Vascular System Flashcards
What is anastomosis
Connecting channel between blood vessels (capillaries to venues)
What is an artery
Large vessels, arises from heart and carry blood away from the heart
What is an arteriole
Smaller branch of an artery
What is the capillary
Smallest branch of an arteriole
What are capillary loops/net work
Supplies blood to a large tissue area
What is venous drainage
Anastomoses with lymphatic vessels to recover blood plasma
What is a vein
Large vessel that carries blood back to the heart
**What are valves
Found in the veins of the body; nearly absent in the head and neck region
What are Venules
Smaller veins, anastomose with capillary loops to drain large tissue areas
What is a venous sinus
Blood filled space between two layers of tissue
What is a Venous plexus
Large area network of blood vessels
What are atria
Receiving chambers (right and left)
What are ventricles
Pumping chambers (right and left)
Right atria
Receives deoxygenated blood via veins from the tissues and pumps it to the lungs
Left atria
Receives oxygenated blood from the lungs and pumps at the tissues via the arteries
Two branches of the brachiocephalic artery
Right common carotid artery
Right subclavian artery
Branches of the aorta
Brachiocephalic artery
Left common carotid artery
Left subclavian artery
Which is longer, the right or left brachiocephalic vein?
Left is horizontal and longer while the right is vertical and shorter
Branches to the superior vena cava
Brachiocephalic vein
Right and left internal jugular vein
Right and left external jugular vein
Right and left subclavian vein
Describe the common carotid arteries
Branchless, lateral to the larynx and trachea. End at upper border of the thyroid cartilage
Describe the carotid sinus
Swelling just before the common carotid artery bifurcates into the internal and external carotid arteries
What is contained in the carotid sheath. Where is it located
Located beneath the SCM and contains the internal and external credit artery, internal jugular vein, and the Vagus nerve
Carotid pulse
Most reliable and accessible. Palpable when peripheral arteries are not
Located at the level of the thyroid cartilage just medial to the anterior border of the SCM
What does the ophthalmic artery supply
The eye, orbit and lacrimal gland
Which artery supplies the internal cranial structures?
Internal carotid artery
The internal carotid artery supplies the internal cranial structures via which branches?
Ophthalmic artery
Anterior cerebral artery
Middle cerebral artery
Anterior communicating artery
What is the external carotid artery supply
Tissues of the head, neck, and oral cavities
What are the four branches grouped by location to the external carotid
Anterior branches (superior thyroid, lingual, facial) Medial branch (ascending pharyngeal) Posterior branches (occipital, posterior auricular) Terminal branches (superficial temporal, maxillary)
Where is the lingual artery located
At the level of the hyoid bone
What does the dorsal lingual artery supply?
Base and body of the tongue
What does the deep lingual artery supply
Apex of the tongue
What does the sub lingual artery supply
Mylohyoid muscle, sublingual salivary gland and mucosal tissue of the floor of the mouth
What does the supra highway to arteries supply
Suprahilar muscles (digastric, mylohyoid, geniohyoid and stylohyoid)
Where is the facial artery located
Superior to the lingual artery and terminates at the medial canthus
Cervical branches of the facial artery
Ascending palatine
Glandular
Submental
Facial branches of the facial artery
Inferior labial
Superior labial
Angular/nasal
Where is the ascending pharyngeal artery located
Close to the origin of the external carotid artery
What are the branches of the ascending pharyngeal artery
Pharyngeal branch
Meningeal branch
Tonsillar branch
Where is the occipital artery located
Just superior and opposite to the facial artery, origin is closely related to the hypoglossal nerve
Branches of the occipital artery
Muscular- Suprahyoid muscle Sternocleidomastoid Auricular- scalp above ears Meningeal- meninges tissue in the occipital region Descending- Trapezius muscle
Where is the posterior auricular artery located
Superior to the occipital artery
Branches of the posterior auricular artery
Auricular- internal ear
Stylomastoid- mastoid air cells
Where is the superficial temporal artery located
In the retro mandibular Fossa (runs superior/anterior to ear)
Pulse may be visible in the temporal region
Branches of the superficial temporal artery
Transverse facial- carotid gland and duct, masseter muscle, TMJ and external ear
Middle temporal- Temporalis muscle
Frontal- scalp in the frontal regions
 parietal-Scalp in the parietal regions
Where is the mandibular region of the maxillary artery located
Behind the neck of the mandible
Five branches of the maxillary artery
Deep auricular Anterior Tympanic Middle meningeal Accessory meningeal Inferior alveolar
Inferior alveolar arteries
Supply the mandibular posterior teeth with buccal gingiva
Mylohyoid- Mylohyoid muscle and floor of mouth
Mental-Skin of chin and mucosa of lower lip
Incisive-mandibular anterior teeth with facial gingiva
Where is the pterygoid region of the maxillary artery located? What are the four arterial branches?
