Arteries, Veins, Lymphatics (COMBINED)

Where does the CCA bifurcate in the neck?

C3-C5

What does the CCA travel in as it ascends into the neck?

Carotid sheath (with IJV and CN X - Vagus)

Where doe the left and right CCA originate from?

L CCA directly from aortic arch; R CCA from brachiocephallic trunk

What 2 vessels provide blood to the brain?

Vertebral a. (1st branch off subclavian) and ICA

Describe the path of the vertebral artery as it comes off subclavian.

Branches off subclavian as it enters the neck, ascends and enters transverse foramina at C6 (miss C7), entera foramen magnum to enter posterior cranial fossa, L and R join to form basilar artery in the circle of willis.

What is to origin of the anterior spinal artery?

L and R vertebral artery

Where does the ICA enter the skull?

Carotid canal (gives off ophthalmic a. and branches of the circle of willis - posterior communicating a., anterior communicating a., anterior cerebral a.)

What arteries are part of the circle of willis?

Basilar a., posterior cerebral a., posterior communicating a., ICA, anterior communicating a., anterior cerebral a.

What are the 3 layer of mater covering the brain (superficial -> deep)

Dura, arachnoid, pia

What is a subdural hematoma?

Hemorrhage occur between arachnoid and meningeal layer dura due to a severed cerebral vein ("banana" shaped on CT)

What can cause a subdural hematoma?

Car accident, sudden change in velocity of the brain (severed cerebral vein).

What vessels are vulnerable to lacerations from skull fractures (esp in the temple region)?

Branches of the middle meningeal artery

What is an epidural hematoma?

Hemorrhage occur between bone and dura due to severed middle meningeal a. (rounded on CT, may be able to palpate area)

What is a cerebral artery rupture (aneurysm/stroke/subarachnoid hematoma)?

Hemorrhaging blood within the arachnoid space (see gray surrounding brain on CT)

Subarachnoid bleeding symptoms occur rapidly/slowly.

Rapidly

Why does blood accumulate quickly in CSF space?

Arterial pressure

Blood will appear in a lumbar puncture in the case of a _____________ hematoma.

Subarachnoid

What are the primary branches of the ECA (inferior -> superior)

Superior thyroid a, ascending pharyngeal a., lingual a., facial a., occipital a., posterior auricular a., maxillary a., superficial temporal a.

What branch of the ECA supplies deep structures of the face (including the mandible, pterygoid, infratemporal fossa, and parts of the pterygopalatine fossa)?

Maxillary a.

Which divisions of the maxillary a. are within the infratemporal fossa?

1st (posterior to lateral pterygoid m.) and 2nd (lateral to lateral pterygoid m.)

What are the branches of the 1st division of the maxillary a.?

Deep auricular a., Anterior tympanic a., Middle meningeal a., Inferior alveolar a.

Inferior alveolar a. branches off to ...

Mylohyoid a. (provides floor of oral cavity) and mental a. (travel through mandibular foramen, mandibular canal, and exit mental foramen)

What are the branches of the 2nd division of the maxillary a.?

Anterior deep temporal a., Middle deep temporal a., Posterior deep temporal a., Buccal a., Masseteric a., Pterygoid branches

What are the branches of the 3rd division of the maxillary a.?

Pharyngeal a., Descending palatine a., A. of pterygoid canal, Sphenopalatine a., Posterior superior alveolar a., Infraorbital a.

Which branches of maxillary a. supply maxillary dentition?

Posterior superior alveolar a. and infraorbital a.

What is the path of blood from the heart to palate (hard and soft)

Heart, CCA, ECA, Maxillary branch, Descending palatine a., Pterygopalatine fossa, branch to greater palatine a. (greater palatine foramen) to hard palate and lesser palatine a. (lesser palatine foramen) to soft palate

Which vessel follows a tortuous path between the nasolabial fold and medial canthus of the eye?

Facial a.

What are the cervical branches off the facial a.?

Ascending palatine a., tonsillar branch, submental a., glandular branches

Which artery supplies the submandibular gland?

