Session 3 Flashcards
(102 cards)
1
Q
Which blood vessels arise from the brachiocephalic trunk?
A
Subclavian and Common carotid arteries
2
Q
Which arteries are given of the subclavian at the base of the neck?
A
- Vetebral artery
- Internal thoracic
- Thyrocervical arteries
3
Q
What does the common carotid bifurcate into?
A
- External carotid artery
- Internal carotid artery
4
Q
What do the branches of the thyrocervical trunk do?
A
- Ascending cervical and Transverse cervical arteries supply the neck
- Suprascapular supplies the shoulder
- Inferior thyroid supples the lower pole of the thyroid gland
5
Q
What is the path of the vetebral arteries?
A
- ARise from the subclavian arteries on the right and left
- Ascend in the neck through transverse foramina in cervical vertebrae 6-1 and pass through the foramen magnum
- Vertebral arteries supply the brain
6
Q
How does the internal cariotid artery enter the skull?
A
Through the carotid canal
7
Q
Where does the internal jugular vein lie?
A
Lateral to the common carotid and mostly under the sternocleidomastoid
8
Q
Where does the common carotid artery bifurcate?
A
-C4 at the level of the superior border of the thyroid cartilage
9
Q
What commonly forms at the birfurcation of the carotid artery and what is the effect?
A
Atheromas. This causes stenosis of the artery. Also rupture of the clot can cause an embolus to travel to the brain. Leading to a transient ischameic attack
10
Q
What is located at the carotid sinus?
A
Baroreceptors for detecting changes in arterial blood pressure.
11
Q
What is a carotid sinus?
A
Swelling at region of bifurcation
12
Q
What is located in the carotid body?
A
Peripheral chemoreceptors which detect arterial O2.
13
Q
What are the borders of the carotid triangle?
A
Superior: Posterior belly of the digastric muscle.
Lateral: Medial border of the sternocleidomastoid muscle.
Inferior: Superior belly of the omohyoid muscle.
14
Q
What is the importance of the carotid triangle?
A
- Important for surgical approach to the carotid arteries or internal jugular vein
- Access the vagus and hypoglossal nerves
- Carotid pulse can felt in just below the birfurcation
- Carotid sinus massage
15
Q
Why can you terminates a supraventricular tachycardia with a carotid sinus massage?
A
- A carotid massage increase pressure in the artery
- This means that the vagus nerve is stimulated and send signal in the brain to decrease the heart rate in order to decrease the pressure
16
Q
What is the path of the internal carotid artery?
A
- Enters the skull through the carotid canal
- Turns medially and horizontally
- Enters cranial cavity and makes an S-shaped bend
- Courses through the cavernous sinus
17
Q
What are the contents of the cavernous sinus?
A
- Plexus of extremely thin-walled veins on upper surface of sphenoid
- Internal carotid artery
- Oculomotor nerve
- Trochlear nerve
- Abducent nerve
- Opthalmic and Maxillary nerve of the trigeminal nerve
18
Q
What are the branches of the external carotid artery?
A
- Superior thyroid
- Lingual
- Facial
- Ascending pharyngeal
- Occipital
- Posterior auricular
- Superficial temporal
- Maxillary
19
Q
What is the blood supply to the scalp and their roots?
A
From internal carotid artery
- Supra-orbital artery
- Supratrochlear artery
From external carotid artery
- Superficial temporal artery
- Posterior auricular artery
- Occipital artery
20
Q
Describe the blood supply to the scalp?
A
Rich blood supply with many anastomoses
21
Q
What are the layers of the scalp?
A
Skin (Dense) Connective tissue Aponeurosis Loose Connective tissue Periosteum
22
Q
Where do the blood vessels in scalp lie?
A
In subcutaneous connective tissue layer
23
Q
How is constriction of the blood vessels limited and what are the issues of this?
A
Walls of the arteries are closely attached to connective tissue.
However you can get profuse bleeding as a result of this if damaged
24
Q
What are implication of the numerous anastomoses in the scalp?
A
You can get profuse bleeding
25
The Loss of the scalp results in bone necrosis. True/False
False. Blood supply to the skull is mostly via the middle meningeal artery
26
Why can deep lacerations involving epicranial aponeurosis cause profuse bleeding?
Due to the opposing pull of occipitofrontalis.
27
Where can the facial artery pulse be felt?
- Inferior border of mandible
| - Anterior to the masseter muscle
28
Which superficial facial arteries don’t arise from the external carotid arteries?
Supra-orbital
| Supratrochlear
29
What are some important branches of the maxillary artery?
- Middle meningeal
| - Sphenopalatine
30
What is the blood supply to the nasal septum?
