ANATOMY 119

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Questions and Answers

Which structure collects blood from the brain, face, and neck?

Superior thyroid vein

Jugular vein (correct)

Anterior vertebral vein

Pharyngeal vein

Which of the following is NOT a tributary of the jugular vein?

Inferior petrosal sinus

Vertebral vein (correct)

Lingual vein

Common facial vein

Where does the anterior vertebral vein commence?

At the base of the skull

Around the suboccipital triangle

Around the transverse processes of the lower cervical vertebrae

Around the transverse processes of upper cervical vertebrae (correct)

Which of the following pairs correctly matches a superficial lymph node with its anatomical counterpart?

Occipital - Superficial cervical (B) Signup and view all the answers

Which type of vein is formed in the suboccipital triangle from tributaries of internal vertebral venous plexuses?

Vertebral vein (B) Signup and view all the answers

What is the main artery that enters the skull to supply the brain and orbit?

Internal carotid artery (C) Signup and view all the answers

What is the main function of the carotid body?

Acts as a chemoreceptor (A) Signup and view all the answers

Which artery is the most inferior branch of the external carotid artery?

Superior thyroid artery (C) Signup and view all the answers

What does the ascending pharyngeal artery primarily supply?

Cranial meninges (B) Signup and view all the answers

Where does the occipital artery end its course?

In the posterior part of the scalp (B) Signup and view all the answers

Which structure is mainly supplied by the facial artery?

Palate and submandibular gland (B) Signup and view all the answers

What is the role of the carotid sinus?

Sensing changes in blood pressure (A) Signup and view all the answers

Where does the external carotid artery run in relation to the mandible?

Between the neck of the mandible and the lobule of the auricle (D) Signup and view all the answers

Which area does the external jugular vein primarily drain blood from?

Upper and back part of the neck (B) Signup and view all the answers

What is the terminal branch of the superficial temporal artery?

Frontal branch (A), Parietal branch (C) Signup and view all the answers

Which vein begins in the occipital region and runs down the back part of the neck?

Posterior external jugular vein (B) Signup and view all the answers

Which structure does the first part of the mandibular nerve supply?

Dura mater (C) Signup and view all the answers

What forms the external jugular vein?

Posterior division of retromandibular vein and posterior auricular vein (D) Signup and view all the answers

Which of the following veins opens into the termination of the external jugular vein or subclavian vein?

Anterior jugular vein (B) Signup and view all the answers

The second part of the mandibular nerve primarily supplies which function?

Muscles of mastication (B) Signup and view all the answers

What is not a tributary of the external jugular vein?

Superficial temporal vein (D) Signup and view all the answers

Study Notes

Arteries of the Neck

Common Carotid Artery: Runs with the internal jugular vein (IJV) and vagus nerve in the carotid sheath.
- Divides into the internal carotid artery (ICA) and external carotid artery (ECA).
Internal Carotid Artery (ICA): Arises from the CCA at the superior border of the thyroid cartilage.
- Has no branches in the neck.
- Enters the skull and becomes the main artery of the brain and orbit.
External Carotid Artery (ECA): Supplies structures external to the skull.
- Each artery runs between the neck of the mandible and the lobule of the auricle.
Carotid Sinus: Dilatation of the proximal part of the ICA. Contains receptors sensitive to changes in blood pressure.
Carotid Body: Small mass of tissue located at the bifurcation of the CCA.
- A chemoreceptor that responds to changes in the chemical composition of blood.

