Příčný řez stonkem rostliny pod mikroskopem Clinical anatomy of head and neck vessels. Lymphatic drainage MUDr. Erik Kročka EXTERNAL CAROTID ARTERY Ventral branches Superior thyroid artery Lingual artery Facial artery Medial branches Ascending pharyngeal artery Dorsal branches Occipital artery Posterior auricular artery Terminal branches Maxillary artery Superficial temporal artery INTERNAL CAROTID ARTERY Petrous segment Caroticotympanic arteries Cavernous segment Tentorial basal branch Tentorial marginal branch Meningeal branch Branches to nerves Branches to trigeminal ganglion Capsular branches (cavernous sinus) Inferior hypophyseal artery Cerebral segment Superior hypophyseal artery Ophthalmic artery Anterior choroidal artery Anterior cerebral artery Middle cerebral artery Posterior communicating artery The carotid bifurcation → side predilection of an atherosclerosis Obsah obrázku text, černá Popis byl vytvořen automaticky Obsah obrázku text Popis byl vytvořen automaticky Obsah obrázku šipka Popis byl vytvořen automaticky CAROTID ENDARTERECTOMY VERTEBRAL ARTERY Cervical branches Spinal branches Muscular branches Meningeal branch Cranial branches Basilar artery Posterior cerebral arteries CIRCULUS ARTERIOSUS CEREBRI WILLISI Obsah obrázku mapa Popis byl vytvořen automaticky ARTERIAL SUPPLY OF THE BRAIN Anterior 2/3 → internal carotid artery Posterior 1/3 → vertebral artery Obsah obrázku šipka Popis byl vytvořen automaticky ANEURYSMS IN THE CIRCLE OF WILLIS Obsah obrázku text Popis byl vytvořen automaticky SUBCLAVIAN STEAL SYNDROM SUPERIOR THYROID ARTERY •Superior laryngeal artery •Cricothyroid artery •Infrahyoid branch •Sternocleidomastoid branch •Glandular branches (anterior, lateral and posterior) LINGUAL ARTERY •Suprahyoid branch •Sublingual artery •Dorsal lingual branches •Deep lingual artery THE LINGUAL ARTERY LIGATION 1. The Béclard´s angle •the greater horne of the hyoid bone caudal •the posterior belly of the digastric muscle cranial 2. The Pirogov triangle •the posterior border of the mylohyoid muscle •the intermediate tendon of the digastric muscle •hypoglossal nerve Obsah obrázku text Popis byl vytvořen automaticky BEHCET´S DISEASE FACIAL ARTERY •Ascending palatine artery •Submental artery •Tonsillar branch •Glandular branches •Superior and inferior labial artery •Lateral nasal branch •Angular artery •Ascending palatine artery •Submental artery •Tonsillar branch •Glandular branches •Superior and inferior labial artery •Lateral nasal branch •Angular artery FACIAL ARTERY MAXILLARY ARTERY 1. MANDIBULAR PORTION •Deep auricular artery •Anterior tympanic artery •Middle meningeal artery -Frontal branch -Parietal branch -Orbital branch -Superior tympanic artery •Inferior alveolar artery -Mylohyoid branch -Dental branches -Gingival branches -Mental artery 2. PTERYGOID PORTION •Masseteric artery •Pterygoid arteries •Deep temporal arteries •Buccal artery Obsah obrázku šipka Popis byl vytvořen automaticky 3. PTERYGOPALATINE PORTION •Posterior superior alveolar artery -Dental branches -Gingival branches •Infraorbital artery -Anterior superior alveolar arteries §Dental branches §Gingival branches •Artery of pterygoid canal •Descending palatine artery -Greater palatine artery -Lesser palatine arteries •Sphenopalatine artery -Posterior lateral nasal arteries -Posterior septal branches §Nasopalatine branch POSTERIOR AURICULAR ARTERY OCCIPITAL ARTERY •Sternocleidomastoid branch •Auricular branch •Mastoid (meningeal) branch •Occipital branches •Muscular branches •Glandular branches •Auricular branch •Stylomastoid artery -Posterior tympanic artery -Mastoid branches -Stapedial branch •Occipital branch ASCENDING PHARYNGEAL ARTERY •Pharyngeal branches •Posterior meningeal artery •Inferior tympanic artery SUPERFICIAL TEMPORAL ARTERY •Parotid branches •Transverse facial artery •Anterior auricular branches •Zygomatico-orbital artery •Middle temporal artery •Frontal branch •Parietal branch Obsah obrázku text, osoba, muž, zavřít Popis byl vytvořen automaticky TEMPORAL ARTERITIS Obsah obrázku text, různé Popis byl vytvořen automaticky BLOOD VESSELS OF THE ORBIT Ophthalmic artery •Central retinal artery •Lacrimal artery -Anterior ciliary arteries -Lateral palpebral arteries •Short posterior ciliary arteries •Long posterior ciliary arteries •Anterior ciliary arteries •Muscular arteries •Supraorbital artery •Posterior ethmoidal artery •Anterior ethmoidal artery -Anterior meningeal branch •Medial palpebral arteries •Supratrochlear artery •Dorsal nasal artery Obsah obrázku text, bezobratlí, ostnokožci Popis byl vytvořen automaticky Obsah obrázku text, interiér Popis byl vytvořen automaticky Obsah obrázku text, zavřít Popis byl vytvořen automaticky Obsah obrázku oranžová Popis byl vytvořen automaticky RETINAL ARTERY OCCLUSION Obsah obrázku text, nastavit, zavřít Popis byl vytvořen automaticky CENTRAL RETINAL VEIN OCCLUSION VENOUS DRAINAGE OF THE HEAD AND NECK 1.Cerebral veins 2.Meningeal veins 3.Dural venous sinuses 4.Diploic veins 5.Veins of labyrinth 6.Emissary veins 7.Retromandibular vein •Superficial temporal vein •Middle temporal vein •Transvers facial vein •Maxillary veins 8. Ophthalmic veins 9. Pharyngeal veins 10. Facial vein 11. Lingual vein •Sublingual vein •Vena comitans nervi hypoglossi 12. Superior thyroid vein 13. Middle thyroid vein 14. External jugular vein PTERYGOID PLEXUS •Middle meningeal veins •Venous plexus of foramen ovale •Internal carotide venous plexus •Venous shunt in the foramen rotundum •Deep temporal veins •Vein of pterygoid canal •Anterior auricular veins •Articular veins •Tympanal veins •Stylomastoid vein •Parotide veins •Pharyngeal veins •Sphenopalatine vein •Inferior ophthalmic vein •Infraorbital vein •Deep facial vein •Descending palatine vein •Posterior superior alveolar veins •Inferior alveolar vein INTERNAL JUGULAR VEIN •Sigmoid sinus + Inferior petrosal sinus •Pharyngeal veins (pharyngeal venous plexus) •Retromandibular vein •Facial vein •Lingual vein §Sublingual vein §Vena comitans nervi hypoglossi •Superior thyroid vein §Superior laryngeal vein §Sternocleidomastoid vein •Middle thyroid vein (inconsistent) •External jugular vein §Anterior jugular vein LYMFATIC SYSTEM - OVERVIEW OVERVIEW OF THE HEAD AND NECK LYMPH NODES Occipital nodes •afferents: scalp in the occipital region •efferents: superficial cervical nodes and deep cervical nodes Mastoid nodes •afferents: scalp behind the auricle, posterior side of the auricle •efferents: superficial cervical nodes and deep cervical nodes Superficial and deep parotide nodes •afferents: scalp in the temporal and frontal region, lateral part of the eyelids, buccal region, anterior side of the auricle and external auditory meatus, middle ear, parotide gland, soft palate •efferents: superficial cervical nodes and deep cervical nodes Submandibular nodes •afferents: lower eyelids, nose, upper lip, cheeks, paralingual region, hard palate, floor of mouth, teeth •efferents: deep cervical nodes Submental nodes •afferents: lower lip, chin, anterior floor of mouth, anterior teeth, tip of tongue •efferents: superficial cervical nodes and deep cervical nodes LYMPH NODES OF THE HEAD Nodi retropharyngei •afferents: pharynx, middle ear, Eustachian tube, posterior and superior nasal cavity, paranasal sinuses •efferents: nodi cervicales profundi LYMPH FROM THE TONGUE Apical collecting vessels → juguloomohyoid node or via submental nodes External marginal collecting vessels → submental nodes Internal marginal collecting vessels → internal jugular nodes from anterior tongue → jugulodigastric node from posterior tongue Central collecting vessels → submandibular nodes and juguloomohyoid node Basal collecting vessels → internal jugular nodes and jugulodigastric node + lingual nodes in the lingual base Lateral superficial cervical nodes •external jugular nodes Lateral deep cervical nodes a. internal jugular nodes §tonsillar node (Wood´s node) §jugulodigastric node (Küttner´s node) b. spinal accessory nodes c. supraclavicular nodes §Wirchov´s nodes on the left side Anterior deep cervical nodes §praelaryngeal nodes §thyroid nodes §preglandular nodes §pretracheal nodes §paratracheal nodes Anterior superficial cervical nodes §anterior jugular nodes References: HOMBACH-KLONISCH, S., T. 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