Vascular structure head and neck Almas khan , Khorfakkhan hospital


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Vascular structure head and neck Almas khan , Khorfakkhan hospital

  1. 1. Vascular structure of head and neck Almas khan Radiographer Khorfakkhan Hospital
  2. 2. Vascular structure of head and neck Talk plan:-  Explain Vascular system and Circulations  Co relation with Anatomical landmark  Common Indications.
  3. 3. Components of circulatory system Circulatory system Cardiovascular Lymphatic system Cardio Vascular Lymph (heart) (vessels) Lymph vessels Lymphatic nodules Pulmonary Systemic ( lung) ( body) The circulatory system consists of cardiovascular and lymphatic components . The cardiovascular portion includes heart, blood , and vessels that Transport the blood.
  4. 4. Blood vessels • Arteries: carry blood away from the heart Arterioles – smallest arteries , carrying blood to tissue. • Veins: carry blood back to the heart • Venules – smallest vein , returning blood from tissue. • Capillaries: microscopic blood vessels .
  5. 5. Blood vessels • Carry blood to and from the heart • Blood moving away from the heart: full of oxygen and nutrients • Blood moving back to the heart: full of carbon dioxide and wastes • blood only moves in one direction
  6. 6. 3 sections of circulatory system • Coronary circulation • Pulmonary circulation • Systemic circulation
  7. 7. Coronary Circulation • Flow of blood to and from tissues of the heart Coronary artery – blood supply to heart muscles. • The right coronary artery branches into: • Right marginal artery • Posterior descending artery • The left main coronary artery branches into: • Circumflex artery • Left Anterior Descending artery Venous drainage :- • Coronary sinus – venous drainage from heart
  8. 8. Pulmonary Circulation • Flow of blood through the heart, to the lungs, and back to the heart • Venous Blood returning to the heart enters the right atrium. – Enters through 2 major veins: superior and interior vena cava • Superior vena cava: returns blood from head and neck • Inferior vena cava: returns blood from lower body – Blood is high in carbon dioxide and low in oxygen
  9. 9. Systemic Circulation • Oxygen-rich blood flows to organs and body tissues, and oxygen-poor blood returns to the heart • Largest of the three parts of the circulatory system • Oxygen-rich blood exits left ventricle, enters aorta, and is taken throughout body by arteries and capillaries • Oxygen-poor blood is taken back to heart by veins, then superior and inferior vena cava take this blood to heart’s right atrium
  10. 10. Vascular structure
  11. 11. Aorta Four segments of Aorta 1) Aortic bulb ( root ) 2) Ascending aorta 3) Ascending arch 4) Descending aorta. Branches of Arch of Aorta :- 1) Brachiocephalic artery 2 ) Left common carotid artery 3) Left subclavian artery
  12. 12. Arch of aorta Variants of Arch :- A) Left circumflex – Arch to left B) Inverse aorta – Arch to right C) Pseudocoarctation - Arched descending aorta Normal
  13. 13. Head and neck arteries • Blood Supply of the Brain : - The four major arteries supplying the brain • 1 ) Right common carotid artery • 2) Left common carotid artery • 3) Right vertebral artery • 4) Left vertebral artery
  14. 14. Head and neck arteries • 1) The brachiocephalic trunk bifurcates in to • a) Right subclavien artery • b) Right common carotid 2) Right and Left vertebral artery arise from subclavien artery on each side Bifurcation posterior to right sterno clavicular joint.
  15. 15. Head and neck arteries
  16. 16. Subclavian Artery Right Subclavian Artery • Arises from the brachiocephalic artery, behind the right sternoclavicular joint • Arches upward and laterally over the pleura and between the scalens anterior and medium muscles. • At the outer border of the first rib, it becomes the axillary artery. Left Subclavian Artery • Arises from the arch of the aorta in the thorax. • Ascends to the root of the neck and then arches laterally in a manner similar to that of the right subclavian artery
  17. 17. Head and neck arteries Each common carotid divides in to internal and external carotid arteries at the levels of C3 - C4 ( upper border of thyroid cartilage ) Left common carotid is slightly longer than the right, because it directly arise from the arch. External carotid artery branches :- a) facial artery b) Maxillary artery c) Superficial temporal artery d) Occipital artery supply – neck , face , scalp and meninges
  18. 18. Head and neck arteries External carotid artery branches :- facial artery Maxillary artery Superficial temporal artery . Superior thyroid artery Occipital artery supply – neck , face , scalp and meninges
  19. 19. Head and neck arteries Internal carotid arteries :- ICA • Passes through carotid canal in the petrous part of temporal bone. • The ICA passes through a collection of venous channel around of sella turcica . • ICA passes through dura matter medial to each anterior clinod process to supply the cerebral hemispheres. • The anterior circulation of brain supplied by ICA • The S – Shaped portion of each internal carotid artery is termed the carotid siphon.
