W11 Vascular system

Question 1

Identify the majors vessels of the heart to/from the head and neck, and their main branches

Answer 1

Arterial Supply: Arteries that arise from summit of the aorta and carry blood to head, neck upper limbs.

• Brachiocephalic trunk
• Left common carotid
• Left subclavian
• Venous Drainage
• Internal Jugular Vein → unites with subclavian vein to form the brachiocephallic vein. Brachiocephalic veins unite to form the Superior Ven Cava (delivers deoxygenated blood of the head and neck to the right atrium).

L brachiocephalic vein is longer than the R brachiocephalic vein.

Question 2

Name the divisions of the carotid artery, and be able to name and identify each of the branches of the external carotid artery

Answer 2

Common carotid arteries are broken up into two branches; They lie beneath carotid sheath, together with in internal jugular vein and CN Vagus, travels through neck. Of which bifurcate on either side of the trachea at the superior border of the thyroid cartilage.

• Internal carotid
• external carotid

Question 3

Describe in detail the branches of the lingual (of the ECA)

Answer 3

Origin: arises from anterior aspect of ECA.

Supplies: tissues superior to hyoid bone, FOM and tongue via dorsal lingual, deep lingual, sublingual and suprahyoid branches

Path: arises at the level of hyoid bone, forms a short upward loop, crosses hypoglossal nerve, before running anterior, deep to hypoglossus muscle to enter the base of tongue

Question 4

Be able to name and identify the branches of the maxillary artery (of the ECA) that supply the teeth and surrounding structures, and muscles of mastication.

Answer 4

1. Mandibular
2. Pterygoid
3. Pterygomandibular Supplies structures of the oral cavity, nose meninges, muscles of FOM, mastication, tympanic cavity.

Begins at neck of condyle, within the parotid gland → enters the infratemporal fossa and aligns itself close to the lateral pterygoid m and crosses the lateral pterygoid m → enters the pterygopalatine fossa via the pterygomaxillary fissure

Question 5

Describe the arterial supply of the teeth, lips, palate and tongue

Answer 5

Teeth:

Incisive artery - dental and alveolar branches to anterior teeth.

Inferior alveolar artery: mandibular teeth, PDL, bone, buccal and lingual gingiva.

Anterior Superior Alveolar Artery: Maxillary anterior teeth & periodontium.

Posterior Superior Alveolar Artery: Maxillary posterior teeth Lips: Facial artery - Superior labial a. Inferior labial a. Mental a - inferior laial

Palate: Ascending pharyngeal. Descending palatine artery. Lesser palatine artery: soft palate.

Greater palatine artery: Supplies hard palate Tongue: Lingual artery,

Question 6

Describe the venous drainage of the teeth, lips, palate and tongue

Answer 6

Teeth

Superior Alveolar Veins: maxillary teeth.

Inferior Alveolar veins: manidibular teeth

Lips

Superior labial vein - upp lip.

Inferior labial vein - lower lip.

Palate

Great/Lesser drains hard/soft palate: Maxillary vein

Tongue: Lingual vein

Question 7

Identify the location of the pterygoid plexus and state its clinical significance

Answer 7

Located in infratemporal fossa.

The Pterygoid plexus.

By either filling or emptying, the pterygoid plexus can accommodate changes in the volume of infratemporal foosa that occur when the mandibe moves. Formed by numerous tributaries corresponding with the branches of the maxillary artery.

Clinical significance: protects the maxillary artery from being compressed during mastication.

Question 8

What does the Superior Thyroid branch (ECA) supply?

Answer 8

Superior thyroid - supplies upper part of thyroid, sternocleidomastoid muscle, some infrahyoid muscles, larynx.

