Vasculature of the Head and Neck

Question 1

a cricothyrotomy can be complicated by what vein?

Answer 1

anterior jugular vein

Question 2

jugular venous pressure/pulse can indicate what?

Answer 2

heart problems

Question 3

cavernous sinus thrombosis is caused by drainage from what vein?

Answer 3

superior and inferior angular veins (near nasal area) through ophthalmic veins to cavernous sinus

Question 4

describe the middle meningial a.

Answer 4

• supply dura and calvaria
• pterion - site of damage
• epidural hematoma site
• enters via foramen spinosum

Question 5

what structures run through the cavernous sinus?

Answer 5

• internal carotid a., CN III, IV, V1, V2, VI run through
• CN II just runs in front
• pituitary sits inside it

Question 6

name the 4 regions of the internal carotid artery

Answer 6

also know the relative areas within the skull where the divisions are

Question 7

which foramen does the ophthalmic artery exit the skull, and which areas does it supply?

Answer 7

• optic canal
• all parts of orbit: retina, extraocular muscles, lacrimal gland
• ethmoid bone (nasal cavity)
• superficial branches that supply facial tissues around the eye: dorsal nasal, frontal (supratrochlear), and supraorbital

Question 8

where does the superior thyroid a. come off of the external carotid a.?

Answer 8

ventral

Question 9

describe the anastomoses that can occur with the superior thyroid a.

Answer 9

contralateral superior thyroid artery (ex. carotid a.) and inferior thyroid artery (thyrocervical a.)

Question 10

name the 4 branches of the superior thyroid a. and what they supply. where does the branching start (which triangle)?

Answer 10

• superior laryngeal - larynx
• cricothyroid - larynx
• hyoid - strap muscles adjacent to hyoid bone
• SCM - sternocleidomastoid
• branching starts in carotid triangle

Question 11

where does the ascending pharyngeal a. go? name its branches

Answer 11

• ascends deep to stylopharyngeus, anterior to ear
• pharyngeal, meningeal, and tympanic branches

Question 12

what does the ascending pharyngeal artery supply?

Answer 12

• pharyngeal constrictors
• stylopharyngeus
• soft palate
• all soft palate muscles except levator veli palatini (middle meningeal artery)
• palatine tonsil
• meninges
• middle ear
• auditory tube

Question 13

where does the superficial temporal a. go?

Answer 13

ascends within parotid gland, anterior to ear

Question 14

where does the occipital a. go?

Answer 14

runs deep to posterior belly of digastric

Question 15

what are the branches of the occipital a., and what do they supply?

Answer 15

• SCM branch - SCM
• auricular branch - posterior aspect of ear
• meningeal branch - posterior dura and cranial bones
• descending branch - suboccipital and deep back muscles of the neck

Question 16

describe anastomoses created by the occipital a.

Answer 16

• descending branch of the occipital a., transverse cervical a. (thyrocervical trunk), and vertebral a.

Question 17

what are the 3 parts of the maxillary artery and the general regions they supply?

Answer 17

• mandibular - ear and mandible
• pterygoid - muscles of mastication
• pterygopalatine - maxilla, palate, nasal

Question 18

describe the branches of the mandibular portion of the maxillary artery that run inferiorly

Answer 18

• mylohyoid branch - serves mylohyoid
• inferior alveolar - teeth and gums, ends as mental a.
• mental - chin and lower lip, anastomosis with submental and inferior labial aa.

Question 19

describe the branches of the mandibular portion of the maxillary artery that run superiorly

Answer 19

• deep auricular - TMJ, tympanic membrane, external acoustic meatus
• ant. tympanic - middle ear cavity
• middle meningial a.

Question 20

name the 4 branches in the pterygoid portion of the maxillary artery (hint - serves muscles of mastication)

Answer 20

• temporal branch - runs superior
• masseteric branch - runs inferior
• pterygoid branches - run inferior
• buccal branch - runs inferior

Question 21

name the 4 main branches of the pterygopalatine portion of the maxillary artery and their respective branches

Answer 21

• infraorbital (infraorbital foramen): superior alveolar - anterior/supply front teeth
• superior alveolar - middle and posterior branches
• descending palatine: greater and lesser palatine aa. (greater and lesser palatine foramen)
• sphenopalatine: posterior nasal and posterior septal branches

Question 22

T or F:
the nasal wall and septum are supplied by the external carotid only

Answer 22

false:

vascular supply by both ICA and ECA

• ICA: ophthalmic a. - anterior and posterior ethmoidal aa.
• ECA: maxillary a. - sphenopalatine a. - posterior septal and nasal aa.

Question 23

describe Kiesselbach’s area

Answer 23

anastomoses of 4 arteries in nasal wall and septum (bloody nose here)

• ethmoidal a. (ophthalmic a.)
• septal a. (maxillary a.)
• greater palatine a. (maxillary a.)
• superior labial a. (facial a.)

Question 24

what sits in the sella turcica?

Answer 24

• cavernous sinus
• pituitary gland

Question 25

where does the lingual a. go?

Answer 25

runs deep to the hyoglossus m.

Question 26

name the 3 branches of the lingual a.

Answer 26

* dorsal lingual * deep lingual * sublingual

Question 27

what does the lingual a. and its branches supply?

Answer 27

* tongue, palatine tonsil, sublingual gland * dorsal branch - p. tongue, tonsils * deep branch - a. tongue * siblingual branch - sublingual glands

Question 28

describe the anastomoses within the lingual a.

Answer 28

* dorsal branch anastomoses with contralateral a.

Question 29

T or F: deep and sublingual branches of the lingual a. form an anastomosis

Answer 29

false they cannot anastomose due to the lingual septum

Question 30

where does the facial a. go?

Answer 30

runs deep to digastric sling and submandibular gland, and emerges over the body of the mandible

Question 31

name the 5 branches of the facial a.

Answer 31

* tonsillar * superior labial * inferior labial * lateral nasal * angular

Question 32

superficial course of what artery can allow manual reduction in flow at the mandible?

Answer 32

facial artery

Question 33

describe the anastomoses of the facial a.

Answer 33

* anastomosis with ophthalmic a. via angular branch * anastomosis with mental a. (inf. alveolar a.) via inferior labial a.

Question 34

what do each of the branches of the facial artery supply?

Answer 34

* tonsillar branch - palatine tonsils * labial branches - external surface of lips * lateral nasal branch - dorsal and lateral surface of nose * angular branch - dorsal nasal branch to superior ophthalmic a., external medial orbit

Question 35

where does the superficial temporal artery go?

Answer 35

ascends within the parotid gland, anterior to ear

Question 36

name the branches of the superficial temporal a.

Answer 36

* transverse facial * frontal * parietal * zygomatic/orbital

Question 37

where can a pulse be felt on the superficial temporal a.?

Answer 37

superior to the zygomatic arch, anterior to the ear

Question 38

what do the branches of the superficial temporal a. supply?

Answer 38

* transverse facial branch - parotid gland, facial muscles, masseter and temporalis * zygomatic branch - skin, muscles towards orbits * frontal branch - skin and muscles over frontal bone, can anastomose with supraorbital arteries * parietal branch - skin, superior auricular muscle

Question 39

where does the posterior auricular artery go?

Answer 39

ascends superior to posterior digastric; runs between external acoustic meatus and mastoid process

Question 40

T or F: there are no major branches of the posterior auricular a.

Answer 40

true

Question 41

what does the posterior auricular a. supply?

Answer 41

scalp and posterior ear