Vascular System Flashcards
The vascular system of the head and neck consists of:
• Arterial blood supply
• Capillary networks
• Venous drainage
A large network of vessels within the vascular system is a
vascular plexus
Blood vessels may communicate with each other within vascular system by way of__
anastomosis (plural anastomoses)
What are Anastomosis?
cross-connection between blood vessels
Anastomosis between arteries are ___
arterio-arterial anastomosis
Anastomosis between veins are
veno-venous anastomosis
Anastomosis between arteries and veins are
arterio-venous anastomosis
Function of anastomoses
Serve as backup routes for the flow of blood if one vessel is blocked or otherwise compromised
There are how many layers or tunics for every blood vessel?
Three
What are the layers or tunics for every blood vessel?
• Tunica externa - outer connective tissue layer.
• Tunica media - middle smooth muscle layer with varying amounts of elastic fibers.
• Tunica intima - inner endothelium that lines the blood vessels.
An artery is part of the___ blood supply
arterial
Arteries begin at the____ and carries blood
heart; away from it
Each artery starts as a large vessel and branches into smaller vessels, forming___
arterioles
Arterioles branch into smaller vessels, forming____
networks of capillaries
A vein is part of the ____to drain blood from an area
venous drainage system
Smallest parts of the veins, called____, drain capillaries of their blood supply
venules
Venules coalesce to form___
larger veins
Veins travel____, carrying blood to it
to the heart
Capillaries have a___ diameter
than arterioles
smaller
Capillaries can supply blood to a larger tissue area because they are_____
more numerous and work together as a network
Capillary networks are present throughout the body for
the exchange of oxygen, metabolic waste products, and carbon dioxide between blood and tissue cells
What are different kinds of venous networks in the body?
• Superficial veins - Found immediately deep to the skin
• Deep veins - Usually accompany larger arteries in a deeper, more protected location within the tissue
Venous sinuses are_____
blood-filled spaces between two layers of tissue
Venous networks are connected by
anastomoses
The major arteries that supply the head and neck include___
the common carotid and subclavian arteries
How are the origins from the heart of the common carotid and subclavian arteries different for the right and left sides of the body?
• Left side of the body: these arteries originate directly from the aorta
• Right side of the body: these arteries branch off from the brachiocephalic artery
What are the direct branches of the aorta?
Brachiocephalic artery
Left subclavian
Left common carotid
The common carotid artery is a major artery supplying blood to the
brain
Does the common carotid artery have branches?
No
The common carotid travels
superiorly along the neck, lateral to the trachea and larynx, to the superior border of the thyroid cartilage
Travels in the carotid sheath with the internal jugular vein and vagus nerve deep to the sternocleidomastoid muscle
Common carotid artery
What is in the carotid sheath?
internal jugular vein, common carotid and the tenth cranial nerve (X) (vagus nerve)
• Carotid sheath is part of the___ of the neck
deep cervical fasciae
The common carotid artery ends by dividing into the_______
internal and external carotid arteries around the level of the larynx
• Just before the common carotid artery splits into the internal and external carotid, it exhibits a swelling called the___
carotid sinus
The carotid sinus is the location for obtaining the
carotid pulse
The subclavian artery begins____
lateral to the common carotid artery
The subclavian artery travels___
upwards and laterally between the anterior and middle scalene muscles
The subclavian artery supplies blood to the
head, neck, and arms (upper arms)
The internal carotid artery travels
superiorly, in a slightly lateral position to the external carotid artery in the carotid sheath
This artery is covered by the SCM
Internal carotid artery
What are the divisions of the common carotid artery?
Internal and external carotid
Are there branches of the internal carotid artery located in the neck?
No
The internal carotid artery supplies blood to___
intracranial structures and is the source of the ophthalmic artery
Supplies the eye, orbit, lacrimal gland, much of the forehead
The external carotid artery travels
superiorly, in a slightly medial position to the internal
The external carotid artery supplies blood
extracranial tissue of the head and neck, including the oral cavity
The external carotid artery has what four branches?
Anterior branch
Medial branch
Posterior branch
Terminal branch
There are how many anterior branches of the external carotid artery?
3
What are the three anterior branches of the external carotid artery?
Superior Thyroid Artery
Lingual Artery
Facial Artery
What are the four branches of the superior thyroid artery?
• Infrahyoid artery
• Sternocleidomastoid branch
• Superior laryngeal artery
• Cricothyroid branch
The branches of the superior thyroid artery supplies what structures?
supply the structures inferior to the hyoid bone; infrahyoid muscles, SCM, muscles of the larynx, and thyroid gland
What are the branches of the lingual artery?
