Arterial Supply and Venous Drainage of the Face and Head Flashcards
Left common carotid
DIRECT branch off of the aortic arch
Right common carotid
one of the two terminal branches from the brachiocephalic trunk
bifurcation of the common carotid artery/ course of it
common carotid artery ascends within the neck to the SUPERIOR BORDER of the THYROID CARTILAGE @ C3/4 VERTEBRAL LEVEL
bifurcation of the common carotid artery into?
Internal and External carotid artery
AT THE SUPERIOR BORDER OF THE THYROID CARTILAGE C3-4 LEVEL
orientation of the carotid sheath
common carotid artery is MEDIAL to internal jugular vein. the vagus nerve is positioned POSTERIORLY between the artery and vein –> all 3 of these structures are located in the carotid sheath
internal carotid artery position
passes DEEP to the posterior belly of the digastric and stylohyoid muscles
ascends ANTERIOR to the transverse processes of C1-C3 to reach the base of the skull –> here it passes into the CAROTID CANAL (within the petrous portion of temporal bone) to reach the cranial cavity /middle cranial fossa
hypoglossal nerve and relationship with internal and external carotid artery
hypoglossal nerve CROSSES the internal/external carotid arteries.
so it passes SUPERFICIAL to both the internal and external carotid arteries
T/F the internal carotid artery has no branches in the neck region
TRUE
internal carotid artery is major source of blood to what?
Brain and orbit - a lot of anterior portions
four parts of the internal carotid artery
- Cervical Part
- Petrous Part
- Cavernous
- Cerebral
Cervical Part of the carotid artery
bifurcation of the common carotid artery to lower end of the carotid canal
Petrous part of ICA
passes through the carotid canal (in petrous temporal bone)
Cavernous part of ICA
3rd part
courses through the caverous sinus (along the body of the sphenoid)
Cerebral part of ICA
4th part
After piercing the dura (near the anterior clinoid process) the ICA gives off the OPTHALAMIC ARTERY BEFORE terminating as the anterior cerebral artery and middle cerebral artery
opthalamic artery
emerges from the internal carotid immediately upon leaving the cavernous sinus
how does opthalamic artery enter orbit?
through the optic canal
what does the opthalmic artery give rise to?
ciliiary arteries, ethoidal arteries, muscular branches–> including two that PASS TO THE FOREHEAD –> supraorbital artery
supratrochlear artery
branches from opthalmaic artery that pass to the forehead region
Supraorbital
Supratrochlear arteries
relation of the supraorbital artery and the supratrochlear artery
the supratrochlear artery is more MEDIAL and the supraorbital is above the bony orbit and lateral to the supratrochlear
Course of the external carotid artery
passes deep to the posterior belly of the digastric and stylohyoid muscles
courses POSTERIOR TO THE RAMUS OF THE MANDIBLE where it is EMBEDDED in the parotid gland
main supply of the external carotid artery
the external carotid artery and its branches mainly supply structures EXTERNAL to the skull (exceptions exist –> middle meningeal artery)
T/F the external carotid artery has branches in the neck
TRUE - several
External carotid artery branches
pnemonic
pnemonic is
Sally Ann Likes Flirting On Philadelphias Main Street
External Carotid Artery Branches
- Superior Thyroid Artery
- Ascending pharyngeal artery
- Lingual artery
- Facial artery
- Occipital artery
- Posterior auricular artery
- MAXILLARY ARTERY
- SUPERFICIAL TEMPORAL ARTERY
all caps = terminal branches
External carotid artery terminal branches
Maxillary artery
Superior Temporal Artery
Superior Thyroid Artery
course and innervation
typically most inferior of the branches
passes anteroinferior, DEEP THE THE INFRAHYOID (STRAP) MUSCLES to reach the thyroid gland
supplies thyroid gland and gives off branches to local muscles - infrahyoid muscles and SCM
GIVES RISE TO THE SUPERIOR LARYNGEAL ARTERY –> supplies the larynx
superior laryngeal artery
from the superior thyroid artery and supplies the larynx
*not a branch off of the external carotid it is off of the superior thyroid artery
ascending pharyngeal artery
where it arises and course and where it sends branches
branch of the external carotid artery
arises near the origin of the external carotid artery and is its SMALLEST branch.
It ascends between the internal carotid artery and the pharynx to the base of the skull.
Along its course it sends branches to the PHARYNX, MIDDLE EAR CAVITY AND CRANIAL MENINGES
Lingual Artery
Arises
Course
Supplies
Arises from the anteromedial aspect of the external carotid artery between the superior thyroid and facial arteries.
CROSSED by the hypoglossal nerve
PASSES DEEP TO the stylohyoid and posterior digastric muscles before disappearing DEEP TO THE HYOGLOSSUS
Passes to the inferior aspect of the tongue where it gives rise to the DEEP LINGUAL AND SUBLINGUAL BRANCHES
PRIMARY BLOOD SUPPLY TO THE TONGUE AND FLOOR OF THE ORAL CAVITY
Facial Artery
Arises
Course
Supplies
Arises from ECA, immediately superior to the lingual artery
Passes DEEP TO THE DIGASTRIC AND STYLOHYOID MUSCLES AND MEDIAL TO THE RAMUS/ANGLE OF THE MANDIBLE
Passes along the lower border of the mandible, where it has a CLOSE RELATIONSHIP TO THE SUBMANDIBULAR GLAND.