Question 9

Describe in detail the branches of the facial arteries (of the ECA)

Answer 9

Origin: arises from anterior aspect of ECA. Supplies: Submandibular gland, tonsils and muscles of palate. Tissues of the face in the oral, buccal, zygomatic, nasal, infraorbital, and orbital regions. Paths: passes superiorly and anteriorly deep to diagastric m to the submandibular gland. S shape crosses the inferior border of the mandible. Crosses onto the face and runs anteriosuperiorly to the medial angle of the eye to anastomose with opposite facial artery. Branches in the face: - Angular - Nasal - Superior labial - Inferior labial

Question 10

Describe the ECA Posterior Auricular

Answer 10

Supplies internal ear and mastoid air cells

Question 11

Describe the Occipital ECA

Answer 11

Supplies: suprahyoid and SCM muscle, scalp and meningies in occipital region.

Question 12

What does the Posterior Auricular branch (ECA) supply?

Answer 12

Supplies internal ear and mastoid air cells

Question 13

What does the Occipital branch (ECA) supply?

Answer 13

Supplies: suprahyoid and SCM muscle, scalp and meningies in occipital region.

Question 14

What does the Ascending Pharyngeal branch (ECA) supply?

Answer 14

Ascending pharyngeal: supplies pharyngeal wall, soft palate, meninges

Question 15

What does the Ascending Superficial Temporal (ECA) supply?

Answer 15

Arises at the level of the parotid gland. It has several branches to supply the parotid gland duct and surrounding facial tissue, temporalis and scalp

Question 16

Describe the Maxillary artery (ECA) & 5 subdivisions

Answer 16

All of the branches that arise before the artery crosses the lateral pterygoid muscle, all of these enter bone via foramina spinosum. Subdivisions of: - Accessory meningeal - anterior tympatic - inferior alveolar artery - middle minigeal - deep auricular

Question 17

Describe the Mental Artery (Maxillary artery ECA)

Answer 17

Exits mental foramen SUpplies: chin, anastomoses with submental and inferior labial arteries

Question 18

Describe the Incisive Artery (Maxillary artery ECA)

Answer 18

Continuation of the IAN within bone after it gives of mental branch. Dental and alveolar branches to anterior teeth

Question 19

Describe the Inferior Alveolar Artery (Maxillary artery ECA)

Answer 19

Enterys mandibular foramen and within canal gives off dental and alveolar branches. Supplies: all mandibular teeth, PDL, bone, buccal and lingual gingiva some perforation branches to mucosa. Mylohyoid branch; branch of IAN nerve before it enters the mandibular foramen. Supplies: mylohyoid muscle

Question 20

Describe the Pterygoid part of the (Maxillary artery ECA)

Answer 20

All of the branches that arise from the artery, whilst it crosses the lateral pterygoid muscle. All the branches are to muscle. Subdivisions of - Pterygoid arteries [lateral and medial pterygoid m) - Buccal artery [ buccinator muscle] - Deep temporal arteries [ant & post temporalis muscle - Masseteric artery [ masseter m.]

Question 21

Describe the Pterygopalatine of the (Maxillary artery ECA)

Answer 21

All of the branches that arise from the artery after it has crossed the pterygoid muscle and entered the pterygopalatine fossa. Branches accompany maxillary nerve → enter via foramina. Subdivisions branches: - Infraorbital artery → enters orbit through IOF. Gives off anterior superior alveolar artery in IO groove & canal via infra orbital foramen to anastomose with facial artery. Anterior Superior Alveolar Artery: gives off dental and alveolar branches to the maxillary anterior teeth and periodontium

Question 22

Describe the Anterior Superior Alveolar Artery of Pterygoid part (maxillary ECA)

Answer 22

Anterior Superior Alveolar Artery: gives off dental and alveolar branches to the maxillary anterior teeth and periodontium

Question 23

Describe the 3 Palatine arterys (Pterygoid part) (maxillary ECA)

Answer 23

Descending palatine artery: travels to the palate through the palatine canal terminating as Greater and Lesser Palatine Arteries. Lesser palatine artery: supplies soft palate Great Palatine artery: enter oral cavity through the greater palatine foramen, runs anteriorly to incisive canal - to anastomse with sphenopalatine artery (supplies hard palate)