Dorsal lingual branch
Deep lingual branch
tonsillar branches
sublingual branch
suprahyoid branch
The Dorsal lingual branch and Deep lingual branch of the lingual artery supply blood to what structure?
Tongue
The sublingual branch of the lingual artery supplies blood to___
mylohyoid muscle, sublingual salivary gland, oral mucosa of the floor of the mouth, periodontium, and mandibular gingiva
The tonsillar branches of the lingual artery supply blood to ____
The lingual tonsils and soft palate
The suprahyoid branch of the lingual artery supplies
The suprahyoid muscles
What are the branches of the facial artery?
• Ascending palatine artery (cervical)
• Tonsillar branches (cervical)
• Submental artery (cervical)
• Glandular branches (cervical)
• Inferior labial artery (facial)
• Superior labial artery (facial)
• Angular artery (facial)
The facial artery runs from the
inferior border of the mandible, anteriorly and superiorly near the labial commissure and along the lateral side of the naris of the nose and terminates at the medial canthus of the eye
The facial artery supplies the
face in the oral, buccal, zygomatic, nasal, infraorbital, and orbital regions
What are the cervical branches of the facial artery?
Glandular branch
Tonsillar branch
Ascending palatine artery
Submental artery
The Ascending palatine artery supplies
soft palate, palatine muscles
Tonsillar branches of the facial artery supply
palatine tonsils
Submental artery supplies
submandibular lymph nodes, mylohyoid and digastric muscles
Glandular branches of the facial artery supplies
submandibular salivary gland and nearby muscles
What are the facial branches of the facial artery?
Inferior labial artery
Superior labial artery
Angular artery
Inferior labial artery Supplies
lower lip area including that area’s muscles of facial expression
Superior labial artery Supplies
upper lip area including that area’s muscles of facial expression
Angular artery Supplies
the lateral naris of the nose
There are how many medial branches from the external carotid artery?
Only one
What artery is apart of the medial branch of the external carotid?
Ascending Pharyngeal Artery
This artery is small. Cannot be viewed in most lateral views of the head and neck
Ascending pharyngeal artery
How many branches are apart of the ascending pharyngeal?
Has many small branches that include the pharyngeal branch and the meningeal branch
The pharyngeal branch and meningeal branch of the ascending pharyngeal artery supply
the pharyngeal walls, soft palate, and meninges
What are Meninges?
three layers of membranes that cover and protect the brain and spinal cord
If there is serious blood loss or bleeding during a tonsillectomy, it is from this artery
Ascending pharyngeal artery
There are how many posterior branches of the external carotid artery?
There are two
What are the two posterior branches of the external carotid artery?
Occipital Artery
Posterior Auricular Artery
What are the branches of the Occipital Artery?
sternocleidomastoid branch
muscular branches
auricular branch and meningeal branch
Descending branches
The SCM branch of the occipital artery supplies the
SCM
The occipital artery supplies the
Occipital region and many other regions by its branches
The muscular branches of the occipital artery supplies
other muscles such as the suprahyoid muscles
The auricular branches of the occipital artery supplies
Auricular region
The meningeal branches of the occipital artery supply
The meninges
The descending branches of the occipital artery supply
Trapezius muscle
Branches of the occipital artery undergo anastamoses between the
external carotid and the subclavian artery to provide regional collateral circulation
Small. Begins superior to the occipital artery and stylohyoid muscle at approximately the level of the tip of the temporal bone’s styloid process
Posterior auricular artery
The posterior auricular artery has what branches
auricular branch
stylomastoid artery
The auricular branch of the posterior auricular artery supplies
the internal ear
The stylomastoid artery of the posterior auricular artery supplies
the mastoid process
There are how many terminal branches of the external carotid artery?
two
What are the two terminal branches of the external carotid artery?
Superficial Temporal Artery
Maxillary Artery
The external carotid artery splits into the terminal branches within the
parotid salivary gland
Smaller terminal branch of the external carotid artery
Superficial Temporal Artery
The superficial temporal artery begins at the
parotid salivary gland
The superficial temporal artery can be visible___
under the skin covering the temporal region
The superficial temporal artery has what branches?
