Arteries of head and neck

Question 1

What are the main arteries supplying the head and neck?

Answer 1

Common carotid arteries

Vertebral arteries

Question 2

What do the common carotid arteries arise from?

Answer 2

Right common carotid artery arises as medial branch from brachiocephalic trunk

Left common carotid artery arises as last branch from aortic arch

Question 3

Is the right common carotid artery longer or the left common carotid artery? Why?

Answer 3

Left common carotid artery

because it arises directly from the arch of the aorta

Question 4

What is the surface landmark as to where the brachiocephalic trunk divides into the right common carotid artery?

Answer 4

Right sternoclavicular joint

Question 5

Where does the common carotid artery travel after it has arisen?

Answer 5

Ascends up the neck

Question 6

How does the common carotid artery ascend up the neck?

Answer 6

In the carotid sheath

Question 7

What are the branches of the common carotid artery?

Answer 7

Internal carotid artery

External carotid artery

Question 8

Where in the neck itself does the common carotid artery bifurcate into the internal and external carotid arteries?

Answer 8

Carotid triangle

Question 9

At what level does the common carotid artery bifurcate into the internal and external carotid arteries?

Answer 9

C4

Superior margin of thyroid cartilage

Question 10

Where can the common carotid artery be palpated?

Answer 10

In the carotid triangle just below its bifurcation

Question 11

Why might palpating a patient’s common carotid artery be avoided?

Answer 11

Carotid sinus baroreceptors may be hypersensitive
may result in bradycardia, hypotension
which would lead to underperfusion of brain, syncope

Question 12

What is located at the bifurcation of the common artery between the internal and external carotid arteries?

Answer 12

Carotid body

Question 13

What is the carotid body?

Answer 13

Group of chemoreceptors

Question 14

What is the function of the carotid body?

Answer 14

Detect changes in partial pressures of oxygen and carbon dioxide in the blood

Question 15

What is located in the internal carotid artery just after it has arisen?

Answer 15

Carotid sinus

Question 16

What is the carotid sinus?

Answer 16

Swelling in internal carotid artery just after it has arisen

Contains baroreceptors

Question 17

What is the clinical significance of the carotid sinus?

Answer 17

Can massage it

to alleviate supraventricular tachycardias

Question 18

How does massaging the carotid sinus alleviate supraventricular tachycardias?

Answer 18

Increased pressure in carotid sinus
baroreceptor reflex
decreased heart rate

Question 19

What pathological process occurs at the bifurcation of the common carotid artery into the internal and external carotid arteries as a common site?

Answer 19

Atheroma formation

Question 20

What are the complications of atheromatous plaques at the bifurcation of the common carotid artery into the internal and external carotid arteries?

Answer 20

Rupture of plaque, clot formation
rupture of clot, embolus
gives transient ischaemic attack or stroke

Question 21

How can atheromatous plaques at the bifurcation of the common carotid artery into the internal and external carotid arteries be treated?

Answer 21

Carotid end arterectomy

which is where an incision is made into the common carotid artery, and the plaque is physically removed

Question 22

What are the risks of a carotid end arterectomy?

Answer 22

Damage to internal jugular vein

Damage to vagus nerve, hypoglossal nerve

Question 23

Where does the internal carotid artery travel in the neck?

Answer 23

Ascends up the neck

Question 24

How does the internal carotid artery ascend up the neck?

Answer 24

In the carotid sheath

Question 25

What does the internal carotid artery enter after the neck?

Answer 25

Cranial cavity

Question 26

How does the internal carotid artery enter the cranial cavity?

Answer 26

Through carotid canal of petrous part of temporal bone

Question 27

Where does the internal carotid artery travel in the cranial cavity?

Answer 27

Travels antero-medially then through cavernous sinus then turns on itself to travel postero-superiorly

Question 28

What does the internal carotid artery do in the cranial cavity?

Answer 28

Gives off branches

Question 29

What is the first branch of the internal carotid artery?

Answer 29

Opthalmic artery

Question 30

What are some important branches of the ophthalmic artery?

Answer 30

Central retinal artery Supra-orbital artery Supra-trochlear artery Anterior ethmoidal arteries

Question 31

What is the blood supply of the retina?

Answer 31

Only the central retinal artery | so it is a true anatomical end artery

Question 32

What is the clinical significance of the central retinal artery being an end artery?

Answer 32

Blockage of this artery gives loss of blood supply to retina, become ischaemic hypoxic immediate loss of vision on that side

Question 33

What are the causes of blockage to the central retinal artery? Which is the most common cause?

Answer 33

Thrombus Embolism, from atherosclerotic plaque in carotid artery - most common cause

Question 34

Where does the external carotid artery travel in the neck?

Answer 34

Ascends up the neck

Question 35

How does the external carotid artery ascend up the neck?

Answer 35

Posteriorly to condylar process of the mandible Anteriorly to the lobule of the ear

Question 36

What does the external carotid artery do in the neck?

Answer 36

Gives off branches

Question 37

What branches does the external carotid artery give off in the neck, in the order that they arise?

Answer 37

Superior thyroid artery Ascending pharyngeal artery Lingual artery Facial artery Occipital artery Posterior auricular artery Maxillary artery Superficial temporal artery

Question 38

Where does the external carotid artery end?

Answer 38

Parotid gland

Question 39

How does the external carotid artery end in the parotid gland?

Answer 39

Divides into its terminal branches | the maxillary artery and superficial temporal artery

Question 40

What does the superior thyroid artery supply?

