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Neurovasculature and lymphatic drainage of head and neck

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  • This is an overview of the arterial, venous and nerve supply with the lymphatic drainage of the head and neck, this demonstration will give u a brief overview and a better picture on the arteries of head and neck.....What do u mean by neurovasculature??
  • AT THE END OF THE DEMONSTRATION YOU AS A STUDENT SHOULD BE AWARE OF THE FOLLOWING arteries, veins and nerves.Their pathways, the tributaries that they give out and the clinical significance.
  • So starting with the common carotid artery......In human anatomy, the common carotid artery is an artery that supplies the head and neck with oxygenated blood; it divides in the neck to form the external and internal carotid arteries.The common carotid artery is a paired structure, meaning that there are two in the body, one for each half. The left and right common carotid arteries follow the same course with the exception of their origin. The right common carotid originates in the neck from the brachiocephalic trunk. The left arises from the aortic arch in the thoracic region.The common carotid artery is contained in a sheath known as the carotid sheath, whichenclosesthe internal jugular vein and vagus nerve, the vein lying lateral to the artery, and the nerve between the artery and vein......VNA.On opening the sheath, each of these three structures is seen to have a separate fibrous investment.At approximately the level of the fourth cervical vertebra, the common carotid artery bifurcates into an internal carotid artery (ICA) and an external carotid artery (ECA)......OR U CAN SAY THE UPPER BORDER OF THE THYROID CARTILAGE. While both branches travel upward, the internal carotid takes a deeper (more internal) path, eventually travelling up into the skull to supply the brain via the carotid canal. The external carotid artery travels more closely to the surface, and sends off numerous branches that supply the neck and face.It is related to the following structures.....sternohyoid and sternothyroid muscles.....remaines of the thymus.Common carotid artery lies on the trachea, esophagus, left recurrent laryngeal nerve and the thoracic duct.
  • Clinical application.....The common carotid artery is often used in measuring the pulse,[2] especially in patients who are in shock and who lack a detectable pulse in the more peripheral arteries of the body.The carotid artery should be palpated gently and while the patient is sitting or lying down. Stimulating its baroreceptors with low palpitation can provoke severe bradycardia or even stop the heart in some sensitive persons. Also, a person's two carotid arteries should not be palpated at the same time. Doing so may limit the flow of blood to the head, possibly leading to fainting or brain ischemia. It can be felt between the anterior border of the sternocleidomastoid muscle, above the hyoid bone and lateral to the thyroid cartilage.
  • The external carotid artery begins at the level of the upper border of thyroid cartilage, and, taking a slightly curved course, passes upward and forward, and then inclines backward to the space behind the neck of the mandible, where it divides into the superficial temporal and maxillary artery and terminates within the parotid gland.In the child, it is somewhat smaller than the internal carotid; but in the adult, the two vessels are of nearly equal size. At its origin, this artery is more superficial, and placed nearer the middle line than the internal carotid, and is contained within the carotid triangle.
  • (first letter from each word)............Some Attendings Like Freaking Out Potential Medical Students.Terminal branches Maxillary arterySuperficial temporal arteryU dont need to know the whole pathways of different arteries...ut just the important ones....as in.Superior thyroid artery supplies the cricothyroid muscle.MAXILLARY ARTERY......SUPPLIES THE UPPER AND LOWER JAW......ITS DIVISION THE ANTERIOR DIVISION OF THE MIDDLE MENINGEAL ARTERY...PTERION...EXTRADURAL HEMORRHAGE.
  • FACIAL ARTERY.....IT LOOPS ON THE LATERAL SURFACE OF THE PHARYNX AND GROOVES OR NTERS THE SUBMANDIBULAR GLAND....ASCENDS OVER THE FACE AND TERMINATES AT THE MEDIAL ANGLE OF THE ORBIT.BRANCHES OF THE FACIAL ARTERY SUPPLY THR TONSIL, SUBMANDIBULAR GLAND AND MUSCLES AND SKIN OF THE FACE.