Branches of the External Carotid Artery

Superior Thyroid Artery: Most inferior branch.
- Runs deep to infrahyoid muscles to reach the thyroid gland.
- Branches to the thyroid gland, SCM, infrahyoid muscles, and gives rise to the superior laryngeal artery which supplies the larynx.
Ascending Pharyngeal Artery: Ascends on the pharynx deep to the ICA.
- Sends branches to the pharynx, prevertebral muscles, middle ear, and cranial meninges.
Lingual Artery: Passes deep to the hypoglossal nerve, stylohyoid, and posterior belly of the digastric muscles.
- Passes deep to the hyoglossus muscle where it becomes the deep lingual artery.
Facial Artery: Gives off a tonsillar branch, branches to the palate and submandibular gland.
- Passes under the digastric, stylohyoid muscles, and angle of the mandible.
- Loops Anteriorly and enters a deep groove in the submandibular gland.
- Hooks around the inferior border of the mandible and enters the face.
Occipital Artery: Passes along the inferior border of the posterior belly of the digastric muscle.
- Ends in the posterior part of the scalp.
Posterior Auricular Artery: Ascends posterior to the external acoustic meatus.
- Supplies adjacent muscles, parotid gland, facial nerve, structures in the temporal bone, auricle, and scalp.
Maxillary Artery: Terminal branch. Arises posterior to the neck of the mandible and deep to its condyle.
- Passes deep to the lateral pterygoid muscle and enters the infra-temporal fossa.
- Divided into three parts:
  - First Part: Supplies the tympanic membrane, dura, and mandibular teeth.
  - Second Part: Supplies the muscles of mastication.
  - Third Part: Supplies the maxillary teeth, face, orbit, palate, and nasal cavity.
Superficial Temporal Artery: Terminal branch. Emerges on the face between the TMJ and the ear.
- Ends in the scalp by dividing into frontal and parietal branches.
- Gives off a transverse facial artery within the parotid gland.
- Supplies the parotid gland, duct, masseter muscle, and skin of the face.

Venous Drainage of the Neck

Veins of the neck return blood from the head and face:
- External Jugular Vein: Receives the greater part of blood from the exterior of the cranium and deep parts of the face.
- Anterior Jugular Vein: Returns blood from the skin & superficial muscles in the upper & back part of the neck.
- Posterior External Jugular Vein: Begins in the occipital region.
- Internal Jugular Vein: Collects blood from the brain, superficial parts of the face, and neck.
- Vertebral Vein: Formed in the sub-occipital triangle from numerous small tributaries which spring from the internal vertebral venous plexuses.
- Anterior Vertebral Vein: Commences in a plexus around the transverse processes of the upper cervical vertebrae.

Tributaries

External Jugular Vein:
- Posterior external jugular veins
- Anterior jugular veins
- Suprascapular
- Transverse cervical
Posterior External Jugular Vein:
- Opens into the external jugular vein just below the middle of its course.
Anterior Jugular Vein:
- Laryngeal veins
- Thyroid vein
- Two anterior jugular veins communicate by a transverse trunk - venous jugular arch (receive tributaries from inferior thyroid veins, each also communicates with the IJV)
Internal Jugular Vein:
- Inferior petrosal sinus
- Common facial
- Lingual
- Pharyngeal
- Superior & middle thyroid veins
Vertebral Vein:
- Vertebral vein communicates with the transverse sinus by a vein that passes through the condyloid canal.
- Occipital vein
- Internal & external vertebral venous plexuses
- Anterior vertebral & deep cervical veins
Anterior Vertebral Vein:
- Descends with the ascending cervical artery between the scalenus anterior and longus capitis muscles.
- Opens into the terminal part of the vertebral vein.

Lymphatic Drainage of the Head and Neck

Divided into a superficial ring of lymph nodes and a vertical group of deep lymph nodes:
Superficial Lymph Nodes:
- Occipital
- Mastoid
- Pre-auricular
- Parotid
- Submental
- Submandibular
- Facial
- Superficial Cervical
Deep Lymph Nodes:
- Divided into superior & inferior deep cervical
- Includes:
  - Prelaryngeal
  - Pretracheal
  - Paratracheal
  - Retropharyngeal
  - Infrahyoid
  - Jugulodigastric (tonsillar)
  - Jugulo-omohyoid
  - Supraclavicular nodes

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