Vasculature of Neck Flashcards
What are the arteries of the neck?
Brachiocephalic trunk (on R only!)
Common carotid
Subclavian
What are the three parts of the subclavian artery?
Medial, deep, and lateral parts -> outlined via anterior scalene
What are the four branches of the subclavian artery?
Vertebral artery, internal thoracic artery, thyrocervical trunk, costocervical trunk
What are the two branches of the costocervical trunk?
Supreme intercostal -> supplies intercostal spaces downward
Deep cervical -> supplies the head
What is in 50% of people?
Descending dorsal scapular artery
What are the branches of the thyrocervical trunk?
Inferior thyroid artery, ascending cervical artery, transverse cervical artery, and suprascapular artery
What does the internal thyroid run behind?
Thyroid
What does the ascending cervical artery run parallel with?
Phrenic nerve
Where does the ascending cervical artery run?
On the surface of anterior scalene
What does the transverse cervical artery supply?
Trapezius, levator scapulae, rhomboids
Where does the supraspacular artery run?
Clavicle
What is a key feature of the descending (dorsal) scapular artery if individuals have it?
It runs through the brachial plexus
What can the rhomboids be supplied by?
Either deep branch of transverse cervical artery, or descending (dorsal) scapular artery
Where does the vertebral artery go to?
Brainstem + cerebellum
What are the contents of the carotid sheath?
Common and internal carotid
Internal jugular vein
Vagus
Superior root of ansa cervicalis
Deep cervical lymph nodes
Where does the carotid crotch divide?
Cartilage of thyroid
What can occur in the carotid artery?
Narrowing (stenosis) due to plaque
Makes specific sound
What are the branches of the external carotid artery?
Superior thyroid artery, lingual artery, facial artery, maxillary artery, superficial temporal, posterior auricular, occipital, ascending pharyngeal artery
What is the mnemonic for the external carotid artery?
Some Little Fat Man Stole Papa’s Only Apple
What branches come off the lingual artery?
Suprahyroid, dorsal lingual, sublingual, deep lingual
What branches come off the facial artery?
Ascending palatine, tonsillar, submental, glandular
What is the relation of cranial nerve XII?
Hypoglossal nerve + occipital artery wrap around one another
What are the branches of the occipital artery?
SCM, mastoid, auricular, muscular, descending, meningeal, occipital
What are the branches of the posterior auricular artery?
Muscular, stylomastoid, auricular, occipital
What does the carotid sinus act as?
Baroreceptor -> pressure
What does the carotid sinus consist of?
Dilation of the lower end of the internal carotid artery
What is inside the adventitia?
Sensory nerve endings, mainly from CN IX (glossopharyngeal)
Where is the carotid body found?
At carotid crotch, innervated CN IX > CN X (pre-ganglionic)
What branches of the superior thyroid anastomose cross over at the midline?
Infrahyoid and superior laryngeal artery
What branches of the lingual artery cross over at the midline?
Suprahyroid artery, dorsal lingual artery, sublingual artery
What branches of the facial artery cross over at the midline?
Ascending palatine artery
What branches of the occipital artery cross over at the midline?
Occipital branches
Occipital branches anastomose with
Posterior auricular artery & superficial temporal artery
Superior laryngeal artery anastomose with
Inferior laryngeal artery
Since the descending branch of occipital artery anastomose with branches from the thyrocervical trunk, costocervical trunk and vertebral artery, what should be aware of?
Clamping axillary and facial will still allow collateral blood flow to occur, since arteries can backfill!
Key concepts for veins
- Veins are highly variable in their course and anastomoses
- There are SUPERFICIAL and DEEP venous networks
a. Deep veins travel with the main arteries (branches from carotid system)
b. Superficial veins are external to the investing fascia
c. Superficial and Deep veins anastomose - There are 3 JUGULAR veins
a. Internal
b. External
c. Anterior
What is the internal jugular vein deep to?
Sternocleidomastoid muscle
What begins in jugular foramen?
Cranial nerve IX, X, XI at base of skull
What does the internal jugular vein run parallel with?
Common carotid artery
Where does the internal jugular vein end?
Joins the subclavian vein (at jugulo-venous angle) to form the brachiocephalic vein
What are the tributaries of the internal jugular vein?
- Inferior Petrosal Sinus (skull)
- Occipital
- Pharyngeal
- Facial (see anterior division of the
retromandibular vein) - Lingual
- Superior & Middle Thyroid Veins
Jugular veins -> … -> Brachiocephalic veins -> …
Jugulovenous angles, SVC
Where does the lymph in the neck come from?
Capillary beds
What is a key understanding of lymph?
Follows gravity!
In the head & neck, lymph drains…
Down to the jugulo-venous angles
How are the lymph seperated?
Levels
Level II, III, and IV are deep to…
SCM
-> follows veins
Deep cervical nodes are situated around…
Internal jugular vein
Where are superior deep cervical found?
Level II
Where are inferior deep cervical found?
Level IV
Supraclavicular nodes are also called…where are they found?
Virchow’s node, level V
What nodes are found in level I?
Submental, submandibular
What nodes are found in level II?
Superior deep cervical
What nodes are found in level III?
Deep cervical
What nodes are found in level IV?
Inferior deep cervical
What nodes are found in level V?
Posterior cervical, accessory, supraclavicular
What nodes are found in level VI?
Prelaryngeal, pre¶tracheal
