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BLOOD VESSELS OF HEAD AND

NECK…

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The Structure of Blood Vessels

• A Comparison of a Typical Artery and a Typical Vein

Figure 13-1

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Arteries

Veins

Common carotid artery

Subclavian artery

Jugular vein

InternalJuglar vein

external Jugular vein

Vertebral artery

Internal carotidartery

External carotid artery

ascending pharyngeal a. sup. Thyroid a. lingual a. facial a. occipital a. post. Auricular a. superficial temporal a. maxillary a.

facial vein lingual vein sup. Thyroid vein

CLASSIFICATION

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ARTERIES OF HEAD AND NECK

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COMMON

CAROTID

ARTERY

BEGINNING, COURSE AND TERMINATION : It is a branch of brachiocephalic trunk on right side and a direct branch of arch of aorta on the left side. The artery runs upwards along the medial border of sternocleidomastoid muscle enclosed within the carotid sheath. The artery ends by dividing into internal carotid and external carotid at the upper border of the thyroid cartilage.

AREA OF DISTRIBUTION: This artery has only two terminal branches. These are internal carotid and external carotid.

COMMON CAROTID ARTERY

In front •Platysma >omohyoid •Sterno-mastoid > thyroid, •Sterno-hyoid > lingual & facial veins Externally

•Internal jugular vein

Behind•Sympathetic nerve•Inferior thyroid artery•Recurrent laryngeal nerve

Internally•Trachea•Thyroid gland•Inferior thyroid artey•Larynx•pharynx

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INTERNAL CAROTID ARTERY• The internal carotid arteries begin at the upper border of the

thyroid cartilage and ascend to reach the base of the skull where it enters the carotid canal.

• Like latter it is surrounded by carotid sheath along with the internal jugular vein and the vagus nerve.

• Ophthalmic artery is a branch of internal carotid. It is further divided into following branches:

Central artery of retina- first branch of ophthalmic Lacrimal artery- largest branch Post/ant ciliary Supraorbital- supplies skin of forehead Ant $ post. Ethmoidal- supplies ethmoidal sinus Medial palpebral- supplies eyelids Dorsal nasal- to part of nose.

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EXTERNAL CAROTID ARTERY

COURSE AND DISTRIBUTION: The external carotid artery, arises opposite the upper border of the thyroid cartilage, and taking a slightly curved course, ascends upwards and forwards, and then inclines backwards, to the space b/w the neck of the condyle of the lower jaw, and the external meatus, where it divides into the temporal $ internal maxillary arteries.

BRANCHESANTERIORSuperior thyroid

Lingual facial

POSTERIOROccipitalPosterior auricular

ASCENDINGAscending pharyngeal

TERMINALTemporal

Internal maxillary

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Diagrams showing structures crossing Extenal Carotid

Artery

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Landmarks of external carotid artery and its branches

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COURSE: it arises from anterior aspect of ECA forms a typical loop which is crossed by XII nerve. Its 2nd part lies deep to the hyoglossus. The 3rd part runs along the ant. Border of hyoglossus $ 4th part runs forwards under the surface of tongue.DISTRIBUTION: it is chief artery of muscular tongue. It supplies various muscles, papillae n taste buds.also gives branches to tonsils.

LINGUAL ARTERY

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FACIAL ARTERYCOURSE: this tortuous artery from ant. Side also arises a lil higher to lingual artery. It runs in the neck as cervical part $ in the face as facial artery.

DISTRIBUTION: Cervical part gives off ascending palatine, tonsillar, glandular branches, for the submandibular $ sublingual salivary glds. The facial part gives branches to the muscles of face $ skin.

• FACIAL A ARTERY

•

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OCCIPITAL ARTERYCOURSE: it arises from post. Aspect of ECA $ runs upwards along the lower border of post. Belly of diagastric muscle. It runs deep to mastoid process $ the muscle attaches to it. Crosses suboccipital triangle $ pierces trapezius.

DISTRIBUTION: It gives 2 branches to SCM muscles $ branches to neighbouring muscles. It also gives a meningeal $ a mastoid branch.

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SUPERIOR THYROID ARTERY:

COURSE: it arises from the anterior aspect of ECA close to its origin. It runs downwards and forwards deep to the infrahyoid muscles to the upper pole of thyroid gland.

DISTRIBUTION: superior pharyngeal branch which pierces thyroid membrane to supply larynx.terminal branches supply the thyroid gland.

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SUPERFICIAL TEMPORAL

COURSE: It is smaller terminal branch of ECA. Begins behind the neck of the mandible, runs upwards $ crosses the preauricular point, where its pulsations can be felt. It ends by dividing into ant. $ post. Branches.

DISTRIBUTION: supply layers of scalp $ superficial temporal region. It also supplies parotid gland, facial $ temporalis muscles.

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MAXILLARY ARTERY

COURSE: Larger branch of ECA. It is given off behind the neck of the mandible. Its course is divided into 1st, 2nd $ 3rd parts acc. to its relations with lateral pterygoid muscle.

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SUBCLAVIAN ARTERY

COURSE: It the chief artery of upper limb. It also supplies part of neck $ brain.The artery arches from the sternoclavicular joint to the outer border of the first rib where it continues as the axillary artery. It is divided into 3 parts by the crossing of scalenus ant. Muscle.

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Veins from Head and Neck

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INTERNAL JUGULAR VEIN• This is the larger of two vessels

that drain blood from the head and neck into the subclavian.

• COURSE: it is a direct continuation of sigmoid sinus. Begins at jugular foramen, $ ends behind the sternal end of the clavicle by joining the subclavian vein to form the branchiocephalic vein.

• The origin is marked is marked by a dilation, the superior bulb which lies in jugular fossa of temporal bone.

• TRIBUTARIES: 1. INFERIOR PETROSAL SINUS 2. COMMON FACIAL VEIN 3. LINGUAL VEIN 4. PHARYNGEAL VEINS 5. SUP. THYROID VEIN 6. MID. THYROID VEIN

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EXTERNAL JUGULAR VEIN

Formed by union of retromandibular vein and post. Auricular vein. -Drains blood from face and scalp.

Drains into subclavian. This is the smaller of the two vessels that drain blood from the head and neck into the subclavian.

It is lateral to the internal jugular.

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• ATHEROSCLEROSIS- it is a condition in which the artery wall thickens as a result of accumulation of fatty materials such as cholesterol. It is commonly referred to as hardening or furrowing of arteries.

CLINICAL ANATOMY

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• VARICOSE VEINS- veins that have become large and tortuous. It generally refers to veins in the leg. Veins have valves to prevent the blood from flowing backwards. Leg muscles pump the veins to return the blood to the heart, against the efect of gravity. When the valves don’t work properly the blood flows backwards and this results in further enlargement of the vein. This usually occur in parts like leg which are subjected to high pressure due to long standing.

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• LUSORIA- dysphagia caused by compression of esophagus by an aberrant in subclavian artery.

• BRAIN HAEMORRAGE- the middle meningeal artery is of

great surgical importance because it can be torn in head injuries resulting in extradural haemorrage. The haematoma presses on the motor area, giving rise to hemiplegia of the opposite side. The anterior division can be approached surgically by making a hole in the skull over the pterion, 4 cm above the midpoint of the zygomatic arch.

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• CAROTID ARTERY BRUITS- is a systolic sound heard over the carotid artery during auscultation( technical term for listening to internal sounds of the body)

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• CAROTID ENDARTERECTOMY-(CEA) it is a surgical procedure used to prevent stroke by correcting stenosis (narrowing) in common carotid artery. Endarterectomy is removal of material from the inside end of the artery.

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