Blood Vessels II PDF

Blood Vessels II: Head, Neck, and Upper Limb Course Learning Objectives Cardiovascular: Recall the structures that allow for the exchange of gases and nutrients throughout the body by tracing blood flow and identifying related structures...

Blood Vessels II: Head, Neck, and Upper Limb Course Learning Objectives Cardiovascular: Recall the structures that allow for the exchange of gases and nutrients throughout the body by tracing blood flow and identifying related structures in the cardiovascular system.  Lecture Learning Objectives 1. Name and visually identify the blood vessels 5. Describe the importance of the cavernous in the following regions: sinus Crania Superior mediastinum 6. Given a specific location in the upper limb, identify which artery can be used to Neck measure pulse Head Upper limb 2. Trace the pathway of blood, naming the sequence of vessel by name for each region Pay attention to arterial vs. venous blood flow Recall anatomical landmarks for vessel name changes 3. When listed, identify the area each blood vessel will supply 4. Describe the arterial supply and venous drainage of the internal crania Systemic Blood Vessels Except for the largest vessels, most arteries and veins are paired and share the same name Vessels are often named for the region they supply or traverse When following vessels, often same tube with a different name All vessels listed in the PP text (not images) of this PP can be tested  Arteries of the Superior Mediastinum, Head, and Neck  LO 1 and 2 Systemic Blood Vessels To head To head To right upper limb Aorta To left upper limb Heart To abdomen, pelvis, lower limbs Gray’s Basic Anatomy, Drake et al., 2018 Arterial Supply to Head, Neck, and Upper Limbs Aorta  LO 1-3 Right common carotid a. – Left common carotid a.- supplies left Supplies right head head Right subclavian a. – supplies right thoracic wall Left subclavian a. – supplies left and upper limb thoracic wall and upper limb Brachiocephalic a. Aortic arch Ascending aorta  LO 1-3 Left common Right carotid a. common carotid a. Right subclavian a. Left Brachiocephalic a. subclavian a. Aortic arch  Superficial LO 1 - 3 Superficial structures of temporal a. the neck, face, and scalp Occipital a. are primarily supplied by branches of the external Posterior auricular a. carotid artery. Many Maxillary a. vessels will anastomose to Facial a. Ascending pharyngeal a. form networks. Artery What it supplies Lingual a. Internal carotid a.- more Superior thyroid Thyroid gland and posterior branch larynx External carotid a. Ascending Pharynx – more anterior pharyngeal branch L. Common carotid a. Lingual Tongue Facial Face Superior thyroid a. Thyrocervical trunk Maxillary Teeth, gums, nasal cavity, and meninges Subclavian a. Superficial temporal Lateral head and parotid gland Occipital and Scalp posterior auricular  LO 1-3 Superficial temporal a. Facial a. External carotid a. Internal carotid a. Left common carotid a.  LO 1-4 Structures of the internal cranial vault are supplied by branches of the Cerebral internal carotid artery and arterial circle vertebral artery. Basilar a. – supplies brainstem and The internal carotid aa. cerebellum Carotid canal and basilar a. will join to form the cerebral arterial circle (Circle of Willis) to supply the brain. Vertebral a. Internal carotid a. Thyrocervical trunk Common carotid a. Subclavian a.  LO 1 -4 Internal Cranial Arteries Anterior Internal communicating a. carotid a. Anterior Anterior cerebral a. cerebral a. Internal Middle carotid a. cerebral a. Middle cerebral a. Posterior Posterior cerebral a. Posterior communicating a. cerebral a. Basilar a. Basilar a. Anterior Superior superior cerebellar cerebellar a. Anterior inferior Vertebral aa. cerebellar a.  LO 1-4 Internal Cerebral aa. Anterior cerebral a. Middle Artery What is supplies cerebral a. Ophthalmic a. Anterior, middle, Cerebrum and posterior cerebral Ophthalmic Eye Posterior Petrous cerebral a. Posterior Basilar Brainstem and cerebellum part orbit Carotid canal Ethmoidal sinus Internal carotid a. Anterior view of internal cranium. Pathway of ICA through carotid canal and petrous part.  LO 1 -4 Anterior Anterior communicating a. cerebral a. Middle cerebral a. Internal carotid a. (cut) Posterior cerebral a. Posterior Basilar a. communicating a. Vertebral aa.  Think- Pair- Share Of the cerebral arteries, the middle cerebral artery is the larges and the most often occluded during a cerebral stroke. Based on the cortical structures we learned last semester, what primary functional areas may be affected when this type of stroke occurs? What specific portions of the body may be affected? (Hint: remember (or google) homunculus!) Wikipedia  Veins of the Superior Mediastinum, Head, and Neck  LO 1 -4 The right and left Internal jugular v. brachiocephalic vv. Internal jugular v. will drain the head, External jugular v. neck, and upper External jugular v. limbs into the superior vena cava. Subclavian v. – Subclavian v.