Craniofacial Vasculature I

Question 1

Layers of dura

Answer 1

Periosteal layer attaches to periosteum of bone.

Meningeal layer is deeper.

Question 2

When do the dural layers fuse?

Answer 2

They fuse usually, except for when they form dural venous sinuses.

Question 3

What is arachnoid made of?

Answer 3

Arachnoid trabeculae which is made of collagen and elastin.

Question 4

Which layers are the subdural space and subarachnoid spaces between?

Answer 4

Subdural space - dura and arachnoid.

Subarachnoid space - arachnoid and pia mater.

Question 5

What is pia mater made of?

What is it adhered to?

Answer 5

Made of delicate CT and adheres to entire brain and follows all contours.

Question 6

What creates the cranial dural septa?

Answer 6

Extensions of meningeal layer of the dura.

Question 7

4 cranial dural septa

What exists in these septa?

Answer 7

Falx cerebri
Tentorum cerebelli
Falx cerebelli
Diaphragma sellae

Sinuses.

Question 8

Arterial supply to the meninges

Answer 8

Middle meningeal a. (frontal and parietal branches)
Occipital a.
Vertebral a. branches

Question 9

Innervation of the meninges (4)

Answer 9

CN V1 - ophthalmic n.
CN V2 - maxillary n.
CN V3 - mandibular n.
Cervical spinal ns. (C2-C3)

Question 10

Which cranial nerves contribute to the C2-C3 cervical spinal ns.?

Answer 10

C2-C3 from CN XII

C2 from CN X

Question 11

8 sinuses in the brain

Answer 11

Superior sagittal sinus
Inferior sagittal sinus
Transverse sinus
Occipital sinus
Sigmoid sinus
Confluence of sinuses
Cavernous sinus

Question 12

Associated structures with the cavernous sinus (7)

Answer 12

Internal carotid a.
CN V and its branches.
CN III
CN IV
CN VI
Hypophysial fossa
Pituitary glands

Superior orbital fissure

Question 13

4 parts of the ICA

Answer 13

Cervical
Petrous
Cavernous
Cerebral

Question 14

Where does CSF circulate?

Answer 14

Ventricles and subarachnoid space

Question 15

What makes CSF?

Answer 15

Ependymal cells of choroid plexus produce CSF from plasma.

Question 16

What is in greater concentration in CSF than plasma? (2)

Lesser amount? (2)

Answer 16

Greater - Na+ and H+

Lesser - K+ and Ca2+

Question 17

How does CSF drain from brain?

Answer 17

Fluid drains from subarachnoid space into arachnoid villi and then into the dural venous sinuses.

Question 18

Venous drainage from the face is:

Venous drainage from the head is:

Answer 18

Superficial (face)

Head (deeper)

Question 19

Tract of internal jugular v.

Answer 19

Goes thru jugular foramen as a continuation of sigmoid sinus and descends behind and lateral to ICA within the carotid sheath.

Question 20

4 cervical LN regions

Answer 20

Submental and submandibular LNs
Deep cervical LNs (upper, middle, lower)
LNs of posterior cervical triangle
Anterior cervical LNs

Question 21

2 sites in neck where lymph pathways intersect and what empties there?

Answer 21

Jugulofacial venous junction - lymphatics from head meet there and travel down neck.

Jugulosubclavian venous junction - lymph from head and neck meets with thoracic duct from the rest of the body (on left)/

Question 22

What kind of disease process is expected when central lymph nodes affected?

Peripheral nodes?

Answer 22

Central - extensive disease –> bx

Peripheral - localized process

Question 23

What are bulbs of the Internal Jugular V.?

Answer 23

Swellings of the lumen at the start and end of the vein.

Question 24

Which bulb has a bicuspid valve above it?

Answer 24

Inferior bulb

Question 25

What does the Inferior Petrosal Sinus drain? Where does it leave the skull? What vein does it join and where?

Answer 25

Helps drain the cavernous sinus. Leaves via the anterior part of jugular foramen. Drains into IJV just below the superior bulb.

Question 26

What forms the facial v.?

Answer 26

Union of supraorbital v. and supratrochlear v. to form the angular v. Angular v. and deep facial v. join to form facial v.

Question 27

What does the facial v. communicate with?

Answer 27

Cavernous sinus

Question 28

What is the tract of the facial v. and what does it join?

Answer 28

Travels posteroinferiorly down the face to lower border of mandible. Joins the retromandibular v.

Question 29

What does the superior ophthalmic v. drain?

Answer 29

Cavernous sinus

Question 30

What does the deep facial v. drain?

Answer 30

Pterygoid plexus

Question 31

Which 2 veins form the retromandibular v.?

Answer 31

Superficial temporal v. and Maxillary v.

Question 32

Which 2 veins does the pterygoid plexus drain into?

Answer 32

Deep facial v. anteriorly | Maxillary v. posteriorly

Question 33

What gland is near the retromandibular v.?

Answer 33

Parotid gland

Question 34

Where does the anterior division of the retromandibular v. drain? Where does the posterior division of the retromandibular v. drain?

Answer 34

Anterior - facial v. Posterior - posterior auricular v. --> EJV

Question 35

If maxillary v. is occluded, who drains the pterygoid plexus?

Answer 35

Deep facial v.

Question 36

What is the function of the pterygoid plexus?

Answer 36

To act as a peripheral pump to allow venous return when the mouth opens.

Question 37

What muscle does the pterygoid plexus surround?

Answer 37

Lateral pterygoid m.

Question 38

What triggers yawning? Which muscle is contracted when one yawns?

Answer 38

Triggered by venous stagnation. Lateral pterygoid m.

Question 39

Which veins can the pharyngeal vs. drain? (4)

Answer 39

IJV Facial v. Lingual v. Superior thyroid v.

Question 40

Where can the superior thyroid v. drain? (2)

Answer 40

Facial v. or IJV

Question 41

Where does the middle thyroid v. drain?

Answer 41

IJV

Question 42

Where can the occipital v. drain? (2)

Answer 42

Vertebral v. or posterior auricular v.

Question 43

What is the tract of the anterior jugular v.?

Answer 43

Below the chin, passes under platysma m. down to the suprasternal notch.

Question 44

What is the tract of the external jugular v.?

Answer 44

Starts at angle of mandible by union of posterior auricular v. and posterior division of retromandibular v. and drains into subclavian v.