Head and Neck Vascular Supply and Lymphatic Drainage PDF

Head and neck vasculare supply and lymphatic drainage & Lymphatic system Paria SHOJAOLSADATI, assistant professor in human anatomy Istanbul Okan University School of Medicine Head of Department of Anatomy Cardiovascular System Also circulatory system. Consists of: The heart, arteries, veins, capilla...

Head and neck vasculare supply and lymphatic drainage & Lymphatic system Paria SHOJAOLSADATI, assistant professor in human anatomy Istanbul Okan University School of Medicine Head of Department of Anatomy Cardiovascular System Also circulatory system. Consists of: The heart, arteries, veins, capillaries Types of Blood Vessels Arteries: Carry blood away from heart. Veins: Carry blood to heart. Capillaries: Networks between arteries and veins. Valves in Veins The one-way valves in deep veins prevent blood from flowing backward, and the muscles surrounding the deep veins compress them, helping force the blood toward the heart. Varicose veins Varicose veins are dilated, tortuous (having many curves or twists) veins. The valves in these veins have become nonfunctional, causing blood to pool in one area and the vein to swell and bulge. L y m p h a t i c S y s t e m Lymphatic System Components Lymph is the fluid Vessels – lymphatics Structures & organs Functions Return tissue fluid to the bloodstream Transport fats from the digestive tract to the bloodstream Surveillance & defense Lymphatic System Lymphatic vessels Lymph nodes lymph fluid lymphatics Structures & organs(make lymphosites) Lymphatic System At the arterial end of a capillary bed, blood pressure forces fluid from the blood into the interstitial spaces around cells. This fluid is called interstitial fluid. Most of this fluid is reabsorbed at the venous end of the capillaries, but an excess of about 3 liters of fluid per day remains in the interstitial spaces. A network of lymph vessels reabsorbs this excess fluid and returns it to the venous circulation. Lymphatics Originate as lymph capillaries Capillaries unite to form larger vessels - Resemble veins in structure - Connect to lymph nodes at various intervals Lymph Nodes Oval structures located along lymphatics Enclosed by a fibrous capsule Cortex = outer portion Germinal centers produce lymphocytes Medulla = inner portion Medullary cords Lymph enters nodes through afferent lymphatics, flows through sinuses, exits through efferent lymhpatic Lymphatics Lymphatics ultimately deliver lymph into 2 main channels Right lymphatic duct  Drains right side of head & neck, right arm, right thorax  Empties into the right subclavian vein Thoracic duct  Drains the rest of the body  Empties into the left subclavian vein Axiller Inguinal cervical 15 General Vascular Distribution walking stick Aorta pars thorasica Aorta pars abdominalis Vascular supply and Lymphatic drainage of head and neck Head and neck region arterial supply provide by two main arteries: 1. Subclavian 2. commun carotid artery Subclavian artery Each of the subclavian arteries is made up of three parts, defined in relation to the anterior scalene muscle of the neck. A.sublavia’nın dalları: I. Vertebral artery: II. Thyrocervical trunk: 1. inferior thyroid artery 2.Transverse cervical artery 3. Suprascapular artery III. Internal thoracic artery: IV. Costocervical Trunk: 1. Deep cervical 2. Superior intercostalis COMMON CAROTID ARTERY Cervical part of common carotid artery Carotid arteries are generally symmetric and approximately of same size unlike vertebral arteries. In 75% individuals ,CCA bifurcates at the level of C3-C4,roughly at the upper border of thyroid cartilage. COMMUNIS CAROTID ARTERY : Carotid Bifurcation : Upper Border Of Thyroid Cartilage (*C4 vertebra) CAROTID SINUS (BARORECEPTORS) At the bifurcation of common carotid artery Responsive to changes in the arterial blood pressure.It acts as a baroreceptor(pressure receptor) and regulates blood pressure. BLOOD SUPPLY-ICA NERVE SUPPLY-carotid sinus nerve or nerve of hering. CAROTID BODY (CHEMORECEPTORS) It is normally 2.5x 5mm to 4 x7mm flattened structure on the median and deep side of the upper end of the common carotid artery. Blood supply-from small vesssels usually from ECA. NERVE SUPPLY-9TH 10TH 12TH CN EXTERNAL CAROTID ARTERY: ECA is one of the terminal branches of the CCA. Chief artery of supply to structures in front of the neck and in the face. Generally arises medial and anterior to the ICA BRANCHES OF EXTERNAL CAROTID ARTERY Anterior  Superior thyroid  Lingual  Facial Posterior  Posterior auricular  Occipital  Terminal  Superficial temporal  Maxillary Medial  Ascending pharyngeal Branches Of External Carotid Artery 1.Superior thyroid 2. Lingual anterior 3. Facial 4. A. Ascending pharyngeal (medial) 5. occipital postreior 6. Posterior auricular 1. maxillar 2. Superficial temporal Branches before parotid gland. Terminal branches in parotid gland INTERNAL CAROTID ARTERY: Origin- It originates at the carotid bifurcation. Not have any branch in the neck. It supplies most of the ipsilateral cerebral hemisphere, eye, forehead and a part of the nose. A.cerebri ant. A.cerebri media A.vertebralis: Superior thyroid Artery First branch ECA Arises just below the level