  20. 20. Head and neck arteries • Vertebral artery : - • Right and Left vertebral artery arise from subclavien artery on each side • They pass through transverse foramina of vertebra C6 to C 1 • Then pass through foramen magnum posterior and enter in to cranium. • The two vertebral arteries supplied posterior circulation of the brain.
  21. 21. Head and neck arteries Anterior cerebral artery :- Each internal carotid branches in to anterior cerebral artery and middle cerebral artery. Anterior cerebral artery supplies the forbrain on the midline and also mid portion of cerebral hemispheres . Each anterior cerebral artery connects to the opposite one, and posterior circulation.
  22. 22. Anterior cerebral artery
  23. 23. Head and neck arteries Middle cerebral artery :- Largest portion of the ICA Its supplies lateral aspects of anterior circulation and central lobe of brain.
  24. 24. Head and neck arteries Vertebro basilar artery :- Both vertebral arteries enter the cranium through foramen magnum and unite to form basilar artery. Its supplies spinal code and hindbrain Basilar artery rests on clivus Basilar artery gives several branches to hindbrain and posterior cerebrum
  25. 25. Head and neck arteries COW……. ?
  26. 26. Head and neck arteries Circle of Willis :- Blood to brain supplied by ICA and VA Posterior circulation communicates with anterior circulation at the base of brain as the Circle of Willis. Five arteries form the COW. 1) Anterior communicating artery 2) Anterior cerebral artery 3) Internal carotid artery 4) Posterior communicating artery. 5) Posterior cerebral artery
  27. 27. Head and neck arteries Circle of Willis
  28. 28. Common Indications  Aneurysm :- The blood filled bulge of blood vessels , wall become waek.  Infracts :- An area of dead tissue caused by a loss of blood supply.  AVM :- AV malformation is an abnormal connection between the arteries and veins  Hemorrhage :-To lose blood rapidly and uncontrollably  CVA :- It is interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked .  Stroke :- The loss of brain functions when blood supply suddenly interrupted.  Thrombosis :- It’s the formation of blood clot inside the blood vessels  TIA :-(TIA) is a transient episode of neurologic dysfunction caused by ischemia  Stenosis :- Narrowing of an artery inside the brain , Caused by buildup plaque inside the artery.
  29. 29. Aneurysm An aneurysm is an abnormal, weak spot on a blood vessel that causes an outward bulging or ballooning of the arterial wall A hemorrhagic stroke when they rupture, which can lead to brain damage and death.
  30. 30. Indications ACA Infract Left MCA and ACA infract
  31. 31. Indication of head and neck vessels MCA Infract
  32. 32. left MCA and PCA
  33. 33. AV Malformation
  34. 34. Hemorrhage TIA
  35. 35. Stenosis
  36. 36. Venous drainage Dural sinus ( Sinuses of dura mater):- Venous channels which drain blood from brain. It consist of 1) superior sagittal 2) inferior sagittal 3) straight sinus 4) Two transverse sinus 5) Occipital sinus Confluence of sinus : Connecting point of superior sag , straight and occipital .
  37. 37. Venous drainage Sup sag sinus : Received blood from cerebral cortex Inferior sag sinus :- It received blood from mid cerebral hemispheres. Straight sinuses :- Received blood from inferior sag , vein of galan , sup cerebellar vein. Vein of Galan :- it receive blood from a collection of small vein. Transverse sinus :- from posterior aspect. Sigmoid sinus :- posteriorly and inferiorly
  38. 38. Head and neck vein Great vein of the neck :- The three pairs of major veins that drain the head , face and neck. 1) Right and Left Internal jugular vein 2) Right and left external jugular vein 3) Right and left vertebral veins.
  39. 39. Head and neck vein • Each Internal jugular vein drain to meninges and brain. • Pair of external jugular veins are more superficial trunks that drain scalp face and neck • Each external jugular vein join Subclavian vein • Right and left vertebral vein outside of cranium and drain the upper neck and occipital region. Enters transverse foramin C1 – C6 joint to subclavien vein
  40. 40. Head and neck vein Right and left Branchiocephalic vein :- Join to from the superior vena cava , which returns blood to the right atrium
  41. 41. Venous trombosis
  42. 42. Bolus tracking time in MDCT :- CTA Neck = 15 sec , F/R 3.5cc/sec CTA Circle of Willis = 16 to 18 sec ,F/R 3.5sec CT Brain routine = 5minuts after the injection Routine Neck = 20 to 30 sec , F/R 3.5 sec
  43. 43. CONCLUSION  We are able to understand how the circulation of blood is organized in the head and neck.  Helps to identify vessels after injection of contrast.  A good understanding of anatomy is essential while performing angiography. Normal and abnormal distribution of circulatory system  Co relation with Anatomical landmark helps to identify vascular structures of head and neck precisely .
  44. 44. Thanks