Answer 40

Superior pole of thyroid gland

Question 41

What does the ascending pharyngeal artery supply?

Answer 41

Pharynx

Question 42

What does the lingual artery supply?

Answer 42

The tongue

Question 43

What does the occipital artery supply?

Answer 43

Scalp

Question 44

What does the posterior aricular artery supply?

Answer 44

Scalp

Question 45

What does the maxillary artery supply?

Answer 45

Deep face structures

Question 46

What does the superficial temporal artery supply?

Answer 46

Scalp

Question 47

What are the other arteries supplying the scalp, apart from the superficial temporal, occipital and posterior auricular arteries?

Answer 47

Supra-orbital artery Supra-trochlear artery

Question 48

What does the supra-orbital artery arise from?

Answer 48

Opthalmic artery

Question 49

What does the supra-trochlear artery arise from?

Answer 49

Opthalmic artery

Question 50

Where does the facial artery travel in the face?

Answer 50

Over inferior border of mandible, anterior to masseter muscle Supero-medially to medial angle of eye

Question 51

Where is the facial artery palpated?

Answer 51

Inferior border of mandible, anterior to masseter

Question 52

What does the facial artery do in the face?

Answer 52

Gives off branches

Question 53

What are the branches of the facial arteries in the face, in the order that they arise?

Answer 53

Inferior labial artery Superior labial artery Lateral nasal artery Angular artery

Question 54

Where does the inferior labial artery travel in the face?

Answer 54

Below the lower lip

Question 55

Where does the superior labial artery travel in the face?

Answer 55

Above the upper lip

Question 56

Where does the lateral nasal artery travel in the face?

Answer 56

Towards middle of nose

Question 57

Where does the angular artery travel in the face?

Answer 57

To the medial angle of the eye

Question 58

Where does the maxillary artery travel in the face?

Answer 58

Deep to the superior ramus of the mandible | over the maxilla below the eye

Question 59

What does the maxillary artery do in the face?

Answer 59

Gives off branches

Question 60

What are the important branches of the maxillary artery?

Answer 60

Middle meningeal artery Sphenopalatine artery

Question 61

Where does the middle meningeal artery travel after it arises?

Answer 61

Through the foramen spinosum | into the cranial cavity

Question 62

What does the middle meningeal artery do in the cranial cavity?

Answer 62

Divides into an anterior branch and a posterior branch

Question 63

What does the middle meningeal artery supply?

Answer 63

Calvaria Dura

Question 64

Where does the anterior branch of the middle meningeal artery travel after it arises?

Answer 64

Deep to the pterion

Question 65

How does the anterior branch of the middle meningeal artery affect the inner surface of the calvaria?

Answer 65

Forms a groove within it

Question 66

What is the clinical significance of the anterior branch of the middle meningeal artery?

Answer 66

Fracture of pterion, which is the weakest part of the skull could rupture the middle meningeal artery giving an extra-dural haemorrhage

Question 67

Where does the sphenopalatine artery travel after it arises?

Answer 67

Through the sphenopalatine fossa | to the nasal septum

Question 68

What is the blood supply to the nasal septum?

Answer 68

Kiesselbach's plexus

Question 69

What is Kiesselbach's plexus?

Answer 69

Anastamosis of arteries in nasal septum

Question 70

What are the most important branches of Kiesselbach's plexus?

Answer 70

Sphenopalatine artery - septal branch Anterior ethmoidal arteries

Question 71

Where do the anterior ethmoidal arteries arise from?

Answer 71

Opthalmic artery

Question 72

What is the clinical significance of the Kiesselbach plexus?

Answer 72

Leakage from this plexus is most commonly the cause of epistaxis

Question 73

What is epistaxis?

Answer 73

Nosebleed

Question 74

What are the branches of the subclavian artery, in the order they arise?

Answer 74

Vertebral artery Internal thoracic artery Thyrocervical trunk

Question 75

Where do the vertebral arteries travel after they arise?

Answer 75

Ascend up the neck

Question 76

How do the vertebral arteries ascend up the neck?

Answer 76

Through the transverse foramina of C1-C6

Question 77

Where do the vertebral arteries enter the subarachnoid space?

Answer 77

Between the occipital bone and the atlas

Question 78

Where do the vertebral arteries enter after the neck?

Answer 78

The subarachnoid space The cranial cavity

Question 79

What do the vertebral arteries do in the cranial cavity?

Answer 79

Join together to form the basilar artery

Question 80

How do the vertebral arteries enter the cranial cavity?

Answer 80

Through the foramen magnum

Question 81

What does the basilar artery supply?

Answer 81

The brain

Question 82

Where does the basilar artery travel?

Answer 82

Along the anterior aspect of the brainstem

Question 83

What does the thyrocervical trunk divide into, in order?

Answer 83

Suprascapular arteries Transverse cervical artery Inferior thyroid artery

Question 84

What do the vertebral arteries supply?

Answer 84

Posterior neck Posterior parts of brain, so the brainstem and cerebellum

Question 85

What does the inferior thyroid artery do?

Answer 85

Supplies the inferior pole of the thyroid gland Gives off ascending cervical artery

Question 86

What do the ascending and transverse cervical arteries supply?

Answer 86

Neck

Question 87

Where do the internal thoracic arteries travel after they arise?

Answer 87

Run in an inferior direction, laterally to the sternum

Question 88

What do the internal thoracic arteries do?

Answer 88

Give off anterior intercostal arteries

Question 89

What do the internal thoracic arteries end as?

Answer 89

Superior epigastric arteries