Week 3 - Blood Vessels and Lymphatics of the Head and Neck

Question 1

State the branches of the subclavian artery.

Answer 1

1. Vertebral
2. Internal thoracic
3. Thyrocervical artery

Question 2

State the branches of the thyrocervical trunk and what structures they supply.

Answer 2

1. Ascending and transverse cervical arteries - supply the neck
2. Suprascapular artery - supplies shoulder
3. Inferior thyroid artery - supplies the lower pole of the thyroid gland

Question 3

Through what hole does the internal carotid artery enter the skull?

Answer 3

Carotid canal

Question 4

Through what hole do vertebral arteries pass through to enter the skull?

Answer 4

Foramen magnum

Question 5

State the anatomical landmark at which the bifurcation of the common carotid artery occurs.

Answer 5

Superior border of the thyroid cartilage

Question 6

State the relationship of the internal jugular vein to the common carotid artery.

Answer 6

The internal jugular vein lies laterally to the common carotid artery, under the sternocleidomastoid muscle

Question 7

Outline the boundaries of the carotid triangle.

Answer 7

Superior boundary - Posterior belly of digastric
Medial boundary - Superior belly of omohyoid
Lateral boundary - Sternocleidomastoid

Question 8

State the contents of the carotid triangle.

Answer 8

1. Internal jugular vein

2. Bifurcation of the common carotid artery - external and internal carotid artery

Question 9

State all the branches of the external carotid artery.

Answer 9

Superior thyroid artery 
Ascending Pharyngeal 
Lingual
Facial 
Occipital
Posterior auricular 

Terminal branches:
Maxillary
Superficial temporal

Question 10

Name the arteries that form the blood supply to the scalp.

Answer 10

Internal carotid:

1. Supratrochlear
2. Supra-orbital

External carotid:

1. Posterior auricular
2. Superficial temporal
3. Occipital

Question 11

Why do deep lacerations involving the epicranial aponeurosis cause profuse bleeding?

Answer 11

Opposing pull of occipitofrontalis

Question 12

Why does loss of the scalp not lead to bone necrosis?

Answer 12

Because the blood supply to the skull is mostly from the middle meningeal artery

Question 13

Outline the venous drainage of the scalp.

Answer 13

1. Superficial temporal veins
2. Posterior auricular veins
3. Occipital veins
4. Supraorbital and supratrochlear veins unite at medial angle of eye to form the angular vein which drains into the facial vein
5. Deep parts of the scalp in the temporal region have veins which drain into the pterygoid venous plexus

Question 14

What are dural venous sinuses? Where do they form?

Answer 14

Endothelium-lined spaces between the periosteal and meningeal layers of the dura
They form at dural septae

Question 15

What do the sigmoid sinuses continue as?

Answer 15

The internal jugular veins - leave the skull through the jugular foramina

Question 16

State the veins that form the venous drainage of the face.

Answer 16

1. Supraorbital vein
2. Supratrochlear vein
3. Angular vein
4. Facial vein
5. Superior and inferior labial veins
6. Common facial vein
7. Internal jugular vein
8. External jugular vein

Question 17

What do the deep facial veins of the face drain into?

Answer 17

Pterygoid venous plexus

Question 18

What is a better indication of the pressure in the right atrium - IJV or EJV?

Answer 18

The internal jugular vein (right IJV - effectively like a direct connection to the right atrium)

Question 19

How is JVP calculated?

Answer 19

With the patient at a 45 degrees angle, height from sternal angle + 5 cm

Question 20

How can infection spread from the scalp to the cranial cavity?

Answer 20

Via emissary veins

Question 21

How can infection spread from the face to the cavernous sinus?

Answer 21

Via the inferior and superior ophthalmic veins and the deep facial veins

Question 22

State the regions drained by the submandibular lymph nodes.

Answer 22

1. Anterior nasal cavity
2. Upper lip and teeth
3. Lateral part lower lip
4. Submandibular and sublingual glands
5. Tongue - middle
6. Most of face

Question 23

State the regions drained by the submental lymph nodes.

Answer 23

1. Lower lip and teeth - central
2. Anterior chin
3. Tip of tongue
4. Floor of mouth

Question 24

State the regions drained by the pre-auricular lymph nodes.

Answer 24

1. Scalp
2. Parotid gland
3. Anterior part of ear- auricle
4. Some sources state that the eyelids and conjunctiva drain here

Question 25

State the regions drained by the posterior-auricular lymph nodes (mastoid).

Answer 25

1. Scalp
2. Posterior part of ear (auricle)
3. Ear canal

Question 26

State the regions drained by the occipital lymph nodes.

Answer 26

Occipital area of scalp and neck

Question 27

State the regions drained by the superficial cervical lymph nodes (including anterior and posterior).

Answer 27

Skin of the neck

Question 28

State the regions drained by the jugulo-digastric lymph nodes.

Answer 28

1. Palatine tonsils
2. Oral cavity
3. Posterior 1/3rd tongue
4. Pharynx
5. Larynx

Question 29

Outline the functions of the lymphatic system.

Answer 29

1. Remove excess fluid from the interstitial space
2. Returns small proteins and fluid that leaked from capillaries
3. Key role in immune defence and immune surveillance - Physical and phagocytic barrier, source of lymphocytes