Venous Drainage of Head and Neck

Question 1

Where to the veins draining the head and neck lie?

Answer 1

Either superficial or deep to the investing layer of deep cervical fascia in the neck

Question 2

Are there distinct fascial layers in the face?

Answer 2

No, muscle attaches between bone and skin

Question 3

Where does the facial vein run?

Answer 3

With the facial artery, from the medial angle of the eye towards the inferior border of the mandible

Question 4

What does the facial vein drain?

Answer 4

Most structures of the face

Question 5

What does the facial vein drain into?

Answer 5

The internal jugular vein

Question 6

Where does the internal jugular vein lie?

Answer 6

Lateral to the common carotid, mostly under the sternocleidomastoid

Question 7

What does the facial vein have a numbr of important anastomoses with?

Answer 7

Veins draining deeper structures within the skull

Question 8

Where does the facial vein recieve blood from?

Answer 8

The superior and inferior opthalmic veins

Question 9

Where does the facial vein communicate with the superior opthalmic?

Answer 9

At the medial angle of the eye

Question 10

What do the superior and inferior opthalmic veins have a direct connection with?

Answer 10

The pterygoid venous plexus and cavernous sinus

Question 11

Where does the cavernous sinus lie?

Answer 11

Intra-cranially

Question 12

What is the cavernous sinus part of?

Answer 12

The intra-cranial venous system

Question 13

What is the cavernous sinus?

Answer 13

A plexus of extremely thin walled veins on the upper surface of the sphenoid

Question 14

What structures other than veins are found in the cavernous sinus?

Answer 14

• Internal carotid artery
• CN III oculomotor
• CN IV trochlear
• CN VI abducent
• 2 branches of trigeminal; CN V1 opthalmic and CN V2 maxillary

Question 15

Where does cavernous sinus sit?

Answer 15

On the sphenoid bone, either side of pituitary

Question 16

What is the result of the connection between the superior and inferior opthalmic veins (and therefore the facial veins) and the cavernous sinus?

Answer 16

It has implications for infections involving the face, acting as a potential route for infection to track deeper into intra-cranial structures

Question 17

What can formation of a septic thrombi, secondary to infection, in the facial vein cause?

Answer 17

The septic thrombi can pass into the cavernous sinus, leading to a cavernous sinus thrombosis

Question 18

Where is infection most likely to cause the formation of a septic thrombi in the facial vein?

Answer 18

Near the angle of the eye

Question 19

Where do deep facial veins drain into?

Answer 19

The pterygoid venous plexus

Question 20

Do veins of the face have valves?

Answer 20

No

Question 21

What is the result of the veins of the face being valveless?

Answer 21

Blood can flow in either direction

Question 22

What is the result of blood in the veins of the face being able to flow in either direction?

Answer 22

• Infection from facial vein can spread to dural venous sinuses
• Infected clots can travel to intracranial venous system

Question 23

What is thrombophlebitis of the facial vein?

Answer 23

Where there is an inflammation or infection of the vein, and a clot forms

Question 24

What is the result of an infected clot travelling to the intracranial venous system?

Answer 24

Carries infection deeper

Question 25

What is the clinical relevance of the danger triangle of the face?

Answer 25

Infections in this region of the face can spread through the venous system to dural venous sinuses, *e.g. if a spot gets infected in this area*

Question 26

**Insert venous draining of face and head diagram**

Question 27

What do the superficial veins accompany?

Answer 27

Arteries

Question 28

What superficial veins accompanying an artery drain the scalp?

Answer 28

* Superficial temporal veins * Occipital veins * Posterior auricular

Question 29

Where do the supraorbital and supratrochlear veins unite?

Answer 29

At the medial angle of the eye

Question 30

What is formed when the supraorbital and supratrochlear veins unite?

Answer 30

The angular vein

Question 31

What does the angular vein drain into?

Answer 31

The facial vein

Question 32

What do the veins of some parts of the scalp in the temporal region drain into?

Answer 32

The pterygoid venous plexus

Question 33

What are dural venous sinuses?

Answer 33

Endothelium lined-spaces between periosteal and meningeal layers of dura

Question 34

Where do dural venous sinuses form?

Answer 34

At dural septae

Question 35

Where do dural venous sinuses recieve blood from?

Answer 35

Large veins draining brain

Question 36

Give 4 dural venous sinuses

Answer 36

* Superior sagittal sinus * Inferior sagittal sinus * Cavernous sinus * Transverse sinus

Question 37

How does the transverse sinus continue?

Answer 37

As the sigmoid sinus, which continues as internal jugular veins

Question 38

How do the internal jugular veins leave the skull?

Answer 38

Through the jugular foramina

Question 39

How do the veins of the skull connect to diploic veins of the skull?

Answer 39

Through several emissary veins, *and thus dural venous sinuses*

Question 40

Do emissary veins have valves?

Answer 40

No

Question 41

What is the result of the emissary veins being valveless?

Answer 41

Blood can flow in either direction, so infection from scalp can spread to cranial cavity and affect the meninges