Submental a.

What are the facial branches off the facial a.?

Inferior labial a., Superior labial a., lateral nasal branch., angular a.

What arteries supply the lips and cheeks?

Superior labial branch of facial a., superior labial branch of infraorbital a., inferior labial branch of facial a., buccal a., mental a.

What arteries supply the palate?

Greater palatine a., lesser palatine a., ascending palatine a.

What arteries supply the floor of the mouth and tongue?

Submental a. (o: facial a.), sublingual a. (to sublingual gland; o: lingual a.), deep lingual a. (to intrinsic mm.; o: lingual a.), muscular branches (tp extrinsic mm.; o: lingual a.)

What arteries supply the TMJ?

Superior temporal a. (ECA), deep auricular a. (max. a.), anterior tympanic a. (max. a.)

What arteries supply the frontal sinus?

Anterior ethmoidal a., supraorbital a. (Ophthalmic a.)

What arteries supply the ethmoid sinus?

Anterior and posterior ethmoidal aa. (Ophthalmic a) and nasal branches (Sphenopalatine a.)

What arteries supply the sphenoid sinus?

Post ethmoidal aa. (Ophthalmic a.) and nasal branches (sphenopalatine a.)

What arteries supply the maxillary sinus?

Infraorbital a., alveolar aa. (Maxillary a.)

What arteries supply the lateral wall of the nasal cavity?

Nasal branches of sphenopalatine a., facial a., anterior ethmoidal a., and posterior ethmoidal a.

What arteries supply the medial wall of the nasal cavity?

Septal branches of sphenopalatine a., facial a., and anterior ethmoidal a.

What is the network of capillaries that contributes to most nosebleeds in the anterior nose?

Kisselbach plexus

What contributes to deeper nose bleeds?

Anterior and posterior ethmoid aa.

What arteries supply blood to the parotid duct and gland?

Transverse facial a. (superficial temporal a.) and indirectly from maxillary a.

What arteries supply the eyelids?

Supratrochlear a., supraorbital a., lacrimal a., dorsal nasal a., angular a., transverse facial a.

What arteries supply blood to the lacrimal gland?

Lacrimal a. from ophthalmic a. (ICA)

What arteries supply blood to the eyeball?

Short posterior ciliary a., Long posterior ciliary a., Long anterior ciliary a., Central retinal a.

Which artery that supplies the eyeball travels with the optic nerve?

Central retinal a.

What arteries supply the external ear?

Superficial temporal a., posterior auricular a., deep auricular a., anterior tympanic a.

What arteries supply the middle ear?

Posterior auricular a., anterior tympanic a., inferior tympanic a., superior tympanic a., caroticotympanic branch of ICA

What arteries supply the inner ear?

Labyrinthine a., posterior auricular a.

Hemothorax

Accumulation of blood in the pleural cavity (turns potential space into a real space) and can contribute to blood clots. Commonly caused by trauma. Treat with drainage when severe.

Pericardial effusion

Buildup of fluid (not blood) within the pericardial sac (in the pericardial cavity). May be caused by infection, disease, pericarditis, defect in the walls of the heart, or trauma to aorta. Results in tamponade.

If there is a buildup of non-blood fluid in the pleural cavity, what would this be called?

Pleural effusion

Stenotic valves

Stiff, preventing valves from opening all the way. Therefore, the heart must word harder (cardiac hypertrophy)

CAD

Narrowing or blockage of coronary arteries results from plaque buildup (will limit blood supply to myocardium over time).

How would a clot in the LAD a. impact a person?

LAD a is critical to providing blood to the left ventricle, therefore this would severely compromise systemic circulation.

Pulmonary embolism

Blood clots within the extremities (primarily lower) can build up to form a DVT. Parts of this DVT may break off to become free-floating clots. The embolus will travel through the veins until it reaches the lungs where it becomes lodged

What blood vessels are considered functional?

Capillaries

Potential space between parietal and visceral pleura

Pleural cavity

What does the mediastinum refer to?

