx muscles, and thyroid gland > tissues inferior to the hyoid

Question 10

1. what are the further branches of the LINGUAL artery (5)
2. what does the lingual artery supply
3. where does the lingual artery start and where does it travel to

Answer 10

1. dorsal lingual arteries, deep lingual arteries, sublingual artery, suprahyoid branch, and tonsillar branch
2. • suprahyoid muscles via suprahyoid branch
   • lingual tonsils and soft palate via tonsillar branch
   • mylohyoid muscle, sublingual salivary gland, floor of the mouth, lingual periodontium, and gingiva of mandibular teeth via sublingual artery
   • base and body of the tongue via dorsal/deep lingual arteries
3. start at the hyoid bone and travels to the apex of the tongue

Question 11

1. describe the path of the facial artery after branching off of the external carotid
2. what does it supply (general)
3. what are the further branches of the FACIAL artery; are they cervical or facial branches
4. what does the facial artery supply specifically

Answer 11

1. arises MEDIAL to the mandible, travels over the submandibular salivary gland, goes around the lateral/inferior border of the mandible, travels up the labial commissure and naris of the nose until it terminates at the medial canthus of the eye
2. features of the face
3. ascending palatine artery (cervical), submental (cervical) artery, inferior labial artery (facial), superior labial artery (facial), angular (facial)
4. • soft palate, palatine muscles, and palatine tonsils via ascending palatine artery (cervical)
   • submandibular lymph nodes, submandibular gland, mylohyoid and digastric muscles via submental artery (cervical)
   • lower lip via inferior labial artery (facial)
   • upper lip via superior labial artery (facial)
   • side of the nose via angular artery (facial)

Question 12

1. what artery supplies the sublingual glands
2. what artery supplies the submandibular glands
3. what artery supplies the parotid gland

Answer 12

1. external carotid > lingual artery > sublingual artery > sublingual gland
2. external carotid > facial artery > submental artery > submandibular gland
3. external carotid > superficial temporal artery > transverse facial artery > parotid gland

Question 13

1. what is the only medial branch of the external carotid artery
2. what are the branches
3. what structures does it specifically supply
4. what artery does it anastomose with

Answer 13

1. Ascending pharyngeal artery
2. pharyngeal branches, meningeal branches, and tonsillar branches
3. • pharyngeal wall, soft palate, and meninges via pharyngeal and meningeal branches
4. the ascending pharyngeal artery anastomoses with the ascending palatine artery

Question 14

1. what are the branches of the occipital artery
2. what do they supply

Answer 14

1 and 2
- posterior portion of the scalp *
- muscular branches supply the SCM, trapezius, and the suprahyoid muscles*

Question 15

1. what are the branches of the posterior auricular artery
2. what do they supply

Answer 15

1 and 2
- auricular branch supplies the auricular region (internal ear) *
- stylomastoid artery supplies the mastoid process

Question 16

1. where does the superficial temporal artery arise

2 . what general area does it supply

3. what are the branches of the superficial temporal artery and what do they supply

Answer 16

1. the superficial temporal artery arises in the parotid gland
2. it supplies the skin of the temporal region

3.- transverse facial artery supplies parotid gland
- middle temporal artery supplies the temporalis muscle
- frontal branch supplies the frontal region of the scalp
- parietal branch supplies the parietal region of the scalp

Question 17

1. what is the largest and most complicated artery
2. what does the maxillary artery supply generally
3. where does the maxillary artery arise
4. where does the maxillary artery travel

Answer 17

1. MAXILLARY ARTERY!
2. supplies the maxilla, mandible, and nasal cavity
3. in the parotid salivary gland; IT DOES NOT SUPPLY IT
4. runs between the mandible and the sphenomandibular ligament

Question 18

1. the first part of the maxillary artery branches off into what? what do each artery supply

Answer 18

1. • deep auricular artery: auricular region and outer surface of tympanic membrane
   • anterior tympanic artery: tympanic region and inner surface of tympanic membrane
   • middle meningeal artery: dura mater of the brain and cranial bones
   • accessory middle meningeal artery: same as middle meningeal and infratemporal fossa structures
   • inferior alveolar artery

Question 19

1. what are the further branches of the inferior alveolar artery and what does it supply

Answer 19

1. • dental/alveolar branches: mandibular posterior teeth, buccal periodontium and gingiva
   • mylohyoid artery: floor of the mouth and mylohyoid muscle
   • mental artery: mental region
   • incisive artery: mandibular anterior teeth with labial periodontium and gingiva