- drains drains right left upper limb upper limb Brachiocephalic v. Brachiocephalic v. Superior vena cava  LO 1 and 2 Systemic Blood Vessels From head From head From From upper upper limb limb SVC Heart IVC From abdomen, pelvis, and lower limbs Gray’s Basic Anatomy, Drake et al., 2018 Venous Supply to Head, Neck, and Upper Limbs Aorta SVC  LO 1-4 Dural venous sinuses, formed by Superior Cavernous meningeal layers, are the primary ophthalmic v. sinus- coronal drainage for cranial vault section Cavernous Sigmoid sinus sinus Basilar venous plexus Superior petrosal Internal sinus jugular v. Sigmoid sinus Transverse Straight sinus sinus  Superior sagittal sinus LO 1-4 Internal Cranial Veins Inferior sagittal sinus Superior petrosal Falx cerebri sinus Inferior petrosal sinus Straight sinus Confluence of sinuses Transverse sinus Occipital sinus Sigmoid sinus  Inferior sagittal Jugular sinus Superior foramen sagittal sinus Inferior petrosal sinus Sigmoid sinus Straight sinus Straight sinus Transverse sinus LO 1 and 2 LO 1-4  LO 1-4 Several additional Anterior external vessels aid in draining vertebral plexus the cranial vault including the anterior external vertebral Venous plexus plexus, the cervical around vertebral a. Vertebral v. vein, and the venous plexus surrounding the Cervical v. vertebral a. Internal jugular v. Subclavian v.  LO 1-4 The dural venous sinuses are Straight sinus Superior tributaries of the internal jugular and petrosal sinus vertebral vv. Occipital sinus→ vertebral v. Inferior petrosal v. → internal jugular v. Confluence of sinuses Sigmoid sinus Occipital sinus Inferior petrosal sinus Internal jugular vein  LO 1-4 Superficial The face, scalp, and neck temporal v. Posterior auricular drain to the internal and Pterygoid Occipital external jugular vv. There plexus is a great degree of Retromandibular vv. Facial v. anastomoses. Lingual v. External jugular v. continued Common facial v. Vein What it supplies Superior, middle, and Thyroid gland and inferior thyroid larynx Superior, Internal jugular v.- anterior Lingual Tongue middle, branch inferior Facial Face thyroid vv. Pterygoid plexus Teeth, gums, nasal cavity, paranasal External jugular v. – posterior sinuses, nasopharynx branch Superficial temporal Lateral head and parotid gland Occipital and posterior Scalp auricular  LO 5 Clinical Importance of the Cavernous sinus Cavernous Sinus Receives blood from several locations including ophthalmic v., pterygoid plexus, and the dural venous sinuses Facial v. Retromandibular v. Connections provide pathways for infections to Pterygoid plexus pass from extracranial sites into intracranial locations  LO 1-4 Internal jugular v. External jugular v. Subclavian v. Subclavian v. Brachiocephalic Superior vena cava vv.  LO 1 -3 Facial a. Right common Internal jugular v. carotid a Carotid triangle External jugular v. - Inferior belly of digastric - Medial border of sternocleidomastoid - Posterior belly of omohyoid  LO 1 -3 Internal carotid a. External carotid a. Internal jugular v. Left common carotid a Vessels of the Upper Limb  LO 1 -3 Vessels of the Upper Limb Paired arteries and veins with main branches named for region Subclavian Axillary Brachial Radial Ulnar Palmar Also contains unpaired, superficial veins  LO 2 Subclavian a/v supplies: Axillary a/v- Supply superior thoracic structures Bounded by 1st rib and inferior margin of teres major muscle Subdivided into three parts based on pectoralis minor muscle Brachial a/v- supplies arm structures Bounded by inferior margin of teres major muscle and division of radial and ulnar vessels in cubital fossa Gray’s Basic Anatomy, Drake et al., 2018  LO 1 -3 Branches of thyrocervical trunk Subclavian and Axillary Arterial Branches Dorsal scapular a. and axillary a. supply the superior thoracic wall, axilla, and Thyrocervical trunk. shoulder joint. Anterior circumflex humeral Superior thoracic a. Thoraco-acromial a. Posterior Lateral thoracic a. circumflex humeral Subscapular a.  LO 1 -2 Subclavian and Axillary Arterial Branches Transverse cervical a. Inferior thyroid a. Suprascapular a. Thyrocervical trunk Acromial Clavicular Deltoid Thoraco-acromial a. Pectoral  LO 1 and 2 Thoraco-acromial a. Anterior circumflex humeral a. Superior thoracic a. Posterior circumflex humeral a. Lateral thoracic a. Subscapular a.  LO 1 and 2 Major Brachial Arterial Branches Profunda brachii a. Profunda brachii a. “Runs away” with radial nerve Collateral Radial- lateral Collateral Ulnar- medial Recurrent Collateral- travels distally, "side Collateral branch" Recurrent- travels proximally, "repeat" Recurrent  Clinical Application Anterior dislocation of the humeral head Can compress axillary a. resulting the vessel occlusion Can also damage what group of nerves in the region? Gray’s Basic Anatomy, Drake et al., 2018  LO 1 and 2 Vessels of the Forearm and Hand Radial a. Common interosseous a. Ulnar a. Superficial palmar arch a.  Venous Drainage of LO 1 and 2 Upper Limb Superficial unpaired veins Basilic v. Cephalic v. Branches follow arterial branches of axillary a. Clinically Oriented Anatomy, Moore et al., 2018.  LO 1 and 2 Superficial Veins of the Upper Limb Cephalic v.- drains into axillary v. Basilic v. – joins with brachial v. to become axillary v. Median cubital v. Clinical Application: Pulse and Blood Pressure Measurements 1 4 in the Upper Limb There are several locations to measure pulse in the upper limb 2 5 The brachial artery is used to measure blood pressure 3 6 Why are arteries, rather than veins, used to measure pulse and blood pressure? LO 6 Gray’s Basic Anatomy, Drake et al., 2018