Vessels of the head and neck

Dr. Mohamed El fiky

1. Head and Neck
Great Vessels of the Head and Neck
Dr. Mohamed El Fiky
Professor of anatomy and Embryology

2. Brachiocephalic
Artery
Left
Common
Carotid
Right
Common
Carotid
External
Carotid Arteries
Thyroid
Right Internal
Carotid
Artery
Left Internal
Carotid
Artery
Thyroid
Cartilage
Left
subclavian Artery
Left
Common
Carotid
Brachiocephalic
Artery
Right
subclavian
Artery
Right
Common
Carotid
External
Carotid Arteries
Right Internal
Carotid
Artery
Left Internal
Carotid
Artery
Common Carotid Artery
Mohamed el fiky

3. Common Carotid Artery
Origin:
ØTherightistheterminalbranchofthebrachiocephalic,behindthesternoclavicularjoint.
ØTheleftarisesinthethoraxfromthearchoftheaorta.
Courseintheneck:
ØRunsupwardsandbackwardswithinthe
carotidsheath
ØEndsattheupperborderofthethyroid
cartilage(oppositethediscbetween3rdand
4thcervicalvertebrae)bydividinginto
internalandexternalcarotidarteries.
Internal carotid artery
Origin:oneofthetwoterminalbranchesofthecommoncarotidartery
Beginning:attheupperborderofthethyroidcartilage.
Course:isdividedintofourparts:
1.Cervicalpart:intheneck.
2.Petrouspart:withinthepetroustemporalbone
3.Cavernouspart:withinthecavernoussinus.
4.Cerebralpart:theterminalportionatthebaseofthebrainafteremergingfromthecavernoussinus.
Mohamed el fiky

4. Sympathetic Trunk
Vagus Nerve
Glossopharyngeal Nerve
Carotid Sinus
(Baroreceptors)
Carotid Body
(Chemoreceptors)
Carotid Branch of
Glossopharyngeal Nerve
Communicating Branch (Carotid)
of Vagus to Carotid Sinus and Body
Inhumananatomy,thecarotidsinus(orcarotidbulb)isadilatedareaatthebaseof
theinternalcarotidjustsuperiortothebifurcationofthecommoncarotidatthelevelofthe
superiorborderofthyroidcartilage.Thecarotidsinusissensitivetopressurechangesinthe
arterialbloodatthislevel.Itisthemajorbaroreceptionsiteinhumansandmostmammals.
Carotid sinus
The carotid sinus contains numerous baroreceptorswhich function as
a "sampling area" for manyhomeostaticmechanisms for maintaining
blood pressure. The carotid sinus baroreceptors are innervated by the
sinus nerve of Hering, which is a branch ofcranial nerveIX
(glossopharyngeal nerve)
Thecarotid bodyis a small cluster
ofchemoreceptorsand supporting cells located near
the fork (bifurcation) of thecarotid artery.
Carotid body
The carotid body detects changes in the
composition of arterial blood flowing
through it, mainly thepartial
pressureofoxygen, but also ofcarbon
dioxide. Furthermore, it is also sensitive to
changes inpHandtemperature.
Mohamed el fiky

5. S-Shaped Course of
Internal Carotid Artery
Internal Carotid Artery
A)Cervical part of the interalcarotid
qBranches : no branches
B) Intrapetrouspart of internal carotid
Branches:
1.Caroticotympanicbranch:entersthemiddleearby
piercingthethinplateofboneseparatingthecarotidcanal
fromthemiddle
2.Pterygoidbranch:entersthepterygoidcanal
C) Cavernous part of internal carotid
Branches:
uCavernousbranchestothetrigeminalganglion.
vSuperiorandinferiorhypophysealarteriestothepituitarygland. Mohamed el fiky

6. (D) Cerebral part of internal carotid
Branches:
1.Ophthalmicartery
2.Anteriorcerebralartery
3.Middlecerbralartery
4.Posteriorcommunicating5.Anteriorchoroidal
Structures between external and internal carotid :
Internal carotid artery\
Anterior cerebral artery
Middle
cerebral artery
1-deep part of parotid gland
2-styloid process
3-styloglossus muscle
4-stylopharyngeus muscle
5-glossopharyngeal nerve
6-pharyngeal branch of the vagus nerve
Mohamed el fiky