Question 20

1. what are the branches of the SECOND part of the maxillary artery and what do they supply

Answer 20

1. • deep temporal artery > anterior and posterior branches > temporal region and temporalis muscle
   • pterygoid artery: lateral and medial pterygoid muscle
   • masseteric artery: masseter muscle
   • buccal artery: buccinator muscle and buccal region

Question 21

1. what are the branches of the THIRD part of the maxillary artery and what do they supply

Answer 21

1. • posterior superior alveolar artery

• infraorbital artery
  > orbital and terminal branches: orbital and infraorbital regions
  > anterior superior alveolar artery: maxillary anterior teeth with labial periodontium and gingiva
  > middle superior alveolar artery (if present): maxillary premolars with buccal periodontium and gingiva
• descending palatine artery
  > greater and lesser palatine arteries: posterior hard palate with palatal periodontium and gingiva of maxillary posterior teeth and soft palate
• sphenopalatine artery
  > posterior lateral nasal and septal branches: nasal region and nasal cavity
  > nasopalatine: anterior hard palate with palatal periodontium and gingiva of maxillary anterior teeth

Question 22

The maxillary artery begins in the _____ of the _____ within the _____ gland. It runs between the _______ and the ______________ ligament and then into the ____________ fossa. within the fossa the artery gives off/branches into ______________ and ______________

Answer 22

The maxillary artery begins in the NECK of the CONDYLE within the PAROTID gland. It runs between the MANDIBLE and the SPHENOMANDIBULAR ligament and then into the INFRATEMPORAL fossa. Within the fossa, the artery gives off/branches into the MIDDLE MENINGEAL ARTERY, and the INFERIOR ALVEOLAR ARTERY

Question 23

REGARDING THE INFERIOR ALVEOLAR ARTERY
- where does it arise
- where does it travel to
- what does it provides blood supply for

Answer 23

1. arises in the infratemporal fossa
2. travels inferiorly to the mandibular canal
3. provides blood supply to the mandible, mandibular teeth, floor of the mouth, and the mental region including the pulps and periodontium of the mandibular teeth on the side of the jaw

Question 24

what are the major branches of the inferior alveolar artery and where does it go/what do they supply

Answer 24

mylohyoid artery: branches off before entry into the mandibular canal > supplies the floor of the mouth

mental artery: branches off before mandibular canal and through the mental foramen > supplies the chin

incisive artery: branches from the inferior alveolar artery and remains in the mandible > supplies blood to the pulps of the anterior teeth/periodontium/and gingiva.

Question 25

what does the incisive artery anastomosis with

Answer 25

the incisive artery on the other side of the jaw

Question 26

the second part of the maxillary artery supplies MUSCLES, the arteries are named after them, what are they (4)

Answer 26

- deep temporal: temporalis muscle - pterygoid: medial and lateral pterygoid muscle - masseteric artery: masseter muscle - buccal artery: buccinator muscle

Question 27

the maxillary artery transverses the ___________ ______ and enters the ____________ ________. As the maxillary artery enters the _______ ______ it gives off the ____________ _________ artery.

Answer 27

the maxillary artery transverses the INFRATEMPORAL FOSSA and enters the PTERYGOPALATINE FOSSA (deep to the eye). As the maxillary artery enters the PTERYGOID FOSSA it gives off the POSTERIOR SUPERIOR artery.

Question 28

where does the posterior superior artery enter and supply

Answer 28

the posterior superior artery enters the posterior superior foramen (located near the maxillary tuberosity) supplies the pulps of the maxillary posterior teeth/periodontium and gingiva and maxillary sinus

Question 29

1. when does the infraorbital artery form 2. where does it enter and how 3. what does it branch off into > what does this branch supply 4. what does this further branch anastomosis with 5. where does the infraorbital artery finally exit

Answer 29

1. the infraorbital artery forms as the maxillary artery branches in the pterygopalatine fossa THEN> 2. enters the orbit via the infraorbital canal 3. within the infraorbital canal it branches into the ANTERIOR SUPERIOR ALVEOLAR artery with supplies the pulp and periodontium of the maxillary anterior teeth 4. anastomoses with the POSTERIOR SUPERIOR ALVEOLAR artery 5. exits through the infraorbital canal

Question 30

what branches are given off in the pterygopalatine fossa from the maxillary artery (8)

Answer 30

- infraorbital artery - anterior superior alveolar artery - posterior superior alveolar artery - descending palatine artery - greater palatine artery - lesser palatine artery - sphenopalatine artery - nasopalatine artery

Question 31

generally describe the 3 parts of the maxillary artery

Answer 31

first part: where it begins, at the neck of the condyle in the parotid gland second part: where it runs between the mandible and the sphenomandibular ligament anteriorly and superiorly through the infratemporal fossa third part: as it enters the pterygopalatine fossa it gives rise to the posterior superior artery

Question 32

STILL GOING ON THE MAXILLARY ARTERY! after it transverses the __________ fossa along with the ________ _________ muscle, it enters the ___________ fossa. after entering the ^ fossa, branches are given off to supply what two structures?

