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Head and Neck > Week 2.0 - Major Blood Vessels > Flashcards

Week 2.0 - Major Blood Vessels Flashcards

1
Q

Which structure is most lateral, common carotid or internal jugular?

A

-Internal jugular

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2
Q

Describe the major branches arising from the aortic arch

A
  • On the right the brachiocephalic trunk (splits into r subclavian and common carotid)
  • Left common carotid medial to that
  • L subclavian on the left
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3
Q

What 3 arteries arise from the base of the subclavian?

A
  • Vertebral
  • Internal thoracic
  • thyrocervical trunk
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4
Q

Which arteries arise from the thyrocervical trunk? Where does each of these supply?

A
  • Ascending and transverse cervical supply the neck
  • Suprascapular supplies the shoulder
  • Inferior thyroid supplies lower pole of thyroid gland
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5
Q

From where do the vertebral arteries arise, and what is significant about their course?

A
  • Base of subclavian arteries

- Ascend through transverse foramina of C6-1

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6
Q

How do the vertebral arteries enter the cranium? With what do they anastomose to form what structure?

A
  • Through foramen magnum

- Basilar arteries = circle of willis

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7
Q

From where do the basilar arteries arise? How does this enter the skull?

A
  • Internal carotid artery

- Through carotid foramen and then carotid canal

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8
Q

Where does the common carotid bifurcate?

A

-C3/C4

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9
Q

Where is the carotid sinus and carotid body?

A
  • Carotid sinus in internal carotid artery

- Carotid body lies close to this

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10
Q

What is the carotid sinus?

A
  • Swelling at the region of bifurcation which contains baroreceptors for detecting changes in BP
  • Relays this information to the medulla oblongata (the greater the stretch the more signals fire)
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11
Q

What is the carotid body?

A

-A small cluster of peripheral chemoreceptors which detect arterial pO2
(most vascular tissue in the body)

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12
Q

Relative to the carotid arteries, what is a common site of atheroma? Why?

A
  • The level of the bifurcation

- Area of turbulent flow

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13
Q

What are the possible consequences of atheroma at the carotid bifurcation?

A
  • Stenosis of the artery causes symptoms over 70% occlusion

- Risk of embolism causing TIA/Stroke

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14
Q

What is the carotid sheath? What does it enclose?

A

-A layer of fascia within the neck which encloses the common carotid artery, internal jugular vein, vagus nerve and deep cervical lymph nodes

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15
Q

State the boundaries of the carotid triange

A
  • Superior -> Posterior belly of digastric
  • Lateral -> sternocleiodomastoid
  • Medial -> Superior belly of omohyoid
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16
Q

Why is the carotid triangle clinically important? (4 reasons)

A
  • Surgical access to carotid arteries or IJV
  • Access to Vagus and Hypoglossal nerve
  • Carotid pulse
  • Carotid sinus massage
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17
Q

When is carotid sinus massage used and why?

A
  • Supraventricular tachycardia

- Stimulate the baroreceptors to increase vagal activity and resolve SVT

18
Q

State the 8 branches of the external carotid artery

A
  • Superior thyroid
  • Lingual
  • Facial
  • Ascending pharyngeal
  • Occipital
  • Posterior auricular
  • Superficial temporal
  • Maxillary
19
Q

Which 5 arteries are the major supply to the scalp?

A
  • Supra-orbital
  • Supratrochlear
  • Superficial temporal
  • Posterior auricular
  • Occupital
20
Q

Name the 5 layers of the SCALP

A
  • Skin
  • Connective tissue (dense)
  • Aponeurosis
  • Loose connective tissue
  • Periosteum
21
Q

In which layer of the scalp do blood vessels lay?

A

-subcutaneous connective tissue layer (dense layer)

22
Q

From where do the arteries of the scalp arise?

A

-All from ECA except supra-orbital and supratrochlear which are from the ophthalmic branch of internal carotid artery

23
Q

Why is there profuse bleeding with a scalp laceration? (3 reasons)

A
  • Many anastomoses
  • Walls of arteries closely attached to connective tissue -> limits constriction
  • Lacerations involving epicranial aponeurosis can bleed profusely due to opposing pull of occipitofrontalis
24
Q

Is there usually necrosis of the skull in a scalp laceration?

A

-No, mostly supplied by middle meningeal artery

25
Q

Describe the venous drainage of the scalp

A
  • Most superficial veins follow arteries (eg occipital/superficial temporal veins etc)
  • Supraorbital and supratrochlear do not follow the course of their arteries, instead they units at medial angle of the eye to form angular vein which drains into facial vein
  • Some deep parts of the scalp in temporal region drain into pterygoid venous plexus
26
Q

What is an emissary vein?

A

-Connection between the extracranial venous drainage of the scalp and intracranial venous drainage

27
Q

What is a dural venous sinus?

A
  • Endothelial lined Venous channels found at dural septae between the double layers of dura mater (periosteal and meningeal layers)
  • Receive blood from large veins draining the brain
28
Q

Why are emissiary veins clinically significant?

A
  • They are valveless thus blood can flow in either direction

- Potential route for infection spread between scalp and cranial cavity-> can lead to meningitis

29
Q

Describe the orientation of the external and internal jugular vein, relative to sternocleidomastoid

A
  • External is anterior to SCM

- Internal is posterior to SCM

30
Q

What is the pterion and why is it clinically significant?

A
  • Site of fusion of 4 bones of the skull
  • It is a weak area of the skull which overlays anterior branch of middle meningeal artery
  • > Blow to pterion can cause fracture -> risk damage to mma -> extradural haemorrhage
31
Q

What is the main blood supply to skull and dura mater?

A

-Middle meningeal artery

32
Q

Why is the bone and scalp flap retracted inferiorly in a craniotomy?

A

-To preserve blood supply

33
Q

Which major artery supplies the main blood supply to the face?

A

-External carotid

34
Q

From where does the middle meningeal artery arise?

A

-Maxillary artery (from ECA)

35
Q

Name 3 dural venous sinuses

A
  • Cavernous sinus
  • Superior/inferior saggital sinus
  • Transverse sinus
36
Q

Which sinus leaves the brain as internal jugular vein?

A

-Sigmoid sinus

37
Q

Describe venous drainage of the face

A

-Follow the arteries

38
Q

Which veins unite to form angular vein?

A

-Supraorbital and supratrochlear

39
Q

What is clinically significant about facial veins?

A
  • They are valveless and thus blood can flow in either direction
  • They connect to cavernous sinus and pterygoid plexus via ophthalmic and facial veins -> potential route for infection spread to cranial cavity, especially from danger triangle
  • Thrombophlebitis of facial vein can lead to infected clot entering intracranial venous system
40
Q

Describe the cavernous sinus and its contents

A
  • Plexus of extremely thin walled veins on upper surface of sphenoid bone
  • Internal carotid artery
  • CN III, IV, VI (all nerves to eye) and CNV1 and CNV2
41
Q

Which jugular vein is used to measure JVP?

A

-Right Internal jugular

42
Q

Describe how to measure JVP

A
  • Sit patient at 45 degrees
  • Observe pulsation under SCM
  • Height from sternal angle + 5cm = mmHG

Head and Neck (18 decks)

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