The central part of the body

Fissures that separate the right lung

Oblique fissure (between upper and lower lobe), horizontal fissure (between the upper and middle lobe)

Fissures that separate the left lung

Oblique fissure (between the upper and lower lobe)

Describe the bronchial tree.

Branching tubular structure conducting air between the trachea and lungs, comprising the main (primary), secondary (lobar), tertiary (segmental) bronchi, and the bronchioles

What is the difference between bronchial and pulmonary vessels?

Bronchial vessels provide blood for the lung's own usage, pulmonary vessels are part of the pulmonary circulation (gas exchange)

What important feature are present in the superior mediastinum?

Arch of aorta, R brachiocephalic trunk, L CCA, L subclavian a.

What important feature is present in the anterior mediastinum?

Thymus

What important features is present in the middle mediastinum?

Heart

What important feature is present in the posterior mediastinum?

Trachea, esophagus, aorta, primary vessels

What is the function of the pericardial sac?

Limits the movement of the heart, prevents overfilling, provides lubrication, and is a physical barrier

What is fibrous pericardium?

Dense irregular sac that fixes the heart in the mediastinum, outer layer

What is serous pericardium?

Has outer parietal layer and inner visceral layer with a cavity in between, inner layer

What is the pericardial cavity?

Potential space between parietal and visceral serous pericardium

What are the R and L auricles?

Muscles that squeeze blood out of atria (remaining 20%)

What separates L and R atria?

Interatrial septum

What separates L and R ventricles

Interventricular septum

What separates R atrium from L ventricle?

Atrioventricular septum

What keeps tension on the chordae tendineae to keep the valves closed while the ventricles are contracting?

Papillary muscles

What are the irregular muscular ridges or columns found on the inner surfaces of the heart's ventricles?

Trabeculae carnae

What keeps the leaflets of the valve from prolapsing?

Chordae tendineae

When AV valves are open, atrial pressure is greater/less than ventricular pressure.

Greater

When AV valves are closed, atrial pressure is greater/less than ventricular pressure.

Less

Are there chordae tendineae anchoring semilunar valves?

No

Describe the path of DEOX. blood flow.

Blood enters RA through SVC, IVC and coronary sinus.
Blood passes through R AV (tricuspid) valve to enter RV.
Blood moves up through pulmonary trunk past pulmonary valves and out to lungs via pulmonary arteries (R and L).

Describe the path of OX. blood flow.

Newly ox. blood enters LA via pulmonary veins.
Blood passes through left AV (mitral) valve to enter LV.
Blood moves up past aortic semilunar valve and into ascending aorta (to coronary circulation and rest of body)

What does 'lub' represent?

AV valves close

What does 'dub' represent?

Semilunar valves close

What does the LCA give off that provides ox. blood to LV?

Left anterior descending a. (anterior interventricular a.)

What collects deox. blood from the heart?

Coronary sinus (empty to RA)

What are the primary branches of the abdominal aorta?

Celiac trunk, superior mesenteric a., inferior mesenteric a.

The aortic arch gives off ____________ to the right side of the body.

Brachiocephalic trunk

The brachiocephalic trunk gives of ____________ to the right side of the body

RCCA and R subclavian a..

The aortic arch gives off _____________ to the left side of the body.

LCCA and L subclavian a.

What does the aortic arch give off that travels down the spine and splits to each leg?

Thoracic aorta

What does the brachiocephalic trunk become as it goes to the right side of the body and travel down the arm?

Right subclavian artery, axillary artery, brachial artery, and radial and ulnar arteries

What are superficial vv.?

Carry blood from tissues near the surface of the skin to the deep vv.

What are deep vv.?

Deeper in the body surrounded by muscles, and carry the bulk of blood.

What are perforating vv.?

Short vv. that connect the superficial and deep vv. Valves prevent backflow from the deep to superficial vv.

When muscles are relaxed, valves in veins are open/closed.

Closed

When muscles are contracted, valves in veins are open/closed.

Open

What is the dural venous sinus system?

Venous drainage of the brain in paired and unpaired sinuses, empties to IJV.