of the hyoid bone Ends in the thyroid gland. Main brach of that is superior laryngeal artery Ascending pharngeal artery A small branch arises from medial side of ECA Long, slender vessel, deeply seated in the neck It runs vertically upwards. Lingual artery Origin : Lingual Artery arises from the ECA opposite the tip of greater cornu of the hyoid bone. Emerged between the superior thyroid and facial artery. Th lingial artery provides the chief blood supply to the tongue and floor of the mouth Facial artery Lingual artery Facial artery is the chief artery of the face Origin : Arises from the ECA just above the hyoid bone It has two parts, first cervical part in the neck and facial part. It enters the face by winding around the base of the mandible At the antero-inferior angle of the masseter muscle, it can be palpated here. Branche of facail artery 1. Ascending palatine artery 2. Tonsillar arteries 3. Submental artery 4. Superior labial 5. Inferior labial 6. Lateral nasal 7. Angular Occipital artery Arises from the posterior part of the external carotid, opposite the facial Ends in the posterior part of the scalp Occipitalis artery May arise from Internal carotid artery. Posterior auricular artery Posteior auricular artery this small branch arises above the posterior belly of digastric It runs upwards and backwards deep to the parotid gland, crosses the base of the mastoid process and ascends behind the auricle. Occipitalis artery Posterior auricular artery Maxillary artery Larger of the two terminal branches Arises behind the neck of the mandible, and is imbedded in the substance of the parotid gland It supplies the deep structures of the face divided into three parts 1. Mandibular part 2. Pterygoid part 3. Pterygopalatin part Branches of 1st part (mandibular) 1st part (mandibular) : Lies medial to mandible, it runs along the lower border of lateral pterygoid muscle 1. 2. 3. 4. 5. Deep auricular artery Ant.tympanic artery Middle meningeal artery Accessory meningeal artery Inferior alveolar artery Branches of 1st part (mandibular) Inferior alveolar artery Runs downword & forward medial to ramus of mandible to reach mandibular foramina Before entering mandibular foramina gives off lingual and mylohyoid arteries In canal gives branches to mandibular teeth After coming out of canal supply chin via mental artery A.maxillaris Branches of 2nd part (pterygoid part) 2nd part (pterygoid part) : Artery runs forward &upward superficial to the lower head of the lateral pterygoid muscle Branches of 3rd part (pterygopalatine): Terminal portion of the artery passes between the two heads of the lateral pterygoid muscle A.Maxillaris 3.parçasının dalları A.sphenopalatina A.canalis pterygoideus A.infraorbitalis A.alveolaris posterior superior A.palatina descendens A.maxillaris: 1.) Pars mandibularis: A.auricularis profunda A.tympanica ant. A.meningea media A.alveolaris inf. 2.) Pars pterygoidea: A.temporalis profunda ant. ve post. Rr.pterygoidei A.massetrica A.buccales 3.) Pars pterygopalatina: A.alveolaris superior post. A.infraorbitalis A.palatina descendens Ramus pharyngeus A.sphenopalatina Superfacial temporal artery Smaller of the two terminal branches It begins in the substance of the parotid gland, behind the neck of the mandible Divides into two branches, a frontal and a parietal Superfacial temporal artery 1. Transverse facial branch 2. Anterior auricular branch 3. Frontal branch 4. Parietal branch 5. Zygomatico- orbital branch Veines of head and neck Internal jugular vein It receive blood from the brain, face and the neck. It emerges through the jugular foramen, as a continuation of the sigmoid sinus descend down in the neck, first behind then lateral to the internal carotid artery inside the carotid sheath Tributaries Facial vein Is formed by the union of the supraorbital and supratrochlear veins to form the angular vein Communicate with the cavernous sinus through the ophthalmic vein via the supraorbital Facial vein (continued) Runs downwards and backwards behind the facial artery to the lower border of the mandible To be joined by the anterior division of the retromandibular vein Joins the:  Pterygoid plexus through deep facial vein Cavernous sinus through superior ophthalmic 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 Retromandibular vein (continue 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 The maxillary vein A short trunk accompany the first part of the artery. Formed by confluence of the veins of the pterygoid plexus. It passes backward between the sphenomandibular ligament and the neck of the mandible Unite with the superficial temporal vein to form the retromandibular vein. Pterygoid plexus A network of very small veins, lie around and within the lateral pterygoid muscle in the infratemporal region Receive some of the veins that correspond to the maxillary vein, inferior ophthalmic vein (internal carotid blood) and the deep facial vein. External jugular vein 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 Angulus venosus (Pirogow açısı) Nodi parotidei Nodi occipitalis Nodi buccalis Nodi retroauricularis Nodi submentalis Nodi cervicalis superfascialis Nodi submandibularis Nodi cervicalis profundus Nodi juguloomohyoideus