Arteries of the head & neck

1. Arteries of the head & neck • The face receives rich blood supply from two main vessels, the facial and the superficial temporal arteries. • It is supplemented by small vessels, supratrochlear and supraorbitalfrom the internal carotid artery

2. Arteries of the head & neck • Teeth and oral structures are supplied by: • Maxillary artery. • Lingual artery. All the arteries are branches from the external and internal carotid arteries

3. Arteries of the head & neck • Common carotid artery: • The right artery arise from the brachiocephalic artery and the left from the arch of the aorta. • Runs upward and back and divide at the upper border of the thyroid cartilage into two terminal branches the external and internal arteries

4. Arteries of the head & neck • Carotid sinus: • a localized dilatation at the terminal part of common carotid artery • contain numerous nerve endings from glossopharyngeal nerve • It serve as a pressoreceptor that assist in regulating the blood pressure in the cerebral artery

5. Arteries of the head & neck • Carotid body: • A small reddish structure, lies posterior to the bifurcation • innervated by glossopharyngeal nerve • A chemoreceptor sensitive to anoxia, producing a rise in blood pressure, heart rate & increase in respiration

6. Arteries of the head & neck • External Carotid Artery: • It begins at the level of the upper border of the thyroid cartilage near the greater horn of the hyoid bone and terminates in the substance of the parotid gland • At The origin: • It lies medial to the internal carotid then it passes back and lateral

7. Arteries of the head & neck • The internal jugular vein lies lateral but higher up it passes posterior and deep. • It is overlapped by the anterior border of the sternocleidomastoid muscle

8. Arteries of the head & neck • It pass upward deep to the posterior belly of the digastric and stylohyoid muscles • It pierces the deep lamina of the parotid fascia and enters the gland separated from the internal carotid by the deep part

9. Arteries of the head & neck • Branches: • Three from in front: • Superior thyroid • Lingual • Facial • Diverge widely from each other • Two from behind: • Occipital • Posterior auricular • pass up along the upper and lower border of digastric

10. Arteries of the head & neck • One medial: • Ascending pharyngeal • ascend along the side wall of the pharynx • Two terminal: • Maxillary • Superficial temporal • Within the substance of the parotid

11. Arteries of the head & neck • Superior thyroid: • Runs vertically downward to the upper pole of the thyroid cartilage • Branches: • The superior laryngeal artery • A branch to the sterno-cleidomastoid muscle.

12. Arteries of the head & neck • Lingual artery: • It form a loop opposite the tip of the greater horn of the hyoid bone • Pass deep to the hyoglossus muscle to enter the submandibular region • Branches: • Dorsal lingual: • ascend to the dorsum & tip of tongue • Sublingual artery: • sublingual salivary gland & structures

13. Arteries of the head & neck • Facial artery: • Ascend upward on the superior constrictor muscle and deep to the digastric and stylohyoid muscles and submandibular gland • Indent the surface and makes an S bend around the gland and cross the inferior border of the mandible at the anterior border of the masseter

14. Arteries of the head & neckFacial artery: • Runs upward in a tortuous course to the angle of the mouth under the platysma • Ascend deep to zygomaticus and the levator labii superioris along the side of the nose to the medial angle of the eye • Anastomose with the terminal branches of the ophthalmic artery

15. Arteries of the head & neckFacial artery: • Branches: • Five in number then terminate as the angular artery • Tonsillar artery: • Tonsil and soft palate • Submental artery: • Skin of the chin and lower lip, anterior belly of digastric and mylohyoid muscle and sublingual salivary gland.

