VENOUS DRAINAGE OF FACE.pptx

1. VENOUS DRAINAGE OF FACE

2. Veins (vena) are blood vessels that carry blood
towards the heart.
Most veins carry deoxygenated blood from the
tissues back to
the heart
Exceptions are the pulmonary and umbilical veins
Usually travel with arteries

3. Structure of Vein
 Veins are thin walled than arteries.
 Large lumen.
 Valves, maintain unidirection blood flow.
 3 concentric layers ( tunicae)
1) Tunica intima - innermost layer(endothilial cells &
internal elastic lamina)
2) Tunica media –Middle layer ( contains muscle
tissue, elastic fibres, collagen , external elastic
lamina)
3) Tunica adventitia – outer coat (elastic and collegen
tissue, muscle fibres)

5. Differences between arteries and
veins

6. Arteries Veins
Oxygen Concentration: Arteries carry oxygenated blood (with the
exception of the pulmonary artery and umbilical
artery).
Veins carry deoxygenated blood (with the
exception of pulmonary veins and umbilical vein).
Types: Pulmonary and systemic arteries. Superficial veins, deep veins, pulmonary veins
and systemic veins
Direction of Blood Flow: From the heart to various parts of the body. From various parts of the body to the heart.
Anatomy: Thick, elastic muscle layer that can handle high
pressure of the blood flowing through the
arteries.
Thin, elastic muscle layer with semilunar valves
that prevent the blood from flowing in the
opposite direction.
Overview: Arteries are red blood vessels that carry blood
away from the heart. resistance vessels
Veins are blue blood vessels that carry blood
towards the heart. capacitance vessels
Rigid walls: more rigid collapsible
Thickest layer: Tunica media Tunica adventitia
Location: Deeper in the body Closer to the skin
Valves: Aren't present (except for semi-lunar valves) Are present,

7. 1) Return of deoxygenated blood to heart
2) Cushion associated arteries from jaw movements(periarterial
plexus)
3) Protect against extensive intracranial pressure.

8. Veins
Systemic veins PulmonaryVeins
-Right Pulmonary vein
-Left Pulmonary vein
Head & Neck Abdomen &Thorax Upper limb Lower limb

9. Venous Drainage of Face
9
Facial vein : is formed at the medial angle
of eye by union of supraorbital &
supratrochlear veins.
 -it is connected to cavernous sinus
through superior ophthalmic vein. This
connection is of great clinical importance
because it provides a pathway for spread
of infection from face to cavernous sinus.
-It descends behind the facial artery to
the lower border of body of mandible.
-It crosses with the facial artery superficial
to submandibular gland.
 –It is joined by anterior division of
retromandibular vein to form common
facial vein to end into the internal jugular
vein.

10. Tributaries of Facial vein
10
It recevies tributaries that
correspond to the branches of
facial artery.
It is joined to pterygoid
venous plexus ( a venous
network lying around pterygoid
muscles) by deep facial vein
and to the cavernous sinus by
superior ophthalmic vein.
Transverse facial vein joins
superficial temporal vein within
the parotid gland.

11. Lymph Drainage of the Face
11
Lymph from forehead +
anterior part of face drains into
submandibular L.Ns., a few buccal
lymph nodes may be present along
course of these lymph vessels.
Lateral part of face + lateral
parts of eyelids drin into parotid
L.Ns.
Lower lip + chin are drained into
submental L.Ns.

12. APPLIEDANATOMY:
1. Infection from middle ear spreads to IJV
2. Surgical removal of deep cervical nodes can puncture IJV
3. Easy accessibility between two heads of sternocleidomastoid
muscle for introduction of cannula
4. Thrombophlebitis can occur by spread of infection in caverous sinus
5. Systolic thrill felt over the vein in mitral stenosis
6. During CCF dilatation of vein occur
7. Queckenstedt’s test – to find out block in CSF cerculation the test is
perform during lumbar puncture

13. Jugular venous pulse (JVP)
• Determine activity of
atrium
• Seen better then felt
• Preferable over EJV
• Elevation of JVP indicative
of cardiac failure
Hepato Jugular reflex
• Elicited by deep compression
of right lobe of liver

14. a) Facial (anterior facial vein)
• Origin – junction of veins of forehead and nose
• Upper part – angular vein
book

15. Angular vein receives:
1. Frontal vein
(anterior parts of
scalp)
2. Supraorbital vein
(eyebrows)
3. Superior ophthalmic
vein
(opens into
cavernous sinus)

16. FACIAL VEIN
ANASTOMOSE WITH
INFRAORBITAL VEIN
AND MENTAL VEIN.
JOINS THE:
PTERYGOID PLEXUS
THROUGH DEEP
FACIAL VEIN
CAVERNOUS SINUS
THROUGH SUPERIOR
OPHTHALMIC VEIN
Anastomosis of facial vein

17. Applied anatomy:
A. Facial vein is common source of bleeding following
surgery involving posterior vestibule lateral to mandible
B. Infection from face can spread in a retrograde direction
and cause thrombosis of the cavernous sinus.This is
specially occur in presence of infection in upper lip and
lower part of nose. Called dangerous area of the face.
Dangerous area of the face.

