Venous Drainage of the Head and Neck Region

Question 1

What are the boundaries of the scalp

Answer 1

• Anterior: Superior orbital margin
• Posterior: Occipital bone
• Laterally: Zygomatic arch on each side

Question 2

What does SCALP stand for

Answer 2

• S Skin
• C Connective tissue
• A Apponeurosis
• L Loose areolar tissue
• P Pericranium

Question 3

Describe the layers of the scalp from skin down

Answer 3

Skin
Connective tissues
Epicranial Aponeurosis
Pericranium
Bone of skull

Question 4

What are the characteristics of the connective tissue layer of the scalp

Answer 4

• Close network of fibro-fatty tissue
• Connects the overlying skin with the under lying aponeurosis
• Contains large blood vessels
• Contains nerves

Question 5

What can happen if you injure the connective tissue layer of the scalp

Answer 5

• Vessels unable to retract -> Profuse bleeding

* Haematoma formation -> pain

Question 6

Describe the characteristics of the aponeurosis layer of the scalp

Answer 6

• Epicraneous muscle and apponeurosis: Occipito-frontalis muscle
• Tightly attached to the overlying Connective tissue layer.
• Loose subaponeurotic layer

Question 7

What is the line that separates the parietal bone from the occipital bone

Answer 7

lambdoid suture

Question 8

What is the epicranial aponeurosis also known as

Answer 8

The galea aponeurotic

Question 9

Whats the origin and insertion point of the occipital muscle

Answer 9

Origin - superior nuchal line

Insertion - galea aponeurotica

Question 10

Whats the origin and insertion points of the frontal muscle

Answer 10

origin - muscles over the bridge of the nose

insertion - galea aponeurotica

Question 11

Whatre the characteristics of the pericranium

Answer 11

Periosteum of the skull

Continuous with endosteum at the sutures

Question 12

What are the 3 meninges of the brain

Answer 12

• Cerebral dural mater
• Cerebral arachnoid mater
• Cerebral pia mater

Question 13

Describe the feature of the cerebral dura mater

Answer 13

• A thick and dense inelastic membrane that composed of two layers, an inner or meningeal and outer or endosteal
• It is in loose contact with calvaria, and most strongly adherent to base of skull

Question 14

What structures does the dura mater form

Answer 14

• Falx cerebri
• Tentorium of cerebellum - in front there is a gap, the tentorial incisure, for passage of midbrain
• Falx cerebelli
• Diaphragma sellae

Question 15

Describe the falx cerebri

Answer 15

Sickle shaped, between cerebral hemispheres.
Ant. = attached to crest galli of ethmoid
Post. = blends into tentorium cerebelli

Question 16

Describe the falx cerebelli

Answer 16

Smaller between cerebellar hemispheres along post. wall of post. cranial fossa

Question 17

Describe the tentorium cerebelli

Answer 17

Forms the roof of the post. cranial fossa

Question 18

What is the tentorial notch

Answer 18

Opening for the brainstem in the tentorium cerebelli

Question 19

Describe the diaphragma sella

Answer 19

folds over the sella turcica

Question 20

Point out the superior sagittal, inferior sagittal and straight sinuses

Answer 20

sup sag - outside
inf sag - inner
straight connects both

Question 21

Point out the transverse and sigmoid sinuses

Answer 21

transverse round back of post cranial fossa

sigmoid connected to transverse and leads forward

Question 22

Where are the cavernous sinuses

Answer 22

Middle cranial fossa one side of sphenoid bone in each side of sella turcica

Question 23

where are the sup and inf petrosal sinuses

Answer 23

on petrous part of temporal bone

Question 24

What nerves lie in the lateral wall of the cavernous sinus

Answer 24

oculomotor, trochlear and the ophthalmic and maxillary divisions of trigeminal nerve

Question 25

What runs through the cavernous sinus

Answer 25

internal carotid artery and abducent nerve

Question 26

Where does venous drainage from the H+N and brain terminate

Answer 26

The internal jugular vein

Question 27

Describe the course of the internal jugular vein

Answer 27

* Jugular Foramen * Carotid sheath * Joins Subclavian Vein * Brachiocephalic vein * Superior Vena Cava

