Blood and Lymph Flashcards
At what level does the common carotid artery bifurcate?
Superior border of the thyroid cartilage (C4)
Where, anatomically, would you palpate for the carotid pulse?
Anterior tubercle of C6 transverse process
List the layers of the scalp
Skin Connective tissue (dense) Aponeurosis Loose connective tissue Periosteum
Explain the blood supply and venous drainage of the scalp
Blood supply:
Internal carotid A - supratrochlear, supraorbital
External carotid A - superficial temporal, posterior auricular, occipital
Venous drainage:
Subraorbital + supratrochlear –> medial angle of eye –> angular vein–> facial vein
Pterygoid venous plexus –> emissary veins
Superior saggital sinus
Inferior saggital sinus,
Sigmoid sinus
Carvernous sinus
Transverse sinus
Explain why a laceration to the scalp can give profuse bleeding
Artery walls are closely attached to connective tissue –> limits constriction
Many anastomoses
Deep lacerations involving epicranial aponeurosis –> opposing pull of occipitofrontalis
What are the functions of the lymphatic system?
Vessels and lymphoid organs (bone marrow, spleen, thymus, nodes, tonsils) that drain tissue fluid from ECF –> venous system
Assists capillaries in the return of plasma proteins that leak into ECF
Absorbs/transports fats from the digestive system
Major constituent of the immune system (conduit for the spread of infection)
Describe the pathway of lymph
Microscopic lymph capillaries –> lymph vessels (lymphagions) –> collecting trunks –> ducts –> subclavian vein
Explain the differences between the right lymphatic duct and the thoracic duct
Right lymphatic duct: Drains right upper quadrant of body Right venous angle is between right internal jugular vein and right subclavian vein Thoracic duct: Drains rest of the body Left venous angle Cisterna chyli of thoracic duct Starts slightly on right
Describe the differences in superficial/regional and deep/terminal lymph nodes and their drainage
Superficial/Regional:
Outside of deep fascia
Outer circle (peri-cervical collar nodes - chin–> occiput
Inner circle (within outer circle)
Innermost circle (Waldeyer’s ring) has paired (palatine, tubul) and unpaired (pharyngeal, lingual)
Superficial –> regional –> deep
Deep/Terminal: Within deep fascia Under SCM Embedded within carotid sheath Surround length of IJV Contains jugulo-digastric (tonsillar) and jugulo-omohyoid (lingual) tonsils Deep --> regional --> terminal
List some of the important lymph nodes that are palpated in a clinical examination
Preauricular Parotid Tonsillar (jugulo-digastric) Submental Submandibular Anterior cervical chain Posterior cervical chain Supraclavicular Posterior auricular Occipital
Describe some of the conditions associated with lymphatics
Retropharyngeal abscess Lymphadenitis Lymphangitis Lymohoedema Lymphocytosis Lymphoma
Describe the blood supply of some of the arteries in the head and neck
Thyrocervical trunk:
Ascending and transverse supply neck
Suprascapular supplies shoulder
Inferior thyroid supples lower pole of thyroid gland
Vertebral:
Ascend through neck through transverse foramina in C6-1, supplies brain
External carotid:
Six branches (superior, thyroid, lingual, ascending pharyngeal, facial, occipital, posterior auricular)
Two terminal branches (superficial temporal, maxillary)
List the branches of the external carotid artery
Superior thyroid Ascending pharyngeal Lingual Facial Occipital Posterior auricular Maxillary Superficial temporal
List some important anatomical occurrences at the Sternal Angle (angle of Louis)
Bifurcation of trachea Arch of aorta T4/5 Ligamentum arteriosum Loop of L recurrent laryngeal N
Describe how the jugular venous pressure is assessed and understand the clinical importance of measuring this
Patient at 45 degree angle
R neck
Height from sternal angle +5
Clinical - direct connection to R atrium
