NECK - vasculature & lymphatics Flashcards by Jasmine Carter

What are the borders of the ANTERIOR triangle?

(medial, lateral, superior)

Medial = Midline of neck

Lateral = Anterior border of sternocleidomastoid

Superior = Inferior border of mandible

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What are the 4 blood vessels found in the ANTERIOR trinagle?

(4)

Common carotid a.

External carotid a.

Internal carotid a.

Internal jugular v. + tributaries

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What blood vessels are found in the CAROTID triangel (sub-region of anterior)?

(4)

common carotid a.

external carotid a.

internal carotid a.

Internal jugular v.

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Trace the ascent of the R. common carotid a.:

brachiocephalic trunk (posterior to R. sternoclavicular joint) –> R. common carotid a.

Ascent through neck w/i carotid sheath (lateral to trachea + esophagus)
Carotid bifurcation near upper edge of thyroid cartilage (C3-C4 iv disc)

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Trace the ascent of the L. common carotid a.:

aortic arch –> L. common carotid a.

ascent through neck w/i carotid sheath (lateral to trachea + esophagus)
Carotid bifurcation near upper edge of thyroid cartilage (C3-C4 iv disc)

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What is the Carotid sinus?

What is its innervation?

Dilation @ common carotid bifurcation

Baroreceptor (monitors changes in blood pressure)
Innervation = Glossopharyngeal n. (CN IX)

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What is the Carotid body?

What is its innervation?

Collection of receptors @ common carotid bifurcation

Chemoreceptor (monitors changes in O2/CO2 levels in blood)
Innervation = Glossopharyngeal n. (CN IX) + Vagus n. (CN X)

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Identify the branches of the External Carotid Artery (ECA):

“Some Anatomists Like Fucking Over Poor Med Students”

(from the bottom up)

*NOTE: There are NO branches of the ICA in the neck!!

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What are the target areas for the Superior thyroid a. (branch of ECA) ?

(5)

Thyroid gland

Thyrohyoid m.

Sternocleidomastoid m.

Cricothyroid m.

Internal structures of larynx

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What are the target areas for the Ascending pharyngeal a. (branch of ECA) ?

(6)

Palate

Tonsil

Auditory tube

Pharyngeal constrictor mm.

Stylopharyngeus mm.

Meninges in posterior cranial fossa

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What are the target areas for the Lingual a. (branch of ECA) ?

(6)

Muscles of tongue

Palatine tonsil

Soft palate

Epiglottis

Floor of mouth

Sublingual gland

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What are the target areas for the Facial a. (branch of ECA) ?

(5)

Soft palate

Palatine tonsil

Auditory tube

Submandibular gland

Facial structures from inferior border of mandible anterior to masseter m. to medial corner of eye

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What are the target areas for the **Occipital a. **(branch of ECA) ?

(5)

Sternocleidomastoid m.

cervical parts of intrinsic back muscles

Posterior scalp

Meninges in posterior cranial fossa

Mastoid cells

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What are the target areas for the **Posterior auricular a. **(branch of ECA) ?

(~3)

Parotid gland and nearby muscles

External ear and scalp posterior to ear

Middle and inner ear structures

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What are the target areas for the **Maxillary a. ** (branch of ECA) ?

(13)

External auditory meatus

Tympanic membrane (lateral and medial surfaces)

TMJ (temporomandibular joint)

Cranial bones and dura mater

Trigeminal ganglion

(Mylohyoid + Temporalis mm.)

Upper and lower teeth and gum

maxillary sinus

Nasal cavity

Palate

Roof of pharynx

Infra-orbital skin and skin on chin

Structures in infratemporal fossa

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What are the target areas for the **Superficial temporal a. **(branch of ECA) ?

(5)

(Temporalis + Masseter mm.)

Parotid gland and duct

Parietal and temporal fossae

External ear (anterior part)

Lateral face (via Transverse facial a.)

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Internal Jugular Vein (IJV)

4 fun facts!

Dilated continuation of sigmoid sinus
Exits skull through jugular foramen
Enclosed by the carotid sheath in neck
Joins subclavian v.; Subclavian v.+ IJV = Brachiocephalic v.

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Name the 6 tributaries of the IJV:

– inferior petrosal sinus

– pharyngeal vv.

– occipital v.

– common facial v.

– lingual v.

– superior + middle thyroid vv.

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Blood Vessels in the Posterior Triangle?

(3)

Subclavian a. and branches
Subvlacian v.
EJV and tributaries

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Subclavian Artery in the Posterior Triangle:

Where does the 3rd part of subclavian a. emerges from?
What does it becomes after crossing lateral border of rib 1?

between anterior and middle scalene mm.
axillary a.