It is an anastomoses of arteries in Kiesselbach area.
31
What are the most important branches of the kiesselbach area?
- Septal brach of sphenopalatine artery
| - Anterior ethmoidal arteries
32
What is the clinical relevance of the Kiesselbach area?
Common site of nose bleeds.
33
What is the blood supply to the skull and dura?
Middle meningeal artery
34
A fracture to which part of the skull can rupture the middle meningeal artery?
Pterion
35
What is the result of a middle meningeal artery?
Extra-dural haemorrhage
36
How is a craniotomy done and why?
- The bone and scalp are reflected inferiorly to gain access to the cranial cavity.
- To preserve blood supply
37
What is the venous drainage of the scalp?
Superficial veins accompany arteries
- Superficial temporal veins
- Occipital vein
- Posterior auricular veins
38
What forms angular veins and what does it drain into?
Supraorbital and Supratrochlear veins.
Drain into the facial vein
39
Where do the deep veins of the scalp in the temporal region drain into?
The pterygoid venous plexus
40
What is the connection between the venous drainage of the scalp and dural venous sinuses?
Several emissary veins connect to the duplicate veins of the scalp then to the dural venous sinuses
41
What is special about emissary veins and the veins of the face?
They are valveless
42
What is the effect of the spread of infection from the scalp to the cranial cavity?
It can affect the Meninges
43
What happens to the facial vein in the medial angle of the eye?
It communicates with the superior opthalmic and drains into the cavernous sinus.
44
How can infection spread to the dural venous sinuses?
The deep facial veins drain into the pterygoid venous plexus
45
What is thrombophlebitis of facial vein?
An infected clot can travel to intracranial venous system
46
What is the cavernous sinus?
Plexus of extremely thin-walled veins on upper surface of sphenoid
47
What are the contents of the cavernous sinus?
- Internal carotid artery
- Oculomotor nerve
- Trochlear nerve
- Abducent nerve
- Opthalmic and maxillary branch of the trigeminal nerve
48
What the “danger triangle” of the face?
Infection in a region of the fact can spread through the venous system to the dural venous sinuses
49
Which is a better indicator of the pressure of the right atrium? IJV or EJV
Internal Jugular Vein is better indication pressure in the right atrium
50
How do you measure the jugular venous pressure?
- Use the right Internal jugular vein
- PAtient at a 45 degree angle with the head slightly to the left
- Pulsations are observed through the sternocleidomastoid muscle which hide the internal jugular vein
- The height measured in 5cm from the sternal angle
- MEasured in cmH2O
51
What are some important branches of the maxillary artery?
- Middle meningeal
| - Sphenopalatine
52
What is the blood supply to the nasal septum?
It is an anastomoses of arteries in Kiesselbach area.
53
What are the most important branches of the kiesselbach area?
- Septal brach of sphenopalatine artery
| - Anterior ethmoidal arteries
54
How do you measure the jugular venous pressure?
- Use the right Internal jugular vein
- PAtient at a 45 degree angle with the head slightly to the left
- Pulsations are observed through the sternocleidomastoid muscle which hide the internal jugular vein
- The height measured in 5cm from the sternal angle
- MEasured in cmH2O
55
Which is a better indicator of the pressure of the right atrium? IJV or EJV
Internal Jugular Vein is better indication pressure in the right atrium
56
What the “danger triangle” of the face?
Infection in a region of the fact can spread through he venous system to the dural venous sinuses
57
What are the contents of the cavernous sinus?
- Internal carotid artery
- Oculomotor nerve
- Trochlear nerve
- Abducent nerve
- Opthalmic and maxillary branch of the trigeminal nerve
58
What is the cavernous sinus?
Plexus of extremely thin-walled veins on upper surface of sphenoid
59
What is thrombophlebitis of facial vein?
An infected clot can travel to intracranial venous system
60
How can infection spread to the dural venous sinuses?
The deep facial veins drain into the pterygoid venous plexus
61
What happens to the facial vein in the medial angle of the eye?
It communicates with the superior opthalmic and drains into the cavernous sinus.
62
What is the effect of the spread of infection from the scalp to the cranial cavity?
It can affect the Meninges
63
What is special about emissary veins and the veins of the face?
They are valveless
64
What is the connection between the venous drainage of the scalp and dural venous sinuses?
Several emissary veins connect to the duplicate veins of the scalp then to the dural venous sinuses
65
Where do the deep veins of the scalp in the temporal region drain into?
The pterygoid venous plexus
66
What forms angular veins and what does it drain into?
Supraorbital and Supratrochlear veins.
Drain into the facial vein
67
What is the venous drainage of the scalp?
