Blood supply of head & neck

• Carotid system of arteries:

– form major arterial trunk of head and neck
• Venous channel : jugular vein
 Common carotid artery
• Extent :
• Terminal branches :
– External carotid artery
– Internal carotid artery
 External carotid artery
• Extent :upper border of lamina of thyroid cartilage to
point behind neck of mandible
• Lies anteromedial to internal carotid artery at its origin
•
• Ascending
pharyngeal
– Pharyngeal
– Tympanic
– meningeal
• Front :
– Superior thyroid
– Lingual
– Facial
• Behind
– Occipital
– Posterior auricular
• Terminal branches
– Maxillary artery
– Superficial artery
 Facial artery
• Extent : carotid triangle to medial angle of eye as
angular artery
• Divided into two parts
– Cervical part
– Facial part
 Course
• Enters face winding around
base of mandible
• Runs upwards and forward
to a point 1.25cm lateral to
the angle of mouth
• Ascends by the side of nose
up to the medial angle of
eye forms angular artery
• Angular artery anastomoses
with dorsal nasal branch of
opthalmic artery
 Arteries supplying face
• Facial artery
– Superior labial
– Inferior labial
– Lateral nasal
• Superficial temporal
– Transverse facial
– Auricular artery
– Zygomatico-orbital artery
– Middle temporal
– Frontal branch
– Parietal branch
• Facial branch of maxillary artery
– Mental artery
– Buccal artery
– Infraorbital artery
• Facial branches of opthalmic artery
 Internal carotid artery
• Extent : upper border of the thyroid cartilage, ends
inside the cranial cavity by supplying brain
• Carotid sinus
• Carotid body
 Internal Carotid Artery
• Course :
– Traverse carotid canal in petrous
part of temporal bone and enter
middle cranial fossa
– Appears in medial wall of
cavernous sinus
– Turns upward medial to anterior
clinoid process
– Appears in subarracnoid space by
piercing dural roof of cavernous
sinus and aracnoid mater
– Courses backward below the
optic nerve
– Turn upward lateral to optic
chiasma
– Upon reaching the anterior
perforating substance divides into
two terminal branches
• Ophthalmic artery Branches
• Posterior communicating artery
• Choroidal artery
• Anterior cerebral artery
• Middle cerebral artery
• Polygon of arteries formed by
interconnection of major
arteries supplying the brain
• Formed around inter
peduncular fossa

Circle of Willis
Vertebral
Artery
• Branch of first
part of
subclavian
artery
Venous Drainage
• The veins of the brain,
venous sinuses, diploic
veins, and emissary veins
• The veins of the scalp,
face, and neck
 Veins of the Brain
• consist of
– the cerebral veins, the cerebellar veins,
– the veins of the brainstem
• drain into the neighboring venous sinuses.
 Venous Sinuses
• situated between the periosteal and the meningeal
layer of the dura mater
– the superior and inferior sagittal sinuses,
– The straight sinus
– the transverse sinuses
– the sigmoid sinuses
– the occipital sinus
– the cavernous sinuses
– the superior and inferior petrosal sinuses
 Veins of the Face and the Neck
• Superficial temporal vein
• Maxillary vein
• Facial vein
• Retromandibular vein
• External jugular vein
• Anterior jugular vein
• Internal jugular vein
• Superficial temporal vein
• Maxillary vein :
– formed in the
infratemporal fossa from
the pterygoid venous
plexus
• Retromandibular vein
– formed by the union of
the superficial temporal
and the maxillary veins
– Gives anterior and
posterior division
 Facial vein
• formed at the medial
angle of the eye by the
union of the
supraorbital and
supratrochlear veins
• descends down the face
with the facial artery
and passes around the
lateral side of the mouth
• crosses the mandible, is
joined by the anterior
division of the
retromandibular vein
• drains into the internal
jugular vein.
 Superficial veins of neck
• External jugular
• Anterior jugular
External jugular vein
 External jugular vein
• formed behind the angle of the mandible by the
union of the posterior auricular vein with the
posterior division of the retromandibular vein
• Drains mostly face & scalp
• tributaries
– Posterior auricular & retromandibular
– Transverse cervical vein from the skin and the fascia
over the posterior triangle
– Suprascapular vein from the back of the scapula
– Anterior jugular vein
– Posterior external jugular vein
 Internal jugular vein
• a large vein that receives
blood from the brain,
face, and neck
• starts as a continuation
of the sigmoid sinus and
leaves the skull through
the jugular foramen
• ends by joining the
subclavian vein
• Presence of dialataions
– Superior bulb
– Inferior bulb
• Lies lateral to ICA
• Tributaries of internal jugular vein
– Inferior petrosal sinus
– Facial vein
– Pharyngeal veins
– Lingual vein
– Superior thyroid vein
– Middle thyriod vein
 Subclavian Vein
• continuation of
the axillary vein
• joins the internal
jugular vein to
form the
brachiocephalic
vein
• receives the
external jugular
vein