Veins of Head/Neck Flashcards
Superior Vena Cava
formed from L/R Brachiocephalic veins
Brachiocephalic Veins
formed from internal jugular vein and subclavian vein
(right side is bigger than left)
Catheter is then threaded down the right brachiocephalic vein and into the superior vena cava
to monitor central venous pressure and for rapid infusion of IV fluids
Left superior intercostal vein – collects blood from the left 2nd and 3rd intercostal vein. It drains into the left brachiocephalic vein.
Supreme intercostal vein – drains the vein from first intercostal space directly into the brachiocephalic veins.
vertebral vein
inferior thyroid vein
internal thoracic vein
Internal Jugular Vein
begins OUTSIDE skull distal Inferior to the sup. Jug bulb; first tributary of the internal jugular vein is the INFERIOR PETROSAL SINUS; + sigmoid = IJV
It descends in the carotid sheath with the internal carotid artery. The vagus nerve (CN X) lies between the two.
continues to descend before descending into the thorax, usually between the heads of the sternocleidomastoid muscle, before uniting with the subclavian vein to form the brachiocephalic vein.
Tributaries inferior petrosal sinus pharyngeal veins facial vein lingual vein superior thyroid vein middle thyroid vein
(exits via jugular foramen)
Veins on the Face
most of the veins in the face lack valves so if
an infection gets in there it can travel to the
brain
Maxillary vein:
External jugular vein:
comes from posterior auricular vein + posterior
division of the retromandibular v.
Retromandibular vein:
comes from maxillary + superficial temporal vein
Common facial vein:
facial v. + anterior division of the
retromandibular v. It drains into the Internal Jugular Vein
> facial v. connects to cavernous sinus via the deep facial vein and is formed from the supratrochlear+supraorbital veins
There is a vein that joining the facial vein posteriorly with a big plexus of veins (pterygoid plexus of veins). This plexus is connected to the cavernous sinus by way of emissary veins. An infection on the face can
spread in the brain, opthalmic vein etc. This
area on the face is referred to as the DANGER
TRIANGLE The facial vein is connected to the
cavernous sinus by way of the deep facial vein.
Note - the facial vein is the continuous of the
angular vein which is formed by the
supratrochlear + supraorbital veins.
Submental vein drains into
facial vein
Cavernous Sinus
venous sinus that sits on either
sides of the sella turcica –
CN VI pierces the dura and goes through the sinus and enters the orbit through the superior orbital fissure so we are going to have CN III, IV, V1, and VI all pass through that fissure
- lateral wall of the cavernous sinus we have 4 nerves running there CN III, IV, V1 and V2.
- the internal carotid travels with the abducens are medial and within the sinus
Communications: • Ophthalmic veins*** • Angular & facial veins*** – via ophthalamic veins • Cerebral veins • Sphenoparietal sinus • Superior petrosal sinus • Inferior petrosal sinus • Pterygoid plexus****** – via emissary veins
Dural Sinuses
Channels that carry venous blood • Drain the veins of the brain and bones of the cranial cavity; drains into the internal jugular which exits via jugular foramen (goal for emissary veins are to find a way to the jugular foramen) • Between the two layers of dura (endosteal/periosteal and meningeal layers) • Lack valves • Lined by endothelium which is continuous with the veins into which they drain
Superior Sagittal Sinus
trapped in the flax cerebri at the top where the flax cerebri begins
Inferior Sagittal Sinus
directly inferior to the superior sagittal sinus The inferior sagittal sinus courses along the inferior border of the falx cerebri.
Straight Sinus
runs in the midline, connecting the inferior sagittal sinus to the confluence of sinuses right where falx cerebra intersects w/ tentorium
cerebelli.
Transverse/Sigmoid Sinuses
Transverse sinus - paired dural sinus that begins at the confluence of the sinuses and terminates in the sigmoid sinus running in a transverse plane.
Sigmoid sinus - (s-shaped) - The sigmoid sinus receives blood from the transverse sinuses.
Direction of Blood Flow in Dural Sinuses
from the confluence of sinuses to the transverse»_space;» sigmoid sinus»_space;> into internal jugular vein
(does not go in the opposite direction only from confluence to transverse sinus!!!)
Cavernous sinus eventually drains into internal jugular
via superior and inferior petrosal sinuses
Emissary Veins
Connect dural sinuses with veins outside of cranial
cavity (usually scalp veins)
• Do not have valves
• Pass through various openings in the skull (emissary
foramina) which often are inconstant (e.g. foramen of
Vesalius)
• Can allow infections to pass from extracranial to
intracranial sites
Emissary Veins
Connect dural sinuses with veins outside of cranial
cavity (usually scalp veins)
• Do not have valves
• Pass through various openings in the skull (emissary
foramina) which often are inconstant (e.g. foramen of
Vesalius)
• Can allow infections to pass from extracranial to
intracranial sites specifically via the PTERYGOID PLEXUS; any infection in that region can travel up through the emissary veins and go into these 3 foramina (Ovale, Lacreum, and Vesalius) can connect to the cavernous sinus.
Veins of the Nasal Cavity
Nasal venous plexus can drain into cavernous sinus, pteryogid plexus, facial vein, or superior saggital sinus
Veins in ITF
pterygoid plexus of veins, maxillary v., superficial temporal v., retromandibular v., deep facial v., sphenoidal emissary v., cavernous
sinus.
DANGER TRIANGLE
***The inferior opthalmic veins can do a couple of things they can either drain
straight back into the cavernous sinus or into the pterygoid plexus of veins.
When you are trying to do a posterior superior alveolar nerve block and you
accidentally damage one of the veins in the pterygoid plexus of veins that will
find seepage into the orbit and your patient will end up with a black eye.