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Subclavian Artery in the Posterior Triangle:

Where does the Transverse cervical a. branch from?
What 3 muscles does it supply?

branch of thyrocervical trunk (subclavian a.)
* (passes laterally/posteriorly across base of posterior triangle, in front of anterior scalene m.)*
supplies trapezius + rhomboids

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Subclavian Artery in the Posterior Triangle:

Where does the Suprascapular a. branch from?
What muscles does it supply?

branch of thyrocervical trunk
* (passes laterally across posterior triangle)*
muscles on dorsal surface of scapula

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Subclavian Vein in the Posterior Triangle:

(5 fun facts)

subclavian v. is a continuation of …?
runs anterior to what structure in posterior triangle?
passes anterior to what muscle?
what major vein drains into the Subclavian v.?
Subclavian v. + IJV = ???

axillary v.
subclavian a.
anterior scalene m.
EJV
Brachiocephalic v.

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External Jugular Vein in the Posterior Triangle:

what 2 veins converge to form the EJV?
what muscle does the EJV cross before entering the posterior triangle?
Where does it drain into?

Study These Flashcards

Posterior auricular v. + Retromandibular v. = EJV
sternocleidomastoid m.
subclavian v.

* NOTE: this is the ONLY thing you will find on the superficial surface of the SCM

What are the anterior + posterior borders of the **root of the neck**? What blood vessels are in the root of the neck?

**Anterior** = manubrium + upper margin of clavicle **Posterior** = T1 + upper margin of scapula up to coracoid process *(Thoracic cavity projects into root of neck)* **Blood vessels:** * ● Subclavian a. and branches* * ● Subclavian v.*

**1st part of subclavian a.:** - location - branches

LOCATION: ascends to the medial border of anterior scalene m. **3 main branches:** - Vertebral a. - Internal thoracic a. - Thyrocervical trunk

What are the 3 branches of the Thyrocervical trunk?

▪ inferior thyroid a. ▪ transverse cervical a. ▪ suprascapular a.

**2nd part of subclavian a.:** location?

passes laterally **between anterior and middle scalene mm.**

**3rd part of subclavian a.:** - location? - becomes...?

- crosses base of posterior triangle - becomes **axillary a.** after crossing rib 1 laterally

**Vertebral Artery** 3 fun facts!

- **1st branch** of 1st part of subclavian a. - Goes through **transverse foramina of C1-C6** - Enters cranial cavity through **foramen mangnum**

**Internal Thoracic Artery** - location? - what 2 branches does it give off?

LOCATION: Descends into thoracic cavity posterior to ribs and anterior to transversus thoracis m. _Gives off:_ - **musculophrenic a.** (to diaphragm) - **anterior intercostal aa**. (to thoracic wall)

**Thyrocervical Trunk: Inferior Thyroid Artery:** - location? - innervates?

Ascends *anterior and medial to* **anterior scalene m.** Supplies **thyroid gland** **\*Superior continuation of thyrocervical trunk\***

**Thyrocervical Trunk: Transverse Cervical Artery:** - location? - branches?

- Runs across *anterior surface* of **anterior scalene m.** **BRANCHES:** **- Superficial branch** continues on *deep surface of trapezius m.* **- Deep branch** continues on *deep surface of rhomboid mm.*

**Thyrocervical Trunk: Suprascapular Artery:** - location (runs across 4 structures)? - what fossa does it enter?

- Runs across *anterior surface* of **anterior scalene m.** + **phrenic n.** + **3rd part of subclavian a.** + **trunks of brachial plexus** - enters **supraspinous fossa** (after crossing over *superior transverse scapular ligament)*

**Subclavian Artery: Costocervical Trunk** The Costocervical trunk is just lateral to the thyrocervical trunk. What are its origins on the LEFT & RIGHT sides? *(hint: not the same)*

**_Right:_** From **2nd part of subclavian a.** **_Left:_** From **1st part of subclavian a.** *(medial to anterior scalene m.)*

**Subclavian Artery: Costocervical Trunk** - location? - what are it's 2 branches and where do they run to?

- Runs *posterior* to **anterior scalene m.** **_divides into two branches:_** 1. **Deep cervical a**. *ascends in the back of neck*, and anastomoses with *occipital a. (ECA)* 2. **Supreme intercostal a.** *descends anterior to rib 1*, and gives off **posterior intercostal arteries 1 + 2**

**Subclavian Artery: Dorsal Scapular Artery** 1. From what part of the Subclavian a.? 2. what structures does it descend near?