  • BRANCHES OF FACIAL ARTERY ARE....OCCIPITAL ARTERYPOSTERIOR AURICULAR ARTERY AND THE SUPERFICIAL TEMPORAL ARTERY.This vessel, both in the neck and on the face, is remarkably tortuous: in the former situation, to accommodate itself to the movements of the pharynx in deglutition; and in the latter, to the movements of the mandible, lips, and cheeks
  • the internal carotid arteries are major arteries of the head and neck that supply blood to the brain. There is a left and a right internal carotid artery; each one arises from the corresponding common carotid artery in the neck and divides in the brain into the corresponding anterior cerebral artery and middle cerebral artery.The internal carotid runs perpendicularly upward in the carotid sheath, and enters the skull through the carotid canal. During this part of its course, it lies in front of the transverse processes of the upper three cervical vertebrae.TERMINATES BY DIVIDING INTO ANTERIOR AND MIDDLE CEREBRAL ARTERY.
  • Branches from the cervical portion - none......or no branches in the neck.Opthalmic artery....gives off central artery of retina.....only blood supply of the retina.Anterior communicating artery is the terminal branch of internal carotid artery....supplies the medial and superolateral surface of the cerebral hemisphere.Middle cerebral artery....largest terminal branch of internal carotid artery......supplis the entire lateral surface of cerebral hemisphere except the narrow strip that is supplied by the ant cerebral artery.......the middle cerebral artery supplies all the motor area of cerebral cortex except the leg area.
  • A cortical homunculus (Motor Homunculus) is a pictorial representation of the anatomical divisions of the primary motor cortex and the primary somatosensory cortex[1], i.e., the portion of the human brain directly responsible for the movement and exchange of sense and motor information (namely touch: sensitivity, cold, heat, pain etc.) of the rest of the body. The resulting image is a grotesquely disfigured human with disproportionately huge hands, lips, and face in comparison to the rest of the body. Because of the fine motor skills and sense nerves found in these particular parts of the body they are represented as being larger on the homunculus. A part of the body with fewer sensory and/or motor connections to the brain is represented to appear smaller.
  • IT LIES IN THE SUBARACHANOID SPACE AT THE BASE OF THE BRAIN.F0RMED BY THE ANASTOMOSIS BETWEEN THE BRANCHES OF 2 INTERNAL CAROTID ARTERIES AND THE TWO VERTEBRAL ARTERIES.ARTERIES THAT CONTRIBUTE TO TO THE CIRCLE OF WILLIS ARE THE.....ANTERIOR COMMUNICATINGANTERIOR CEREBRAL, INTERNAL CAROTID POSTERIOR COMMUNICATING, POSTERIOR CEREBRAL AND BASILAR ARTERY.
  • NOW TALKING ABOUT THE SUBCLAVIAN ARTERIES...............RIGHT SUBCLAVIAN ARTERY.....ARISE FROM THE BRACHIOCEPHALIC ARTERY BEHIND THE STERNOCLAVICULAR JOINT AND AT THE OUTER BORDER OF THE FIRST RIB BECOMES THE AXILLARY ARTERY.LEFT SUBCLAVIAN ARTERY....ARISES FROM ARCH OF AORTA IN THE THORAX.THE SCLANEUS ANTERIOR MUSCLE...DIVIDES THE SUBCLAVIAN ARTERY INTO 3 PARTS.FIRST PART....FROM THE ORIGIN OF THE SUBCLAVIAN ARTERY TO THE MEDIAL PORTION OF THE SCLANEUS ANTERIOR MUSCLE.GIVES VERTEBRAL ARTERY, THYROCERVICAL TRUNK AND INTERNAL THORACIC ARTERY....MAKE A MEUMONC.VERTEBRAL ARTERY MAKES THE BAISILAR ARTERY.SECOND PART OF THE CERVICAL ARTERY.....LIES BEHIND THE SCLANEUS ANTERIOR MUSCLE...GIVES BRANCHES OF THE COSTOCERVICAL TRUNK.THRIRD PART...NO BRANCHES.