Question 28

Describe the formation of the facial vein

Answer 28

Supraorbital and supratrochlear veins join to form facial

Question 29

Describe the course of the facial vein as it descends

Answer 29

it joins the : – Deep Facial vein – Pterygoid Plexus – Retromandibular vein

Question 30

How is the retromandibular vein formed

Answer 30

Superficial temporal vein and maxillary vein join

Question 31

Describe the course of the retromandibular vein

Answer 31

• Passes through Parotid Gland • Two divisions exit: – Anterior: Joins Facial Vein – Posterior: Post. Auricular Vein -> EJV

Question 32

Where does the maxillary vein originate

Answer 32

The pterygoid plexus

Question 33

Describe the course of the maxillary vein

Answer 33

From pterygoid plexus through the sphenomandibular ligament. joins with the superficial temporal vein to form the retromandibular vein

Question 34

What are the functions of the lymphatic system

Answer 34

* 1. Draining excess interstitial fluid * 2. Carrying out immune response: * 3. Transporting dietary lipids & lipid soluble vitamins: A , D, E, & K

Question 35

Name the regional groups of lymph nodes at the post. part of the head

Answer 35

occipital & mastoid

Question 36

Name the regional groups of lymph nodes at the ant. part of the head

Answer 36

parotid & buccal

Question 37

Name the regional groups of lymph nodes beneath the mandible

Answer 37

submental & submandibular

Question 38

Name the regional groups of lymph nodes along the superficial jugular veins

Answer 38

ant. Cerv. & superficial cerv.

Question 39

Name the regional groups of lymph nodes that are deep and related with organs

Answer 39

retropharyngeal, laryngeal and tracheal

Question 40

Where are the occipital lymph nodes and its afferent and efferent vessels

Answer 40

``` Over occipital bone at the apex of occipital protuberence • Afferent V.: – back of SCALP • Efferent V.: – Deep Cervical Lymph Nodes ```

Question 41

Where are the mastoid lymph nodes and its afferent and efferent vessels

Answer 41

``` Over lat. surface of mastoid process • Afferent V.: – SCALP above auricle – post. Med. Auricle – post. Wall of EAM • Efferent V.: – Deep Cervical Lymph Nodes ```

Question 42

Where are the parotid lymph nodes and its afferent and efferent vessels

Answer 42

``` On or in the parotid gland • Afferent V.: – SCALP above parotid – lat. surface of auricle – ant. wall of EAM – lat. eyelids – middle ear • Efferent V.: – DCLN ```

Question 43

Where are the buccal lymph nodes and its afferent and efferent vessels

Answer 43

``` Over buccinator m. Close to facial vein. • Afferent V.: – ant. SCALP & forehead – ant. part of face nose • Efferent V.: – Submandibular LN ```

Question 44

Where are the submandibular lymph nodes and its afferent and efferent vessels

Answer 44

``` Superficial to submandibular salivary gland • Afferent V.: – buccal L.N. – Upper lip – lat. Lower lip – frontal, max. & ethmoidal air sinuses – upper & lower teeth, Except? – gingiva, Except? – Floor of mouth • Efferent V.: ?? ```

Question 45

Where are the submental lymph nodes and its afferent and efferent vessels

Answer 45

``` • Afferent V.: – tip of tongue – lower incisors & associated gums – central lower lip • Efferent V.: – submandibular L.N. ```

Question 46

Where are the anterior cervical lymph nodes and its afferent and efferent vessels

Answer 46

``` Along the course of anterior jugular veins Afferent V.: ant. neck Efferent V.: Deep Cervical Lymph Nodes ```

Question 47

Where are the superficial cervical lymph nodes and its afferent and efferent vessels

Answer 47

``` Afferent V.: • angle of mandible • lobule of auricle Efferent V.: • Deep Cervical Lymph Nodes ```

Question 48

Where are the deep cervical lymph nodes found

Answer 48

Chain of lymph nodes along the internal jugular vein mainly on lateral aspect. extends from the base of the skull to the root of the neck, its part of the carotid sheath

Question 49

Describe the fookin afferent and efferent vessels of the DCLN

Answer 49

afferent v. - receives lymph from all lymphatic structures in the head and neck efferent v. - join to form the jugular lymph trunk --> right lymphatic duct/thoracic duct --> venous system

Question 50

What are the clinically important nodes

Answer 50

Jugulodigastric and juguloomohyoid