7. superior Thyroid Artery
Lingual Artery
Facial Artery
Ascending Pharyngeal Artery
Occipital Artery
Styloglossus
Stylopharyngeus
Glossopharyngeal Nerve
Pharyngeal Branch of Vagus Nerve
Styloid Process
Posterior
Auricular Artery
Superficial Temporal Artery
Maxillary Artery
Posterior belly of digasteric
External Carotid Artery

8. Branches of External Carotid Artery
It gives eight branches which may be grouped as given below :
A. Three anterior
1. Superior thyroid:
2. Lingual: and
3. Facial
B. Two posterior :
1. Occipital ; and
2. Posterior auricular
C. One medial : ascending pharyngeal
D. Two terminal :
1. Maxillary:
2. Superficial temporal Lingual artery
Origin : Arises opposite the tip of the greater cornu of the hyoid bone.
Course: Is divided into three parts by the hyoglossus muscle.
A. First part :
ØLies in the carotid triangle.
ØForms characteristic loop or bend which is crossed by the
hypologossal nerve.
B. Second part : Lies deep to the hyogossus.
C. Third part :
ØIs called arteria profunda linguae or deep lingual artery. Runs
upwards along the anterior border of the hyoglossus and then
forwards on the under surface of the tongue.
Branches :
1. Suprahyoid artery : arises from the first part passes along the upper border of the hyoid bone.
2. Dorsal lingual arteries : aries from the second part and consist of 3 or 4 branches to supply the tongue, tonsil
and soft palate.
3. Sublingual artery : arises from the third part to the sublingual gland.
Mohamed el fiky

9. Facial artery
Origin:fromtheexternalcarotidjustabovethetipofthegreatercornuofthehyoidbone
Course in the neck:
ØAscendsverticallyupwardsdeeptotheposteriorbellyofdigastricandstylohyoidmuscles,lodgedinagrooveat
theposteriorendofthesubmandibularsalivaryglandthispartofthearteryrestsonthemiddleconstrictorand
thenonthesuperiorconstrictorwhichsepararesitfromthepalatinetonsil.
ØPassesdownwardsandforwardsbetweenthesubmandibularglandandthemedialpterygoidtoappearatthe
lowerborderofthemandible
ØCurvesaroundthelowerborderofthemandiblewhereitpiercesthedeepfasciatoenterthefaceatthe
anteroinferiorangleofthemasseter.
Branches
1. Ascending palatine : ascends on the wall
of the pharynx and
then winds round the upper border of the
superior constrictor
muscle to reach the soft palate.
2. Tonsillar artery: is the principal artery of the
tonsil , it pierces the superior constrictor
muscle and supplies the tonsil and root of the
tongue .
3. Glandular branches : to the submandibular
gland
4.Submental artery : accompanies the
mylohyoid nerve and supplies the sublingual
salivary gland.
Mohamed el fiky

10. Facial Artery
2-Ascending palatine
1-Tonsilar
3-Glandular
4-Summental
1-Inferior labial
2-Superior labial
3-Lateral nasal
4-Artery to cheeks
5-Angular
A-Cervical branches
B-Branches in the face
Mohamed el fiky

11. The subclavian artery
Origin:
1.Ontherightside:ittakesoriginbehindthesternoclavicularjoint
asaterminalbranchofthebrachiocephalicartery.
2.Ontheleftside:arisesinthethoraxfromthearchoftheaorta
andascendstoentertheneckbehindthe
sternoclavicualrjoint.
Parts:thescalenusanteriorcorssesanteriortothearteryand
dividesitintothreeparts.
ØThefirstpart:medialtothescalenusanterior
ØThesecondpart:liesbehindthescalenusanterior
ØThethirdpart:lateraltothescalenusanterior
Branchesofthesubclavianartery
(A)Firstpart:gives3branches
1.Vertebral.
2.Thyrocervicaltrunk.
3.Internalthoracicartery.
(B)Secondpart:giveonebranch;
costocervicaltrunk.
(C)Thirdpart:nobranches.
Vertebral artery
Origin : from the first part of the subcalvian
artery.
IT inter the cranial cavity and it supply
spinal cord and brain
1-Thyrocervical Trunk
2-Vertebral Artery
3-Internal Mammary
Costocervical Trunk
Ascending Cervical
Superior Intercostal
Suprascapular
Transverse Cervical
Inferior Thyroid Artery
1
st
Part
3
rd
Part
Deep Cervical
Mohamed el fiky