In the infratemporal Fossa
Deep temporal
Pterygoid
Masseteric
Buccal
Where is the pterygopalatine region of the maxillary artery located
Located in the pterygopalatine fossa
For arterial branches of the pterygopalatine region
Posterior superior alveolar
Infraorbital
Descending Palatine
Sphenopalatine
What does the posterior superior alveolar branch of the pterygopalatine region supply
Maxillary Molars and pre-molars
Dental and alveolar arteries
What does the infraorbital branch of the pterygopalatine region supply
Palpebral- lower eyelids and lacrimal gland
External nasal- Side of nose
Labial- cheek and upper lip
Anterior superior alveolar- maxillary anterior teeth
Middle superior alveolar- maxillary preMolars
What areas does the descending Palatine branch of the pterygopalatine region supply supply
The greater and lesser Palatine regions
Hard and soft palate, palatine tonsils, palatal gingiva and minor salivary gland‘s
What does the sphenopalatine branch of the pterygopalatine region supply
Posterior lateral nasal- mucosa of lateral nasal walls and sphenoid sinuses
Septal- nasal septum to the incisive foramen
Nasopalatine- Anterior 1/3 of the hard palate
General characteristics of Venous drainage of the head and neck
Forms in the opposite direction of arterial supply. Begins as a venule and in large on the way back to the heart
Usually symmetric but may vary and anastomose freely
Veins are generally larger and more numerous
**Do veins have valves?
Do not have valves except for the external jugular vein
What does the internal jugular vein drain?
The brain and most of the other tissues of the head and neck
What does the external jugular vein drain
Only a small portion of the extra cranial tissues
Where does the facial vein anastomose?
Cavernous venous sinus
Pterygoid plexus in infratemporal Fossa
Retro mandibular vein
Joins in drains into the internal jugular vein. No valves to control the direction of venous blood flow
Venous tributariess of the facial vein
Supratrochlear- drains anterior scalp
Supraorbital- drains upper portion of orbital cavity
Ophthalmic- drains tissues of the orbit
Superior labial- drains upper lip
Inferior labial- drains lower lip
Submental- Drains tissues of chin and submandibular region
What is the origin of the lingual vein?
Origin may be from either the facial vein or internal jugular vein
What does the dorsal lingual vein drain
Drains the dorsal surface of the tongue
What does the deep lingual vein drain
Drains the ventral surface of the tongue
Highly visible
What does the sublingual vein drain
Drains the floor of the mouth, located under the sub lingual folds
May be visible
General characteristics of the retro mandibular vein
Formed by merger of superficial temporal and maxillary vein
Emerges from the parotid salivary gland and divides into the anterior and posterior divisions
What does the posterior division of the retro mandibular vein become when it joins the posterior a regular and occipital vein?
