Venous Drainage of the Head and Neck Region Flashcards
What are the boundaries of the scalp
- Anterior: Superior orbital margin
- Posterior: Occipital bone
- Laterally: Zygomatic arch on each side
What does SCALP stand for
- S Skin
- C Connective tissue
- A Apponeurosis
- L Loose areolar tissue
- P Pericranium
Describe the layers of the scalp from skin down
Skin Connective tissues Epicranial Aponeurosis Pericranium Bone of skull
What are the characteristics of the connective tissue layer of the scalp
- Close network of fibro-fatty tissue
- Connects the overlying skin with the under lying aponeurosis
- Contains large blood vessels
- Contains nerves
What can happen if you injure the connective tissue layer of the scalp
- Vessels unable to retract -> Profuse bleeding
* Haematoma formation -> pain
Describe the characteristics of the aponeurosis layer of the scalp
- Epicraneous muscle and apponeurosis: Occipito-frontalis muscle
- Tightly attached to the overlying Connective tissue layer.
- Loose subaponeurotic layer
What is the line that separates the parietal bone from the occipital bone
lambdoid suture
What is the epicranial aponeurosis also known as
The galea aponeurotic
Whats the origin and insertion point of the occipital muscle
Origin - superior nuchal line
Insertion - galea aponeurotica
Whats the origin and insertion points of the frontal muscle
origin - muscles over the bridge of the nose
insertion - galea aponeurotica
Whatre the characteristics of the pericranium
Periosteum of the skull
Continuous with endosteum at the sutures
What are the 3 meninges of the brain
- Cerebral dural mater
- Cerebral arachnoid mater
- Cerebral pia mater
Describe the feature of the cerebral dura mater
- A thick and dense inelastic membrane that composed of two layers, an inner or meningeal and outer or endosteal
- It is in loose contact with calvaria, and most strongly adherent to base of skull
What structures does the dura mater form
- Falx cerebri
- Tentorium of cerebellum - in front there is a gap, the tentorial incisure, for passage of midbrain
- Falx cerebelli
- Diaphragma sellae
Describe the falx cerebri
Sickle shaped, between cerebral hemispheres.
Ant. = attached to crest galli of ethmoid
Post. = blends into tentorium cerebelli
Describe the falx cerebelli
Smaller between cerebellar hemispheres along post. wall of post. cranial fossa
Describe the tentorium cerebelli
Forms the roof of the post. cranial fossa
What is the tentorial notch
Opening for the brainstem in the tentorium cerebelli
Describe the diaphragma sella
folds over the sella turcica
Point out the superior sagittal, inferior sagittal and straight sinuses
sup sag - outside
inf sag - inner
straight connects both
Point out the transverse and sigmoid sinuses
transverse round back of post cranial fossa
sigmoid connected to transverse and leads forward
Where are the cavernous sinuses
Middle cranial fossa one side of sphenoid bone in each side of sella turcica
where are the sup and inf petrosal sinuses
on petrous part of temporal bone
What nerves lie in the lateral wall of the cavernous sinus
oculomotor, trochlear and the ophthalmic and maxillary divisions of trigeminal nerve
What runs through the cavernous sinus
internal carotid artery and abducent nerve
Where does venous drainage from the H+N and brain terminate
The internal jugular vein
Describe the course of the internal jugular vein
- Jugular Foramen
- Carotid sheath
- Joins Subclavian Vein
- Brachiocephalic vein
- Superior Vena Cava
Describe the formation of the facial vein
Supraorbital and supratrochlear veins join to form facial
Describe the course of the facial vein as it descends
it joins the :
– Deep Facial vein
– Pterygoid Plexus
– Retromandibular vein
How is the retromandibular vein formed
Superficial temporal vein and maxillary vein join
Describe the course of the retromandibular vein
• Passes through Parotid Gland
• Two divisions exit:
– Anterior: Joins Facial Vein
– Posterior: Post. Auricular Vein -> EJV
Where does the maxillary vein originate
The pterygoid plexus
Describe the course of the maxillary vein
From pterygoid plexus through the sphenomandibular ligament. joins with the superficial temporal vein to form the retromandibular vein
What are the functions of the lymphatic system
- Draining excess interstitial fluid
- Carrying out immune response:
- Transporting dietary lipids & lipid soluble vitamins: A , D, E, & K
Name the regional groups of lymph nodes at the post. part of the head
occipital & mastoid
Name the regional groups of lymph nodes at the ant. part of the head
parotid & buccal
Name the regional groups of lymph nodes beneath the mandible
submental & submandibular
Name the regional groups of lymph nodes along the superficial jugular veins
ant. Cerv. & superficial cerv.
Name the regional groups of lymph nodes that are deep and related with organs
retropharyngeal, laryngeal and tracheal
Where are the occipital lymph nodes and its afferent and efferent vessels
Over occipital bone at the apex of occipital protuberence • Afferent V.: – back of SCALP • Efferent V.: – Deep Cervical Lymph Nodes
Where are the mastoid lymph nodes and its afferent and efferent vessels
Over lat. surface of mastoid process • Afferent V.: – SCALP above auricle – post. Med. Auricle – post. Wall of EAM • Efferent V.: – Deep Cervical Lymph Nodes
Where are the parotid lymph nodes and its afferent and efferent vessels
On or in the parotid gland • Afferent V.: – SCALP above parotid – lat. surface of auricle – ant. wall of EAM – lat. eyelids – middle ear • Efferent V.: – DCLN
Where are the buccal lymph nodes and its afferent and efferent vessels
Over buccinator m. Close to facial vein. • Afferent V.: – ant. SCALP & forehead – ant. part of face nose • Efferent V.: – Submandibular LN
Where are the submandibular lymph nodes and its afferent and efferent vessels
Superficial to submandibular salivary gland • Afferent V.: – buccal L.N. – Upper lip – lat. Lower lip – frontal, max. & ethmoidal air sinuses – upper & lower teeth, Except? – gingiva, Except? – Floor of mouth • Efferent V.: ??
Where are the submental lymph nodes and its afferent and efferent vessels
• Afferent V.: – tip of tongue – lower incisors & associated gums – central lower lip • Efferent V.: – submandibular L.N.
Where are the anterior cervical lymph nodes and its afferent and efferent vessels
Along the course of anterior jugular veins Afferent V.: ant. neck Efferent V.: Deep Cervical Lymph Nodes
Where are the superficial cervical lymph nodes and its afferent and efferent vessels
Afferent V.: • angle of mandible • lobule of auricle Efferent V.: • Deep Cervical Lymph Nodes
Where are the deep cervical lymph nodes found
Chain of lymph nodes along the internal jugular vein mainly on lateral aspect.
extends from the base of the skull to the root of the neck, its part of the carotid sheath
Describe the fookin afferent and efferent vessels of the DCLN
afferent v. - receives lymph from all lymphatic structures in the head and neck
efferent v. - join to form the jugular lymph trunk –> right lymphatic duct/thoracic duct –> venous system
What are the clinically important nodes
Jugulodigastric and juguloomohyoid