• Transverse facial artery
• Middle temporal artery
• Frontal branch
• Parietal branch
The Transverse facial artery supplies the
parotid salivary gland duct and nearby facial area
The Middle temporal artery supplies the
temporalis muscle
The Frontal branch supplies
part of the scalp in the frontal region
The Parietal branch supplies
part of the scalp in the parietal region
Largest terminal branch
Maxillary Artery
The maxillary artery begins____
inferior to the TMJ, turns anteromedially
to the neck of the mandibular condyle
The maxillary artery travels
deep to the structures of the face; goes between muscles of mastication and ascends towards the pterygopalatine fossa
The maxillary artery has how many parts?
Three
What are the three parts of the maxillary artery?
• First part (mandibular part)
• Second part (pterygoid part)
• Third part (pterygopalatine part)
What are the branches of the mandibular part of the maxillary artery?
Deep auricular artery
Anterior tympanic artery
Middle meningeal artery
Accessory meningeal artery
Inferior alveolar artery
What are the branches of the inferior alveolar artery?
Dental and alveolar branches
Mylohyoid artery
Mental artery
Incisive artery with dental and alveolar branches
The deep auricular artery of the mandibular branch of the the maxillary artery supplies
Auricular region and outer surface of tympanic membrane
The anterior tympanic artery of the mandibular branch of the the maxillary artery supplies
Tympanic region and inner surface of tympanic membrane
The middle meningeal artery of the mandibular branch of the the maxillary artery supplies
Dura mater of brain and cranial bones
The accessory middle meningeal artery of the mandibular branch of the the maxillary artery supplies
Same as middle meningeal and also infratemporal fossa structures
The dental and alveolar branches of the inferior alveolar artery of the mandibular branch of the the maxillary artery supplies
Mandibular posterior teeth, buccal periodontium and gingiva
The mylohyoid artery of the inferior alveolar artery of the mandibular branch of the the maxillary artery supplies
Floor of the mouth and mylohyoid muscle
The mental artery of the inferior alveolar artery of the mandibular branch of the maxillary artery supplies
Mental region
The incisive artery with dental and alveolar branches of the inferior alveolar artery of the mandibular branch of the the maxillary artery supplies
Mandibular anterior teeth, labial periodontium and gingiva
What are the branches of the pterygoid part of the maxillary artery?
Deep temporal artery
Pterygoid artery
Masseteric artery
Buccal artery
What are the branches of the deep temporal arteries of the pterygoid part of the maxillary artery?
Anterior and posterior branches
The anterior and posterior branches of the deep temporal arteries of the pterygoid part of the maxillary artery supplies
Temporal region and temporalis region
The pterygoid arteries of the pterygoid part of the maxillary artery supplies
The lateral and medial pterygoid muscles
The masseteric artery of the pterygoid part of the maxillary artery supplies
Masseter muscle
The buccal artery of the pterygoid part of the maxillary artery supplies
Buccinator muscle and buccal region
What are the branches of the pterygopalatine part of the maxillary artery?
Posterior superior alveolar artery
Infraorbital artery
Descending palatine artery
Sphenopalatine artery
What are the branches of the posterior superior alveolar artery of the pterygopalatine part of the maxillary artery?
Dental and alveolar branches
What are the branches of the infraorbital artery of the pterygopalatine part of the maxillary artery?
Orbital and terminal branches
Anterior superior alveolar artery with dental and alveolar branches
Middle superior alveolar artery if present
What are the branches of the descending palatine artery of the pterygopalatine part of the maxillary artery?
Greater and lesser palatine arteries
What are the branches of the sphenopalatine artery of the pterygopalatine part of the maxillary artery?
Posterior lateral nasal and septal branches
Nasopalatine branch
The dental and alveolar branches of the posterior superior alveolar artery of the pterygopalatine part of the maxillary artery supplies
Maxillary posterior teeth, buccal periodontium, gingiva and maxillary sinus
The orbital and terminal branches of the infraorbital artery of the pterygopalatine part of the maxillary artery supplies
Orbital region and infraorbital region
The anterior superior alveolar artery with dental and alveolar branches of the infraorbital artery of the pterygopalatine part of the maxillary artery supplies
Maxillary anterior teeth, labial periodontium, and gingiva
The middle superior alveolar artery of the infraorbital artery of the pterygopalatine part of the maxillary artery supplies
Maxillary premolars, buccal periodontium, and gingiva
The greater and lesser palatine arteries of the descending palatine artery of the pterygopalatine part of the maxillary artery supplies
Posterior hard palate, palatal
periodontium, gingiva of maxillary
posterior teeth, and soft palate
The Posterior lateral nasal and septal
branches of the sphenopalatine artery of the pterygopalatine part of the maxillary artery supplies
Nasal region and nasal cavity
The nasopalatine branch of the sphenopalatine artery of the pterygopalatine part of the maxillary artery supplies
Anterior hard palate, palatal periodontium and gingiva of maxillary anterior teeth
The veins of the head and neck start out as____ and become ____as they near the base of the neck on their way to the heart
smaller diameter venules; larger in diameter
Veins are generally____ and____ than arteries in the same tissue area
larger in diameter; more numerous
Veins of the head can be divided into what two groups?
