Blood supply to head, neck and limbs

Question 1

What does the arterial supply to the head and neck consist of?

Answer 1

Common carotid (external and internal)
Subclavian (vertebral)

Question 2

When do the common carotid arteries bifurcate?

Answer 2

Common carotids ascend neck
Bifurcate at C4 (margin of thyroid cartilage)
Within carotid triangle

Question 3

What forms the carotid triangle?

Answer 3

Omohyoid (left)
Digastric (upper)
Sternocleidomastoid (right)

Question 4

Describe the external carotid artery

Answer 4

Supplies head and neck (outside cranium)
8 branches
Terminates in the parotid gland

Question 5

What are the 8 branches of the external carotid artery?

Answer 5

Superior thyroid a.
Lingual a. (tongue)
Facial a. (superficial skin and underlying tissues)
Ascending pharyngeal a.
Occipital a.
Posterior auricular a.
Superficial temporal a. (scalp)
Maxillary a. (deeper supply)

Question 6

What is the carotid sinus?

Answer 6

Dilated segments of common and internal carotid arteries

Detection and regulation of blood pressure (baroreceptor)

Question 7

Describe the internal carotid artery

Answer 7

Supplies the brain, eyes and forehead

Forms part of the Circle of Willis entering the cranial cavity via the carotid canal

Question 8

Describe the vertebral artery

Answer 8

Arise from subclavian artery
Ascend through the transverse foramina of c spine
Enter foramen magnum and converge
Supply the brain via the Circle of Willis

Question 9

What are the types of jugular veins?

Answer 9

Internal
External
Anterior

Question 10

Describe the internal jugular vein

Answer 10

Deepest and largest, drains brain and skull

Combines with subclavian vein to form brachiocephalic vein

Question 11

Describe the external jugular vein

Answer 11

Drains face and scalp

Empties into subclavian vein

Question 12

Describe the anterior jugular vein

Answer 12

Drains anterior neck

Empties into subclavian vein

Question 13

What is the carotid sheath?

Answer 13

Paired structures found on either side of the anterior neck

Question 14

What are the contents of the carotid sheath?

Answer 14

Common carotid artery
Internal jugular vein
Vagus nerve
Cervical lymph nodes

Question 15

What does the subclavian artery become and where?

Answer 15

Axially artery at lateral margin of first rib

Passes through the axilla

Question 16

What does the axillary artery become and where?

Answer 16

Brachial artery

Inferior margin of Teres Major

Question 17

What are the arteries supplying the upper limb?

Answer 17

Profunda brachii
Brachial
Radial
Ulnar

Question 18

What are the arteries supplying the hands?

Answer 18

Superficial palmar arch

Deep palmar arch

Question 19

What does the ulnar and radial arteries supply in the hands?

Answer 19

Half first digit to thumb= radial

Half of first digit to pinkie= ulnar

Question 20

What are the veins draining the hand?

Answer 20

Dorsal venous network

Anatomical snuffbox

Question 21

What are the veins draining the upper limb?

Answer 21

Cephalic vein 
Basilic vein (subcutaneous superficial and deep)
Median cubital vein
Ulnar veins
Radial veins
Brachial veins
Axillary vein
Subclavian

Question 22

Describe the arterial supply to the lower limbs/ thigh

Answer 22

External iliac artery
Femoral artery (passes under the inguinal ligament)
Deep artery of the thigh/ perfunda femorus
Popliteal artery (passes posteriorly through adductor hiatus)

Question 23

Describe the arterial supply to the lower limbs/ leg

Answer 23

Anterior tibial artery (passes through aperture in interosseous membrane)
Peroneal
Dorsalis pedis artery
/
Posterior tibial artery
Fibular artery

Question 24

Describe the arterial system in the feet

Answer 24

Dorsal arch
Lateral plantar
Medial plantar
Plantar arch
Deep plantar

Question 25

Describe the venous drainage of the feet

Answer 25

Dorsal venous arch | Lateral and medial malleolus (ankle)

Question 26

Describe the venous drainage of the leg

Answer 26

Great and small saphenous vein Anterior and posterior tibial Popliteal vein

Question 27

Describe the venous drainage of the lower limb/ thigh

Answer 27

Femoral vein Deep femoral Femoral circumflex External iliac

Question 28

What is the histology of arteries

Answer 28

Tunica intima= endothelial cells, connective tissue Tunica media= smooth muscle cells and collagen (thickest part) Tunica adventitia= thin connective tissue layer, contains lymphatics, nerves and blood vessels

Question 29

Where can pulses be taken?

Answer 29

Radial= lateral wrist Brachial= medial to biceps tendon Femoral= mid-inguinal point Popliteal= popliteal fossa Anterior tibial= lateral edge of mid tibia Posterior tibial= posterior to medial malleolus Dorsalis pedis= dorsum of foot

Question 30

What is the order of branches of arteries in the face?

Answer 30

Lingual= 2nd Facial= 3rd Maxillary= 4th Superficial temporal= 5th

Question 31

What do the internal jugular and the subclavian veins unite to form?

Answer 31

Brachiocephalic vein

Question 32

What are the differences between superficial and deep veins in the upper limb?

Answer 32

Deep veins usually occur as paired accompanying veins, known as venae comitantes travelling with (and named after) the arteries. Superficial veins originate in the subcutaneous tissue and are mostly single, unpaired vessels

Question 33

Describe the arterial supply to the hand

Answer 33

- Deep palmar arch= predominantly formed from radial artery with an anastomosis with the deep palmar branch of the ulnar artery - Superficial palmar arch= primarily formed from ulnar artery with contribution from superficial palmar branch of radial artery - Arches separated by passage of flexor tendons of the digits (flexor digitorum superficialis and profundus)

Question 34

In which anatomical region does Profunda femoris branch from right femoral artery?

Answer 34

Femoral triangle

Question 35

Where does right common iliac artery branch to form right external iliac and left internal iliac arteries?

Answer 35

Anterior to Sacroiliac joints

Question 36

How can you palpate the brachial artery?

Answer 36

- Halfway down medial side of arm | - Medial and deep to border of biceps muscle, pushing firmly

Question 37

How can you palpate the radial artery?

Answer 37

- Finger lightly on lateral side of wrist at level the wrist creases - Move finger medially along anterior side of wrist until moving against flexor carpi radialis tendon - Lateral to tendon

Question 38

How can you palpate the femoral artery?

Answer 38

- Distal to midpoint of inguinal ligament - Identify anterior superior iliac spine and pubic tubercle on pelvis - Move approx. half way along line between points then move inferiorly into femoral triangle

Question 39

How can you palpate the popliteal artery?

Answer 39

- Popliteal fossa (posterior aspect of knee) - Deep structure so push firmly - Lie prone/ on front with knee flexed to relax popliteal fascia and hamstrings

Question 40

How can you palpate the anterior tibial artery?

Answer 40

- When extending (lifting) toes, palpate long tendons to toes and big toes - Anterior tibial artery palpated anterior to ankle joint between long tendon to big toe (extensor hallucis longus) and tendons to other toes (extensor digitorium)

Question 41

How can you palpate the posterior tibial artery?

Answer 41

- Space between posterior surface of medial malleolus (tibia) and medial border of calcaneal (Achilles) tendon - Invert foot/ move medially to help