16. Arteries of the head & neckFacial artery: • Inferior labial artery: • Runs medially in lower lip, anatomizing with opposite. • Superior labial artery: • Upper lip, nasal septum and ala of nose • Lateral nasal artery: • Skin on the lateral and dorsum of nose

17. Arteries of the head & neck • Occipital artery: • Arises from the back at the level of the facial artery • Ascend backward along the lower border of the posterior belly of the digastric muscle. • Supply the back of the scalp • the posterior triangle • two branches to the sternocleidomastoid muscle

18. Arteries of the head & neck • Posterior auricular artery: • Arises above the upper border of the digastric muscle • Branches: • Auricular branches: • supply the pinna of ear • Stylomastoid branch: • supply the facial nerve • Stapedial branch: • To the stapedius muscle

19. Arteries of the head & neck • Ascending pharyngeal artery: • Arises from the medial side at the beginning of the external carotid artery. • Run deep to the internal carotid along the side wall of the pharynx • Supply the pharyngeal wall and soft palate • Meningeal branches through foramina

20. Arteries of the head & neck • Maxillary artery: • One of the two terminal branches of the external carotid artery. • Enter the infratemporal fossa deep to the condyle with the Auriculotemporal nerve superficial to it.

21. Arteries of the head & neck Maxillary artery: • Pass between the two heads of lateral pterygoid muscle deep into the pterygomaxillary fissure and enter the pterygo-palatine fossa • Leaves the fossa through the foramen and become the sphenopalatine artery to the nose

22. Arteries of the head & neck Maxillary artery: • Branches • Descriptively it is in three parts in relation to the muscle, • each part gives five branches • Branches from the first and third part enter bony foramina • First part • Before it reaches the muscle • Second part • On the muscle • Third part • After the muscle

23. Arteries of the head & neck Maxillary artery: • The first part: • Inferior alveolar artery: • Passes downward and forward and join the nerve and the vein at the mandibular foreman • passes forward in the I-D canal supplying the body • Dental branches supply lower teeth • Mental branch supply the lip and skin • Atrophies in old age when the bone resorb

24. Arteries of the head & neck • Middle meningeal artery: • Enter the skull through foramen spinosum • Supply the base of the skull • Accessory meningeal nerve: • Enter the skull through foramen ovale • Chief arterial supply for the trigeminal ganglion • Deep auricular artery: • Supply the external acoustic meatus • Anterior tympanic artery: • Join the anastomosis around the tympanic membrane

25. Arteries of the head & neck • The second part: • This supply the pterygoid and the temporalis muscle, other accompany the lingual and long buccal nerves • The third part: • Posterior superior alveolar nerve: • Accompany nerves and enter the bone through foramina in the posterior wall of the maxilla

26. Arteries of the head & neck • Greater palatine artery • Enter the foramen and supply the hard palate • Pharyngeal branches: • Enter the palatovaginal canal • Artery of the pterygoid canal • Infraorbital artery: • Enter the inferior orbital fissure along the floor of the orbit then to the infraorbital canal and emerges in the face through the infraorbital foramen

27. Arteries of the head & neck • Superficial temporal artery: • Is a terminal branch of the external carotid passes behind the TMJ crossing the posterior root of the zygomatic arch • Branches widely and supply the skin over the temporalis fascia • Middle temporal artery • pierces the fascia and run deep to the muscle

28. Arteries of the head & neck • Supraorbital artery: • Is a branch of the ophthalmic artery and emerge with the nerve • Is a large branch supply the front of the scalp up to the vertex • Anastomoses with the superficial temporal artery connecting the external & internal carotid arteries

29. Arteries of the head & neck • Supratrochlear artery: • A branch of the ophthalmic, from the internal carotid artery • Supply the frontal part of the skull medially • Anastomose with the superficial temporal artery establishing a free communication between the internal and external carotid arteries

30. Arteries of the head & neck • Clinically: • External carotid artery is exposed through an incision along the anterior border of the sternocleidomastoid muscle, passing downward from the angle of the mandible • It lies anterior and is the only carotid with branches in the neck

31. Arteries of the head & neck • The common carotid is exposed through a transverse incision over the origin of the sternocleidomastoid muscle above the sternoclavicular joint • Free communication between the external carotid arteries and cross circulation through the circle of Willis provide good blood supply to the face and the cranium