Intracranial veins and extracranial veins
Intracranial veins are found___
within the cranial cavity
Intracranial veins include
various dural sinuses, as well as the meningeal, cerebral, and orbital veins
The intracranial veins play a crucial role in
circulation, providing venous drainage from the tissues located within the head, including the brain
Extracranial veins are found
outside the skull - positioned within the soft tissue of the head.
Most of these veins accompany the same named arteries
Extracranial veins
Extracranial veins collect
deoxygenated blood from the skin, subcutaneous tissue, muscles, internal organs, and other structures of the head
Venous drainage of the neck is provided by the
jugular venous system
The jugular venous system can be divided into
deep and superficial veins
Superficial veins of the jugular venous system refer to
external jugular veins and their tributaries
These jugular veins mainly collect venous blood from the skin and subcutaneous tissue
External jugular veins
Deep veins of the jugular venous system of the neck refer to
internal jugular veins and their tributaries
Most of the venous blood from the intracranial cavity, soft tissue, and organs of the head and neck are eventually drained into these vessels
Internal jugular veins
The internal jugular vein drains the
brain as well as most of the other tissue of the head and neck
The external jugular vein drains
only a small part of the extracranial structures
the external and internal jugular veins have many___ that connect them
anastomoses
The facial vein drains into the
internal jugular vein.
The facial vein begins at the
medial canthus of the eye with the junction of two veins from the frontal region
What are the tributaries of the facial veins in the ocular region?
• Supratrochlear vein
• Supraorbital vein
The supraorbital vein also anastomoses with the
ophthalmic veins (these veins drain the orbit)
The facial vein anastomoses with deep veins such as
the pterygoid plexus of veins in the infratemporal fossa
The large retromandibular vein
The facial vein has what important tributaries in the oral region?
• Superior labial vein - drains the upper lip
• Inferior labial vein - drains the lower lip
• Submental vein - drains the tissue of the chin and the submandibular region
The facial vein joins with the internal jugular at the level of the
hyoid bone
Lingual Veins Includes:
• Dorsal lingual veins - drains dorsal surface of tongue
• Deep lingual vein - drains ventral surface of tongue
• Sublingual vein - drains the floor of the mouth
The lingual veins are “Variable” veins meaning_____
• These veins may join to form a single vessel OR may empty into larger vessels separately
• They also may drain into the facial vein OR directly into the internal jugular vein
Lingual veins are capable of____ with topical drug placement
rapid and direct systemic absorption
What are Lingual Varicosities?
• A variant in adults over 60 years of age
• Enlarged lingual veins with usually purple or red enlarged areas on ventral and lateral surface of the tongue
This vein will form the external jugular vein from a part of is route
Retromandibular Vein
This vein is formed from the merging of the superficial temporal vein and the maxillary vein
Retromandibular vein
This vein emerges from the parotid salivary gland and runs inferiorly
Retromandibular vein
Inferior to the parotid gland, the retromandibular vein divides into what two parts?