Superficial veins accompany arteries
- Superficial temporal veins
- Occipital vein
- Posterior auricular veins
68
How is a craniotomy done and why?
- The bone and scalp are reflected inferiorly to gain access to the cranial cavity.
- To preserve blood supply
69
What is the result of a middle meningeal artery?
Extra-dural haemorrhage
70
A fracture to which part of the skull can rupture the middle meningeal artery?
Pterion
71
What are some examples of lympahtic organs and tissues?
- Lymph nodes
- Spleen
- Tonsils
- Thymus
72
How is lymph fluid formed?
- At the arteriole end of the capillary, the hydrostatic pressure is greater than the oncotic pressure
- Fluid moves out of the capillaries into the interstitial space
- At the venule end of the capillary, the oncotic pressure is greater than the hydrostatic pressure so fluid is reabsorbed
- Due to little proteins In the interstitial fluid, some fluid remains in the interstitum
- Excess Fluid that is not reabsorbed moves from the interstitial space into the lymph vessels
73
What is the blood supply to the skull and dura?
Middle meningeal artery
74
What is the clinical relevance of the Kiesselbach area?
Common site of nose bleeds.
75
How much lymph fluid is produced per day?
3-4 litres
76
What is the function lymphatic vessels?
- Continuous removal of remaining tissue fluid and proteins from extracellular space back to blood circulation.
- It is also a route for spread of infection and malignant disease
77
What is the rate of flow of lymph in the lymph node?
It is slower
78
Pressure in the lymphatic system is higher than venous system. True/False
True
79
What is uni-directional flow of lymph?
- Tissue fluid
- Lymphatic Capillary
- Lymphatic vessels
- Lymph nodes
- Lymphatic vessels
- Lymphatic trunks
- Lymphatic ducts
- Venous system
80
How does the fluid flow thorough the lymphatic systems?
- Passive constriction
- Intrinsic constriction
- Fluid goes through valves
81
How does the lymph fluid enter the venous system?
It goes through the lymphatic duct into the subclavian veins
82
What is lymphoedema?
Abnormal collection of protein-rich fluid causing tissue swelling due to compromised lymphatic system
83
What are the causes of lymphoedema?
- Removal or enlargement of lymph nodes
- Infections
- Damage to lymphatic system such as cancer treatments
- Lack of limb movement
- Congenital issues (such as Milroy's syndrome)
84
What is the structure of lymph nodes?
- Tough fibrous outer capsule
| - Reticular connective tissue inside
85
What is the key role of the lymph nodes?
-Immune surveillance and defence
86
How does the lymph node achieve its roles?
Highly organised centres of immune cells such as lymphocytes and macrophages. This helps it deal with the pathogens if they are present in the lymph fluid due to transfer from an infected tissue
87
What makes the lymph node painful in stretch?
Its fibrous capsule
88
What the common causes of an enlarged lymph node?
- Infection
| - Malignancy
89
What does an enlarged lymph node as a result of infection feel like?
- Tender
| - Mobile
90
What does an enlarged lymph node as a result of malignancy feel like?
- Hard
- Matted
- Non-tender
91
What is the organisation of lymph nodes?
- Regional nodes that drain specific area
| - Terminal nodes that receive drainage from number of regional nodes
92
Where are specific regions in the bod where lymph nodes are palpable?
- Neck (cervical)
- Armpit (axillary)
- Diaphragm
- Spleen
- Abdominal
- Pelvic
- Groin
93
What is lymphadenopathy?
Enlarged lymph nodes
94
What separates the deep and superficial lymph nodes in the neck?
Investing layer of deep cervical fascia
95
What structure are most of the deep lymph nodes associated with?
Internal jugular vein in the carotid sheath
96
Where are lymph nodes located?
- Submental
- Sub-mandibular
- Pre-auricular
- Post auricular
- Occipital
97
What is waldeyer's ring?
Annular collection of lymphatic tissue surrounding the entrance to the aerodigestive tracts
98
What is present in Waldeyer's ring?
- Pharyngeal tonsil
- Tubal tonsil
- Palatine tonsils
- Lingual tonsils
99
Where do lymphatics from tonsils draining the upper pharynx drain into?
Retropharyngeal Lymph Nodes
100
Where does lymph from the superficial lymph nodes drain to?
Deep lymph nodes
101
What is the function of the supraclavicular lymph nodes?
Oversee transport of lymph from the thoracic cavity and abdomen
Left node: Abdomen and thorax
Right node: Mid section chest, oesophagus and lungs
102
Where does lymph fluid passing through deep cervical lymph nodes eventually drain?
Drains via thoracic duct into subclavian vein
