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Surgery General 64b700eb

A patient presents with a chief complaint of chronic nose-bleeds. To control the severity of these nosebleeds, his physician decides to ligate the sphenopalatine aery. From which of the following aeries does the sphenopalatine aery arise.

A
Internal carotid
B
facial aery
C
maxillary aery
D
Ophthalmic aery
High-Yield Explanation
Maxillary In the young, the blood comes from Little's area, a highly vascular area at the anteriorborder of the nasal septum. With age the site of bleeding moves posteriorly o The nose and sinuses are supplied by branches of the internal and external carotid aeries. o The superiorpa of the nose receives the anterior and posterior ethmoidal aeries - branches of the ophthalmicaery which itself, is a branch of the internal carotid. o The rest of the nose and sinuses is supplied by the greater palatine, sphenopalatine, and superior labial aeries, all of which are branches of the maxillary aery which itself, is a branch of the external carotid. o Significantly there is a plexus of vessels on the anterior septum - Little's area or Kiesselbach's plexus - where branches of both the internal and external carotid aery anastomose; this is a frequent site for epistaxis. o Venous drainage of the nose and sinuses is the ophthalmic and facial veins (dangerous area of face), and the pterygoid and pharyngeal plexuses. Significantly, drainage is such that infection may spread the veins to the cavernous sinus, leading to cavernous sinus thrombosis

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