The external jugular vein
What does the superficial temporal vein drain
Lateral scalp into the retro mandibular vein
Maxillary vein
Begins in the infratemporal Fossa, deeper to the superficial temporal vein
Joins in collects blood through the pterygoid plexus
What is a plexus
Small collection of anastomosing vessels
General characteristics of the pterygoid plexus
Located around the pterygoid muscles and surrounds the maxillary artery, bilaterally the infratemporal Fossae
What does the pterygoid plexus of veins anastomose with
Facial vein, maxillary vein and Cavernous venous sinus
**What does the pterygoid plexus of veins protect and how
Protects the maxillary artery from being compressed, by accommodating changes in blood volume of the infratemporal faucet during mastication by either filling or emptying
Location of the venous sinuses
Located in the meninges of the brain within the Dura matter of the brain also known as Dural sinuses
What is the function of the venous sinuses
Drains blood from the cerebral veins into the internal jugular vein
What is the largest Venous sinus
Superior sagittal sinus. Drains upper portion of cerebrum
Transverse sinus
Divides the superior, inferior and Cavernous sinuses
Inferior sagittal sinus
Drains inferior portion of the cerebrum
**What is the most important Sinus to dentistry? Where is it located and what does it anastomose with?
Cavernous venous sinus
Located bilaterally on the side of the sphenoid bone. Anastomoses with the pterygoid plexus and ophthalmic vein
Sigmoid sinus
Connects all the Venous sinuses to the internal jugular vein
**Venous drainage
**Deoxygenated blood exits the skull via the internal jugular vein through the jugular foramen
**What does the internal jugular vein drain?
Drains most of the tissues of head and neck region.
No valves, cannot prevent backflow
**Where does the internal jugular vein originate?
Originates in the cranial cavity and leaves the skull through the jugular foramen
**What are the mini tributary is received by the internal jugular vein
Lingual, facial, and retro mandibular veins
**What does the internal jugular vein merge with as it descends into the neck?
Subclavian vein
What is the external jugular vein formed from
Formed from the posterior division of the retro mandibular vein
Descends down the neck, terminating in the subclavian vein
**What is the only head and neck vein that has valves?
External jugular vein
Located near its entry into the subclavian vein
Where does the superior vena cava lead to
Travels to the right side of the heart
Etiology of blood vessel lesions
Patients with blood vessel disease and/or dental related infections have a higher risk for developing blood vessel lesions
Systemic diseases which increased risk for developing blood vessel lesions
High blood pressure, arterial sclerosis, high cholesterol, diabetes
Dental related infection (Periapical abscess and periodontal infections) and dental related trauma
What is a thrombus
Clot that forms on the inner wall of a blood vessel
What is an embolus
Dislodged thrombus/clot, free to travel as foreign material in the blood
What is a stroke
Full vascular occlusion
What is a heart attack
Myocardial infarction
Full occlusion of a cardiac artery
What is a pulmonary embolism
Larges in the lungs, causing the shortness of breath, coughing, excessive sweating, just pain and possible arrhythmia
What is a transient ischemic attack
Temporary interference with blood supply to the brain
What is bacteremia
Bacteria introduced into the circulatory system and that travels in the blood, transient bacteremia can occur with dental treatment and is very serious and certain medically compromised patients
Heart valve damage, mitral valve prolapse, joint replacements, shunts and stents
Infected thrombus
Spreads infection by way of embolus formation to such areas as the Cavernous Venous sinus
Infected needle tract
Bacteria introduced deep into the soft tissues.
Posterior superior alveolar block: incorrectly administered may involve the pterygoid plexus which may lead to infection of the cavernous venous sinus
Dental infections
From Maxillary Teeth or periodontium, which may spread to cavernous Venous Sinus or from the mandibular Teeth and periodontium which may spread to the tongue closing the airway/laryngopharynx
Common developmental anomalies
Mitral valve prolapse
Varicose veins
Mitral valve prolapse
Bicuspid heart valve, a cusp or cusps of the mitral valve prolapses into left atrium during systole; patient of risk for endocarditis require antibiotics prior to dental work or certain surgeries
Varicose veins
Enlarged, twisted superficial veins; occur almost anywhere in the body
Floor of the mouth
Ventral surface of the tongue
Labial mucosa
What would cause a large dental hematoma? How can it be prevented?
Caused by accidentally injecting local anesthesia into a blood vessel
Prevented by aspirating prior to injecting local anesthesia, which prevent most serious hematoma‘s
Use a 27 gauge or larger needle to permit aspiration of a red blood cell
Injections at highest risk of large dental hematoma
Inferior alveolar block
Posterior superior alveolar block
Infraorbital block