Answer 32

after it transverses the INFRATEMPORAL FOSSA along with the LATERAL PTERYGOID muscle, it enters the PTERYGOPALATINE FOSSA. after entering the pterygopalatine fossa, branches are given off to supply the PALATES and NASAL CAVITY

Question 33

1. of the maxillary artery, which branches go towards the maxilla 2. which branches go toward the mandible

Answer 33

1. - middle meningeal artery - posterior superior alveolar artery - infraorbital artery > anterior superior alveolar artery - greater and lesser palatine arteries - sphenopalatine artery 2. - muscle branches - inferior alveolar artery > incisive artery, mental artery, and mylohyoid artery

Question 34

describe venous drainage (4)

Answer 34

- there are more veins than arteries draining the same tissue - veins freely anastomose with each other - veins in the head and neck do not have valve > allows more spread of infection - veins of the head and neck are usually symmetrical but are more variable than arteries

Question 35

- where does the facial vein drain 2. where does the facial vein start

Answer 35

1. the facial vein drains into the INTERNAL JUGULAR VEINS 2. starts at the medial corner of the eye

Question 36

how does the retromandibular vein form

Answer 36

forms from the EXTERNAL JUGULAR VEIN on part of its route and is formed from the merger of the SUPERFICIAL TEMPORAL and MAXILLARY VEINS

Question 37

The retromandibular vein is the merger of the __________ and the ______________ it dives and joins the ________ vein _______ and the _______ vein ________

Answer 37

The retromandibular vein is the merger of the SUPERFICIAL TEMPORAL VEIN and the MAXILLARY VEIN it dives and joins the FACIAL VEIN ANTERIORLY and the POSTERIOR AURICULAR VEIN POSTERIORLY

Question 38

What is the pterygoid plexus of VEINS (7)

Answer 38

- massive network of veins - situated in the INFRATEMPORAL FOSSA - surrounds the maxillary artery - changes in volume - DRAINS INTO THE MAXILLARY VEIN - PROTECTS the maxillary artery from being compressed during mastication * - can be penetrated by the PSA injection and cause a hematoma *

Question 39

WHAT LIES WITHIN THE INFRATEMPORAL FOSSA? (5)

Answer 39

1. maxillary artery 2. pterygoid plexus 3. maxillary vein 4. lateral pterygoid muscles 5. trigeminal nerve (MAXILLARY DIVISION) V2

Question 40

where are venous sinuses located where is the CAVERNOUS VENOUS SINUS located what are venous sinuses for

Answer 40

1. Venous sinuses of the brain are in the meninges of the brain 2. cavernous sinus: located on lateral surface of the body of the sphenoid bone > GROUP OF VEINS THAT ANASTOMOSE AND DRAIN INTO THE BRAIN 3. drainage, anastomoses, fatal infections

Question 41

1. injury on the inner arterial wall can lead to? 2. ^ this causes what? 3. what may be associated with initial arterial wall damage

Answer 41

1. fatty arterial plaque build-up 2. atherosclerosis and partial arterial blockage 3. some oral organisms associated with periodontal disease such as porphyromonas gingivalis that have been found in these plaques

Question 42

what 3 things can cause clots to form on the blood vessel walls

Answer 42

- chronic hypertension - infection - trauma

Question 43

what is the difference between a thrombus and a embolus

Answer 43

Thrombus: blood clot that forms on the inner wall of a blood vessel that can partially or completely block a blood vessel Embolus: when a thrombus becomes dislodged from the inner wall that then travels in the blood vessel to create a possible blocked flow

Question 44

define bacteremia define hematoma name two other vascular lesions

Answer 44

1. bacteria traveling in the bloodstream can and DOES occur after dental treatment and can be especially significant in a medically compromised patient (need for pre-med) 2. trauma to blood vessels can cause leakage of blood into the surrounding tissues 3. periodontal disease and cerebrovascular disease