  • VENOUS SINUSES HAVE ALREADY BEEN COVERED.Diploic veins....these veins occupy channels in the bones of the valut of the skull.Emissary veins.....are valveless veins....that pass through te skull bones. Function connect the veins of the sclap to that of the venous sinuses.....clinical significance....area for the spread of infection
  • Diploic veins.
  • FORMED AT THE MEDIAL ANGLE OF THE EYE BY THE UNION OF THE SUPRAORBITAL AND SUPRATROCLAR VEINDESCENDS OVER THE FACE WITH THE FACIAL ARTERY, PASSINFG LATERALLY OVER THE MOUTH, CROSSING THE MANDIBLE AND JOINS THE RETROMANDIBULAR VEIN DRAINING INTO THE INTERNAL JUGULAR VEIN.
  • Supeficial temporal vein.....formed on the side of the scalp, follows the superficial temporal artery. Enters the parotid glandwher it joins the maxillary vein to form the retromandibular vein.Retromandibular veiin joins te posterior auricualr vein to form the externla jug vein.
  • EXTERNAL JUG VEIN IS FORMD BY THE UNION OF THE POSTERIOR AURICULAR VEIN WITH THE RETROMANDIBULAR VEIN...DRAINING INTO THE SUBCLAVIAN VEIN BHIND THE CLAVICLE.BRANCHES OF THE EXT JUG VEIN ARE THE...SUPERFICIAL CERVICAL VEIN,SUPRASCAPULAR VEIN AND ANTERIOR JUG VIEN.CLINICAL SIGNIFICANCE...FOR CATHETERIZATION.INTERNAL JUGULAR VEIN.....DRAINS BLOOD FROM THE BRAIN, SCALP, FACE AND NECK. STARTS FFROM THE SIGMOID SINUS,LEAVES THE SKULL THROUGH JUGULAR FORAMEN..DESCENDS IN THE CAROTID SHEATH AND ENDS BY JOINIG THE SUBCLAVIAN VEIN TO FORM THE BRACHIOCEPHALIC VEIN BEHIND THE CLAVICLE.
  • Transcript

    • 1. NEUROVASCULATURE ANDLYMPHATIC DRAINAGE OF HEAD AND NECK Dr. Tanya Raza Siddiqui M. Phil Canidate- Anatomy ZMU
    • 2. OBJECTIVES• Common carotid artery.• External and Internal carotid arteries.• Circle of willis.• Cortical homunculus .• Subclavian artery with branches.• Diploic veins and Emissary veins.• Veins of the face and neck.• Lymphatic drainage of the head and neck.• Clinical application.
    • 3. COMMON CAROTID ARTERY
    • 4. External carotid artey
    • 5. BRANCHES
    • 6. FACIAL ARTERY
    • 7. INTERNAL CAROTID ARTERY
    • 8. BRANCHES OF INTERNAL CAROTID ARTERY• Opthalmic artery.• Posterior communicating artery.• Anterior communicating artery.• Middle cerebral artery.
    • 9. CIRCLE OF WILLIS
    • 10. SUBCLAVIAN ARTERIES
    • 11. VEINS OF THE HEAD AND NECK• Diploic veins.• Emissary veins.• Facial veins.• Superficial temporal veins.• Maxillary veins.• Retromandibular veins• External jugular veins.• Internal jugular veins.
    • 12. FACIAL VEINS
    • 13. BRANCHES OF THE INTERNAL JUGULAR VEIN Inferior petrosal sinus. Facial vein Pharangeal vein. Lingual vein. Superior thyroid vein. Middle thyroid vein.
    • 14. Lymphatic drainage• 3 territories-preauricular lymph node (parotid):• Upper territories- greater part of forehead, lateral ½ of eye lid, conjunctiva, lateral part of cheek and parotid area.submandibular lymph node:• Middle territories- median part of forehead, external nose, upper lip, lateral part of lower lip, medial ½ of eye lid, medial part of cheek, greater part of lower jaw.sub mental lymph node:• Lower territories- central part of lower lip, chin and the skin of the chin.
    • 15. Dangerous area of face:• infections from face mainly from upper lip & nose can go to cavernous sinus through ophthalmic vein and deep facial vein

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