18. c) Lingual vein
 The lingual veins begin on
the dorsum, sides, and
under surface of the tongue,
and, passing backward along
the course of the lingual
artery, end in the internal
jugular vein.
 Drains tongue and
sublingual region
 Three branches
a) Dorsal lingual veins
b) Deep lingual veins
c) Sublingual vein

19.  Variations:
1. Mostly drains into common facial vein
2. In others – open into IJV and some into common
facial vein
3. Veins from pharynx often join lingual vein

20. d) Retromandibular Vein
• Retromandibular vein:
• formed by the union of
superficial temporal and
maxillary vein from the
pterygoid plexus
• passes downwards in the
substance of the parotid gland
emerging from its lower
border & divide into two
divisions

21. • Anterior division:
• joins the facial vein
• Posterior division:
• pierces the deep fascia and join the posterior auricular
to form the external jugular.
• It empty into the subclavian vein

22. e) Superficial temporal vein
•It begins on the side and vertex of the
skull in a plexus which communicates
with the frontal vein and supraorbital
vein, with the corresponding vein of
the opposite side, and with
the posterior auricular
vein and occipital vein.
•From this network frontal and parietal
branches arise, and unite above
the zygomatic arch to form the trunk
of the vein, which is joined by the
middle temporal vein emerging from
the temporalis muscle.

23.  It then crosses the posterior root of
the zygomatic arch, enters the substance of
the parotid gland, and unites with the internal
maxillary vein to form the posterior facial vein.
• It drains the lateral scalp
• It drain into and form the retromandibular vein
with the maxillary vein

24. f) Maxillary vein
• It begins in the infratemporal fossa
•It collects blood from the pterygoid
Plexus
•Through the pterygoid plexus It
receives the middle meningeal,
posterior superior alveolar, inferior
alveolar and other veins from the
nose and palate (areas served by
The maxillary artery)
•After that it merges with the
superficial temporal vein to form
the retromandibular vein

25. g) Posterior auricular vein
•The posterior auricular
vein begins upon the side of the
head, in a plexus which
communicates with the
tributaries of the occipital
vein and superficial temporal
veins.
•It descends behind the auricula,
and joins the posterior division of
the posterior facial vein to form
the external jugular.

26. h) Occipital vein
 The occipital vein begins as
a plexus at the posterior
aspect of the scalp from
the external occipital
protuberance and superior
nuchal line to the back part of
the vertex of the skull.
 From the plexus emerges a
single vessel, which pierces
the cranial attachment of
theTrapezius and, dipping
into the venous plexus of
thesuboccipital triangle, joins
the deep cervical
and vertebral veins.

27.  Occasionally it follows the course of the occipital
artery and ends in the internal jugular; in other
instances, it joins the posterior auricular vein and
through it opens into the external jugular.
 The parietal emissary vein connects it with
the superior sagittal sinus; and as it passes across
the mastoid portion of the temporal bone, it
receives the mastoid emissary vein which
connects it with the transverse sinus.
 The occipital diploic vein sometimes joins it

28. Drains major part of face & scalp
•Begins behind the angle of the
mandible by the union of the posterior
auricular and posterior division of the
retromandibular veins.
•It descend obliquely, deep to the
platysma, receive the posterior external
jugular vein pierce the deep fascia just
above the clavicle and drain into the
subclavian vein

29. Tributaries:
 Formative
 Occipital vein
 Oblique jugular
 Posterior external jugular
 Terminal
 Transverse cervical
 anterior jugular
 Suprascapular vein

30. Applied anatomy
a) Injury to the vein cause air embolism
b) Vein becomes dilated above compression level
duringValselva’s manoevre
c) Vene puncture performed on this vein
d) Surgical division of sternocleidomastoid muscle
requires special care of the vein
e) Increased venous pressure indicates congestive
cardiac failure

31. •start below the chin, pass
beneath the platysma to the
suprasternal notch.
•Pierce the deep fascia and is
connected to the other side
by an anastomosing vein the
jugular arch
•angle laterally to pass deep
to sternocleidomastoid and
open in the external

32. Tributaries:
1. Skin
2. Superficial tissues of neck
Applied anatomy:
1. Special care required to
preserve the vein during
surgical treatment
of wry neck

33. Formation:
• Venous spaces between the osteal and meningeal layers of
duramater
• Formed by reduplication of meningeal layer
Features:
• Lined by endothelium
• Receive blood from
a) Brain
b) Orbit
c) Internal ear
d) CSF
• Valveless
• Bidirectional flow

34. Classification
Posterosuperior group Anteroinferior group
Unpaired
a) Superior sagittal
b) Inferior sagittal
c) Straight
d) Occipital
Paired
a)Transverse
b) Sigmoid
c) Petrosquamous
Unpaired
a) Anterior intercavernous
b) Posterior intercavernous
c) Basilar
Paired
a) Cavernous
b) Superior petrosal
c) Inferior petrosal
d) Sphenoparietal
e) Middle meningeal

41. AnatomicalVariations of Internal JugularVein as seen by “Site Rite II”
Ultrasound Machine - an initial experience in Pakistani Population
Hameedullah,M.A. Rauf,F. H. Khan ( Department ofAnaesthesia.The
Aga Khan University Hospital, Karachi. )
49 cases :the angle of the mandible (p value <0.05),
22 cases: the thyroid cartilage
20 cases: the cricoid cartilage
46cases: the supraclavicular area (p value <0.05).
In 93% of cases the IJV was found to be larger than the carotid artery.

42. The jugular veins and its tributaries form the primary venous drainage of
head & neck.
As these are surrounded by many important anatomic structures so care
should be taken to preserve these veins during any surgical manipulation
of surrounding structures.

43. 1. Textbook of oral anatomy-sicher & dubrul
2. Human Anatomy – B.D. Chaurasia
3. Wikipidia