Major BLood Vessels of the Head and Neck

Question 1

What major vessel is superficial to the sternocleidomastoid?

Answer 1

External jugular vein

Question 2

What arteries arise from the arch of the aorta?

Answer 2

Brachiocephalic trunk on right - gives off
common carotid and subclavian artery

Then the common carotid and subclavian on the left.

Question 3

What branches does the common carotid artery give off in the neck?

Answer 3

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Question 4

What does the common artery give off when it bifurcates?

Answer 4

External and Internal arteries

Question 5

What branches does the subclavian artery give off?

Answer 5

Vertebral artery
Internal thoracic artery
Thyrocervical artery

Question 6

What branches does the thyrocervical artery give off?

And what do they supply?

Answer 6

Suprascapular artery - supplies shoulder
Transverse cervical artery - supplies the neck
Ascending cervical artery - supplies the neck
Inferior thyroid artery - supplies the lower pole of the thyroid gland

Question 7

Describe the vertebral arteries - where they arise, their route and what they supply.

Answer 7

They arise from the subclavian arteries on the left and right

They ascend in the neck through the transverse foramina in cervical vertebrae 6-1

They supply the brain

Question 8

Describe the internal carotid artery - where it arises, branches and entrance into skull

Answer 8

It arises from the bifurcation of the common carotid artery

It gives off no branches in the neck

Enters Skull through carotid canal

Question 9

Where does the common carotid artery bifurcate?

Answer 9

At about the level of the superior border of the thyroid cartilage

Question 10

What is the carotid sinus?

Answer 10

A swelling at the region of the bifurcation

The location of baroreceptors for detecting changes in arterial BP.

Question 11

What is the carotid body?

Answer 11

Found at the bifurcation of the carotid artery

It has lots of peripheral chemoreceptors which detect arterial pO2.

Question 12

Bifurcation of the common carotid artery is a common site for what?

Answer 12

Atheroma formation

Question 13

Why is an atheroma formation dangerous at the bifurcation of the common carotid artery?

Answer 13

Rupture of the clot can cause an embolus to travel to the brain and can cause a TIA or stroke

Question 14

What lies within the carotid sheath?

Answer 14

Common carotid artery
Internal jugular vein
Vagus nerve
Deep cervical lymph nodes

Question 15

What are the borders of the carotid triangle?

Answer 15

Superior - posterior belly of digastric
Lateral - sternocleidomastoid
Medial - superior belly of omohyoid

Question 16

What is inside the carotid triangle?

Answer 16

Internal jugular vein
Bifurcation of the common carotid artery
-external and internal carotid artery

Question 17

Why is the carotid triangle useful clinically?

Answer 17

Important for surgical approach to the carotid arteries or internal jugular vein

Can also access the vagus and hypoglossal nerves

Carotid pulse can be felt

Carotid sinus massage

Question 18

What are the branches of the external carotid artery?

Answer 18

Superior thyroid
Lingual
Facial
Ascending pharyngeal
Occipital
Posterior auricular

Terminal branches

• Superficial temporal
• Maxillary

Question 19

Describe the blood supply to the scalp

Answer 19

Lots of anastomoses

5 arteries:

• Supra-orbital artery \\ these are branches of the
• Supratrochlear artery /// internal carotid artery
• Superficial temporal artery \ \ \ these are branches
• Posterior auricular artery &raquo_space;> of the
• Occipital artery / / / external carotid artery

Question 20

Name the layers of the scalp

Answer 20

Skin
Connective tissue (dense)
Aponeurosis
Loose connective tissue
Periosteum 

(Vessels of the scalp lie in the subcutaneous connective tissue layer)

Question 21

What is the clinical relevance of the blood supply to the scalp?

Answer 21

Walls of the arteries are closely associated with the connective tissue, so it limits the constriction of arteries and can result in profuse bleeding

Numerous anastomoses - profuse bleeding

Deep lacerations involving the cranial Aponeurosis cause profuse bleeding as it is attached to two muscles either side that will pull it apart when lacerated

Loss of scalp blood supply does not mean bone necrosis.

Question 22

What generally accompanies the arteries of the scalp?

Answer 22

Superficial veins

• Superficial temporal veins
• Occipital veins
• Posterior auricular veins

Question 23

Where do the supraorbital and supratrochlear veins meet and where do they drain to?

Answer 23

They unite at the medial angle of the eye to form the angular vein, which drains into the facial vein

Question 24

Where do some deep parts of the scalp drain into?

Answer 24

In the temporal region some of the veins drain into the pterygoid venous plexus.

Question 25

How do the veins of the scalp connect to the diploic veins of the skull? And what is the clinical relevance of this?

Answer 25

Through several emissary veins This is relevant because they therefore connect to dural venous sinuses And emissary veins are valve less. And so infection can spread from the scalp to the cranial cavity and effect the meninges

Question 26

What is the main artery that supplies the dura and skull? | And where does it arise from?

Answer 26

The middle meningeal artery, which is a branch of the maxillary artery

Question 27

What does the middle meningeal artery branch into?

Answer 27

The posterior branch and the anterior branch of the middle meningeal artery.

Question 28

What is the clinical relevance of the route of the anterior branch of the middle meningeal artery?

Answer 28

It runs close to the Pterion, which is connection of 4 bones of the skull and is thinner there than usual And so it is easier to break at the pterion which could lead to damage to the anterior branch of the middle meningeal artery and cause an extradural haemorrhage

Question 29

What is a craniotomy? | And how is performed to preserve blood supply?

Answer 29

An operation to gain access to the brain | When cutting away the bone and Scalp, reflect it inferiorly to preserve blood supply.

Question 30

What are the branches of the facial nerve? | And where are they located?

Answer 30

Superior and inferior labial artery - located above and below the lip Angular artery - the angle of the eye Lateral nasal artery - On the nose

Question 31

Which arteries supply the superficial areas of the face? | And which artery supplies the deep areas of the face?

Answer 31

The facial artery and superficial temporal arteries are the main suppliers of the superficial face The maxillary artery is the main supplier to the deep parts of the face.

Question 32

Where can the facial artery pulse be felt

Answer 32

At the inferior border of the mandible, anterior to the masseter muscle

Question 33

What are dural venous sinuses?

Answer 33

Endothelium lined spaces between periosteal and meningeal layers of dura They receive blood from the large veins draining the brain

Question 34

Name the dural venous sinuses

Answer 34

``` Superior sagittal sinus Inferior sagittal; sinus Cavernous sinus Sigmoid sinus Transverse sinus ```

Question 35

Describe the venous drainage of the face

Answer 35

``` Superficial veins are: -Supra-orbital -Supratrochlear -Angular vein -Superior and inferior labial veins -Facial vein -Common facial vein -Internal jugular vein And they drain in that order ```

Question 36

Describe the cavernous sinus and the contents of the cavernous sinus

Answer 36

A plexus of extremely thin-walled veins on upper surface of sphenoid Also in cavernous sinus: - Internal carotid artery - CNIII oculomotor - CNIV trochlear - CNVI abducent - 2 branches of trigeminal - Also has the pituitary gland

Question 37

What is the clinical relevance of the cavernous sinus?

Answer 37

The facial veins communicate with the cavernous sinus, and if you get an infection in the face, if in the right area it can move into the cavernous sinus and cause other problems including damage to the nerves present.

Question 38

What vein is the best indication of right atrial pressure?

Answer 38

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