12. Internal Jugular Vein
Beginning:inthejugularforamenasdirect
continuationofthesigmoidsinus
Course:descendsintheneckwithinthecarotid
sheathlateraltotheinternaland
commoncarotidarteries.
Termination:endsbehindthemedialendofthe
claviclebyjoiningthesubclavianvein
tofromthebrachiocephalicvein.
Tributaires:
1.Inferiorpetrosalsinus.
2.Commonfacialvein.
3.Lingualvein.
4.Pharyngealveins.
5.Superiorthyroidvein
6.Middlethyroidvein.
Mohamed el fiky

13. Thyroid gland
Site:inthelowerpartofthefrontandsidesof
theneck.
Shape:ItisroughlyH-shaped;theverticallimbs
repersentthetwolobesandthehorizontallimb,
theisthmus.
Extent:
1.Liesopposite5th,6th,7th,cervicaland1
st
thoracicvertebrae.
2.Eachlobeextendsfromthemiddleofthe
thyroidcartilagetothefourthorfifthtracheal
rings.
3.Theisthmusliesoppositethesecond,thridand
fourthtrachealrings.
Lobes:Eachlobeisconicalinshapehaving:
(a)apex;(b)base;(c)threesurfaces,lateral,
medialandposteriorand
(d)twoborders,anteriorandposterior.
(a)Apex:
Ødirectedupwards
Ølimitedsuperiorlybytheattachmentofthe
sternothyroidmuscletothe
obliquelineofthethryoidcartilage.
(B)Base:isonthelevelwiththe4thor5thtracheal
rings.
(C)lateral(superficial)surface:isconvexand
iscoveredby:
1.Sternothyroid
2.Sternohyoid.
3.Superiorbellyofomohyoid
4.Anteriorborderofthesternomastoid

14. (D) Medial surface : related to :
a. Two tubes : trachea and oesophagus
b. The upwards continuation of the two tubes : larynx and pharynx.
c. Two muscles : inferior constrictor and cricothyroid.
d. Two nerves : external laryngeal and recurrent laryngeal.
(E) Posterior surface: is related to the carotid sheath and
parathyroid glands.
(F) Anterior border : is thin and related to the anterior branch
of superior thyroid artery.
(G) Posterior border : is thick and rounded and separates
the the medial and posterior branch between the superior and
inferior thyroid arteries ; and (c) prathyroid glands.
The Isthmus
ØConnects the lower parts to the lobes
ØHas (a) two surfaces, anterior and posterior; and (b)two
borders superior and inferior.
Anteriorsurface:iscoveredby:
(a)fasciaandskin.
(b)strenohyoids;
(c)strenothyroids;
(d)anteriorjugularveins
Posteriorsurface:relatedto2nd,3rdand4thtracheal
rings.
Upperborder:isrelatedtotheanastomosingbranches
betweenthetwo
superiorthyroidarteries.
Lowerborder:
ØTheinferiorthyoidveinsleavetheglandatthisborder.
ØRelatedtotheanastomosingbranchesbetweenthetwo
inferior
thyroidarteries.

15. Arterial supply
1.Superiorthyroidartery:isabranchofexternalcarotidartery.
(2)Inferiorthyroidartery:Isabranchofthethyrocervicaltrunkfromthesubclavianartery
(3)Thyroideaimaartery(in3%individuals):Arisesfromthebrachiocephalicarteryortheaorticarch
(4) Accessory thyroid arteries : come from the tracheal and oesophageal vessels.
Mohamed el fiky

16. Venous drainage
1) Superior thyroid vein: end in the internal jugular vein
2)Middlethyroidvein:endsintheinternaljugularvein
3) Inferior thyroid veins:Descend in front of the trachea and drain into the left brachiocephalic vein.
Mohamed el fiky