**1. 3rd segment** (could also be fr. thyrocervical trunk a.k.a. 1st segment) **2.** along *medial border* of **scapula** *deep* to **rhomboid mm**

Identify the branches of the **common carotid artery**:

1 = Common carotid a. (CCA) 2 = Internal carotid a. (ICA) 3 = Ascending pharyngeal a. 4 = Occipital a. 5 = Superficial temporal a. *(Terminal branch ECA)* 6 = Middle cerebral a. *(branch of ICA)* 7 = Anterior cerebral a. 8 = Middle meningeal a. 9 = Maxillary a. 10 = Facial a. *(above lingual a.)* 11 = Lingual a. 12 = External carotid a. (ECA) 13 = Superior thyroid a.

**CIRCLE OF WILLIS:** Identify the numbered branches

Trace the blood flow paths to the circle of Willis for: 1. the vertebral a. 2. the internal carotid a.

1•Aorta → Aortic arch → Subclavian a. → Vertebral a. --\> COW 2•Aorta → Aortic arch → Common carotid a. → Internal carotid a. --\> COW

Which artery in the Circle of Willis is particularily suseptable to strokes?

**Middle Cerebral a.**

**Subclavian Vein in the Root of the Neck** 1. is a continuation of what vein? 2. what major vein drains into it (superiorly)? 3. What vein joins the Subclavian v. to form the Brachiocephalic trunk?

1. continuation of **axillary v**. 2. **External Jugular V**. 3. **Joined by IJV** *(anterior to anterior scalene m) = Brachiocephalic v.*

**External Jugular Vein (EJV): Tributaries** (diagram)

**Lymphatic Drainage of Head and Neck** _match the nodes to their locations:_ - Deep cervical nodes - Pre-auricular and parotid nodes - Superficial cervical nodes - Mastoid nodes - Jugulo-digastric node - Jugulo-omohyoid node - Occipital nodes - Submental nodes - Submandibular nodes

**Superficial lymph nodes: Occipital** 1. drainage area? 2. drains into?

1. Posterior scalp and neck 2. Superficial cervical nodes

**Superficial lymph nodes: Mastiod** 1. drainage area? 2. drains into?

1. Postero-lateral ½ of scalp 2. Superficial cervical nodes **\*receive lymph from *retromandibular* and *pre-auricular nodes***

**Superficial lymph nodes: Pre-auricular and Parotid** 1. drainage area? 2. drains into?

1. Anterior surface of auricle; Antero-lateral scalp; Upper ½ of face; Eyelids and cheeks 2. Deep cervical nodes

**Superficial lymph nodes: Submandibular** 1. drainage area? 2. drains into?

1. Forehead + gingivae + teeth + tongue + structures along the path of facial a. 2. Deep cervical nodes

**Superficial lymph nodes: Submental** 1. drainage area? 2. drains into?

1. Lower lip (central part); Chin and floor of mouth; Tip of tongue; Lower incisors 2. Deep cervical nodes

Superficial cervical lymph nodes drain into…

**_Deep cervical lymph nodes_** - forms chain around IJV - receives all lymphatic drainage from head + neck * (directly or via regional nodes)* - nodes form **jugular trunks**

Jugulo-digastric node receives lymph from...

tonsils and tonsilar region

Jugulo-omohyoid node receives lypmh from...

tongue

Jugular trunks drain into...

**THORACIC DUCT** - forms in abdomen - enters thorax through *aortic hiatus* - terminates in the *junction of **left IJV** and **left subclavian v.***

THORACIC DUCT: what 3 trunks join the jugular trunks here?

**- left jugular trunk** \<-- left side of head and neck **- left subclavian trunk** \<-- left upper limb **- left bronchomediastinal trunk** \<-- left ½ of thorax

What 3 trunks drain into the *junction of* **right IJV** and **right subclavian v.**

**- right jugular trunk** \<-- right side of head and neck **- right subclavian trunk** \<-- right upper limb **- right bronchomediastinal trunk** \<--- right ½ of thorax + right upper intercostal spaces

**Cervical lymphadenopathy:**

- enlargement of cervical lymph nodes - manifestation of disease processes in head and neck - indication of diffuse diseases, e.g., lymphoma, sarcoidosis, glandular fever, HIV, etc.

**Node examination:** If there are soft, tender, inflamed nodes...

...Acute inflammatory process most likely to be infective

**Node examination:** If there are firm multinodular large rubbery nodes ...

Lymphoma (mostly cancerous)

NECK - vasculature & lymphatics Flashcards

(58 cards)