Question 24

Describe the spenopalatine (maxillary - pterygoid part) ECA

Answer 24

Enters nasal cavity via spenopalatine foramen. Enters oral cavity through incisive foramen and anastomoses with Greater palatine artery

Question 25

Describe and drainage of Lingual Vein

Answer 25

Formed by the union of the dorsal, sub and deep lingual veins of the tongue. Converges with the facial vein, anterior branch of the retromandibular vein, and communication branch of the anterior jugular vein to for the common trunk of the Interal Jugular vein. Drains the tongue and floor of mouth

Question 26

Describe and drainage of the Facial Vein

Answer 26

Formed by the union of the Superior Ophthalmic Vein and Supratrochlear Vein unite at the medical corner of the eye, to form the Angular Vein which becomes the facial vein. Travels posteriorly and inferiorly across the face to the inferior border of mandible. - Nasal Veins - Infraorbital @ infraorbital foramen - Deep facial @ infratemporal fossa - Superior Labial vein - upper lip - Inferior Labial vein - lower lip. Converges with anterior branch of retromandibular vein to drain into common trunk.

Question 27

Describe the venous drainage of the Superior Alveolar Vein

Answer 27

Formed by the merging of dental and alveolar branches of maxillary teeth. Drains the maxillary teeth and periodontium into the pyterygoid plexus. Veins accompanying the superior alveolar arteries drain the upper jaw and teeth anteriorly into the facial vein, or posteriorly into the pterygoid venous plexus

Question 28

Describe the venous drainage of the Inferior Alveolar Vein

Answer 28

Formed by merging of dental, alveolar and mental branches in the mandible. Accompanies Inferior Alveolar Artery. Drains the mandibular teeth and periodontium into the pterygoid plexus.

Question 29

Describe venous drainage of the Greater palatine veins and Lesser palatine veins

Answer 29

The veins accompany the arteries, and drain these tissues into the the pterygoid plexus. Drains into the hard palate and soft palate

Question 30

Describe Venous drainage: Maxillary Vein

Answer 30

Begins at the infratemporal fossa. Collects blood from the pterygoid plexus near maxillary artery. This vein drains receives the middle meningeal, posterior superior, inferior alveolar and other veins such as those from the nose and palate. Maxillary vein merges w superficial temporal vein to drain into and from the retromandibular vein

Question 31

Describe Venous drainage of Retromandibular Vein

Answer 31

Formed by the junction of the maxillary veins, and the Superficial Temporal Vein. Anterior and Posterior divisions. The anterior branch unites with the facial vein to join the common trunk of the Internal Jugular vein, w lingual vein then communication branch of the anterior jugular vein. Posterior branch → Posterior Auricular vein. The union of tese two veins marks the commencement of the External Jugular Vein.

Question 32

Describe Venous drainage of the Internal Jugular vein

Answer 32

Exits the skull via jugular foramen and travels with the interal carotid artery → in the neck with common carotid artery. Unites with subclavian vein to form the brachiocephalic cein which drains into the superior vena cava

Question 33

Describe the External Jugular Vein

Answer 33

Formed by union of posterior auricular and occipital with the posterior retromandibular ein to form the external jugular vein, drains into subclavian vein. Drains scalp and neck. Crosses with SCM m obliquely. Superficial than the Internal Jugular vein, deep to platysma m.

Question 34

Describe the Anterior jugular vein

Answer 34

Formed by the union of small veins beneath the mandible in the mental region. Descends lateral to the mid sagital plane. Receives communication branch of the anterior jugular vein before it;s termination. Empties into termination of the External Jugular vein.

Question 35

What is the clinical significance of the Pterygoid Plexus?

Answer 35

It is possible of piercing the Pterygoid plexus during LA. If the vein is pierced a small amount of blood can escape and enters tissues, causing tenderness, swelling and the discoloration of a hematoma. It communicates with other veins, the cavenous sinus is significant as infection has potential to spread fromm the face intracranially routs