Anterior division - joins the facial vein
Posterior division - continues inferiorly to the surface of the SCM
The posterior division of this vein is joined by the posterior auricular vein (which drains the lateral scalp posterior to the ear), and these joined veins become the external jugular vein
Retromandibular vein
This vein drains the lateral scalp
Superficial Temporal Vein
This vein is superficially located in the skin covering the temporal region
Can sometimes be noted on a patient during an extraoral examination
Superficial temporal vein
This vein goes on to drain into and form the retromandibular vein, along with the deeper maxillary vein
Superficial temporal vein
Deeper vein that begins within the infratemporal fossa
Maxillary Vein
Collects blood from the pterygoid plexus of veins
Maxillary vein
Through the pterygoid plexus, the maxillary vein receives
the 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
After collecting blood from the pterygoid plexus of veins, the maxillary vein merges with____ to drain into and form the____
the superficial temporal vein ; retromandibular vein
A collection of small anastomosing vessels located around the lateral pterygoid muscle
Pterygoid Plexus of Veins
The pterygoid plexus of veins surround the _____of the maxillary artery on each side of the face within the____
second part (or pterygoid part); infratemporal fossa
The pterygoid plexus anastomoses with both the___ veins
facial and retromandibular
Protects the maxillary artery from being compressed during mastication
Pterygoid plexus of veins
Drains the veins from the deep part of the face, and then drains into the maxillary vein
Pterygoid plexus of veins
Middle meningeal vein drains blood from
both the dura mater of the meninges and the bones of the cranial vault into the pterygoid plexus of vein
The Posterior Superior Alveolar Vein is Drained by the
pterygoid plexus of veins
The Posterior Superior Alveolar Vein is Formed by the merging of
its dental and alveolar branches
Dental branches of the posterior superior alveolar vein drain____
the pulp of the maxillary teeth by way of each tooth’s apical foramen
Alveolar branches of the posterior superior alveolar vein drain the
Associated periodontium and gingiva of the maxillary teeth
• Drained by the pterygoid plexus of veins
• Formed by the merging of its dental and alveolar branches, and mental branches in the mandible
Inferior Alveolar Vein
• Dental branches of the inferior alveolar vein drain the
pulp of the mandibular teeth by way of each tooth’s apical foramen
____drain the associated periodontium and gingiva of the mandibular teeth
Alveolar branches of the inferior alveolar vein
Mental branches of the inferior alveolar vein enter the mental foramen after
draining the chin area on the outer surface of the mandible, where they anastomose with branches of the facial vein
Venous sinuses are
blood-filled spaces between two layers of tissue
The venous sinuses in the braincase are located in the
meninges
There_____Within the dura mater (a dense connective tissue that lines the inner cranium)
Venous sinuses
What is the Cavernous Sinus?
The venous sinus most important to dental care is the paired cavernous sinus located on the lateral surface of the body of the sphenoid bone, at either side of the midline sella turcica
• Drains most of the structures of the head and neck
• Does NOT drain the dentition
• Originates in the cranial cavity and leaves the skull through the jugular foramen
Internal Jugular Vein
The internal jugular vein receives many tributaries including veins from the___
lingual, sublingual, pharyngeal areas as well as the facial vein
The internal jugular vein travels
(along with the common carotid artery and the vagus nerve) in the carotid sheath
The ___lymph nodes form a chain along the internal jugular vein
deep group of cervical
This vein descends in the neck to merge with the subclavian vein
Internal jugular vein
• Posterior division of the retromolar vein becomes the____
External Jugular Vein
The external jugular vein descends___ and terminates in the____
inferiorly; subclavian vein
• This vein is usually visible as it crosses the SCM
External jugular vein
The only vein in the head and neck with valves
External jugular vein
Lack of valves in the veins of the head and neck may contribute to severe and rapid spread of
Dental infections
Bacteria can travel against the normal blood flow due to the
absence of valve
Anterior Jugular Vein Drains into the
external jugular vein (or directly into the subclavian vein) before it joins the subclavian vein
The anterior jugular vein begins___
inferior to the chin
The anterior jugular vein communicates with veins in the area and Decsends near the midline within the
superficial fascia
The anterior jugular vein receives branches from the
superficial cervical structures
• Two anterior jugular veins are usually present, but it’s possible for there only to be one
• They anastomose with each other through a___
jugular venous arch
On each side of the body, the external jugular vein joins the___ from the arm
Then, the internal jugular vein merges with the subclavian vein to form the
Brachiocephalic veins unite to form the___
The superior vena cava travels____
Superior vena cava is on the___ side of the heart
This makes the brachiocephalic veins___
Right brachiocephalic vein length wise is____. While the Left brachiocephalic vein is___
subclavian vein; brachiocephalic vein; superior vena; to the heart; right; asymmetrical; short and vertical; long and horizontal
Atherosclerosis
- narrowing and possible blockage of the diameter of arteries
Atherosclerosis impedes
blood flow
Atherosclerosis Occurs due to
chronic inflammatory reaction in the walls of the arteries
Atherosclerosis Can result in
arterial plaque deposition
Arterial plaque
fatty materials that is deposited within the walls of arteries
Arterial plaque Can consist of
cholesterol, calcium, clotting proteins, or other substances
Thrombus
clots that form on the inner vessel wall
Embolus
a clot that dislodges, and can travel through the vascular system
Emboli can partially or fully___
impede blood flow
Emboli can produce
cerebrovascular accidents (CVA, or stroke)
Bacteremia
bacteria traveling in the vascular system can cause a bacterial infection in the blood system - can be a serious complication with dental treatment