Prior to entering the face, the facial artery gives off the SUBMENTAL ARTERY.
This hooks around the inferior border of the mandible (where it can be palpated) and ENTERS THE FACE.
FACIAL branches of the facial artery
Inferior labial artery
Superior labial artery
Lateral nasal branch
Angular artery
angular artery
branch off of the facial artery
common term for the terminal part of the facial artery as it travels to the medial angle of the eye
FORMS AN ASTAMOSIS WITH THE OPTHALAMIC ARTERY (branch of the internal carotid artery)
submental artery
PRIOR to entering the face, the facial artery gives off the submental artery
BEFORE it hooks around the inferior border of the mandible where it enters the face and gives off facial branches
Occipital Artery
ARISES from the posterior aspect of the external carotid artery, OPPOSITE to the origin of the facial artery
Passes posteriorly, parallel and deep to the posterior belly of the digastric muscle as it courses to the posterior scalp
Has several branches that supply structures in the area including the scalp and muscles in the area
Posterior Auricular Artery
A small posterior branch of the external carotid artery, it ascends posteriorly between the external acoustic meatus and the mastoid process
Passes several branches to structures in the area, including the middle ear cavity, posterior auricle and muscles in the area
Superficial Temporal Artery
originates where
course
gives off?
The smaller of the TERMINAL BRANCHES of the external carotid artery, it originates WITHIN the parotid gland
Passes between the neck of the mandible and external acoustic meatus, enters the temporal fossa, and terminates by dividing into FRONTAL AND PARIETAL BRANCHES
branches INCLUDE THE TRANSVERSE FACIAL ARTERY
Transverse Facial Artery
Arises from the superficial temporal artery WITHIN THE PAROTID GLAND and CROSSES the face superficial to the masseter, approximately a finger’s breadth inferior to the zygomatic arch
supplies the parotid gland, parotid duct, masseter, and skin of the face
ANASTAMOSES WITH BRACHES OF THE FACIAL ARTERY
Maxillary Artery
LARGER of the two terminal branches of the external carotid artery
arises within the parotid gland POSTERIOR TO THE NECK OF THE MANDIBLE
Passes medial to mandible to enter the infratemporal fossa
Within the infratemporal fossa, the maxillary artery may pass SUPERFICIAL OR DEEP to the lateral pterygoid muscle
Passes through the pterygomaxillary fissure to enter the pterygopalatine fossa
Maxillary artery is divided into three parts by the lateral pterygoid muscle
How is maxillary artery divided?
Into THREE parts by the lateral pterygoid muscle
First = mandibular part
Maxillary first part and its branches
Mandibular Part and divisions: Deep auricular artery Anterior tympanic artery Middle meningeal artery Accessory meningeal artery Inferior alveolar artery
Pneumonic for maxillary artery
Down at my aunt’s island
Deep auricular artery
from the 1st/mandibular part of the maxillary artery
pierces the wall of the EXTERNAL ACOUSTIC MEATUS and supplies the lateral surface of the tympanic membrane
Anterior tympanic artery
from the 1st/mandibular part of the maxillary artery
traverses the petrotympanic fissure and supplies the medial surface of the tympanic membrane
Middle meningeal artery
from the 1st/mandibular part of the maxillary artery
Traverses the foramen spinosum to enter the middle cranial cavity, where its blood supply includes the dura matter
Accessory meningeal artery
from the 1st/mandibular part of the maxillary artery
Traverses the foramen ovale to enter the middle cranial cavity, where its blood supply includes the dura matter
Inferior Alveolar artery
from the 1st/mandibular part of the maxillary artery
traverses the mandibular foramen –> enters the mandibular canal –> supplies the mandibular teeth and adjacent gingiva
branches from the inferior alveolar artery
Incisive/incisor branch
By the FIRST PREMOLAR TOOTH, the inferior alveolar artery divides into two branches –> incisor/incisive and mental
incisive/incisor branch
from the inferior alveolar artery –> this branch continues its course towards the midline and supplies the anterior teeth and gingiva
mental branch of…
of the inferior alveolar artery
this passes through the mental foramen to supply the chin
before passing into bone, the inferior alveolar artery gives off the MYLOHYOID BRANCH which travels with the mylohyoid nerve
second part of maxillary artery
2nd or Pterygoid Part
pneumonic for pterygoid part of maxillary artery (second part)
Mary Dove Past Barracuddas
Branches of the Pterygoid Part
Masseteric artery
Deep temporal arteries (anterior and posterior)
Pterygoid arteries
Buccal artery
Masseteric artery
from the 2nd/Pterygoid part of the maxillary artery
Passes superior to the mandibular notch to reach the deep surface of the masseter muscle, which it supplies
supplying the masseter muscle
Deep temporal arteries
from the 2nd/Pterygoid part of the maxillary artery
anterior and posterior regions
ascends to supply the temporal muscle
Pterygoid arteries
from the 2nd/Pterygoid part of the maxillary artery
supplying the pterygoid muscles
Buccal artery
from the 2nd/Pterygoid part of the maxillary artery
Supplies the buccinator muscle
Third part of the Maxillary artery
The Pterygopalatine Part of the maxillary artery
pneumonic for branches off of the Pterygopalatine Part (3rd)
Plus Incoming Dolphins And Perplexed Sharks
Branches from the 3rd part/ Pterygopalatine Part of the Maxillary artery
Posterior superior alveolar artery Infraorbital artery Descending palatine artery Artery of pterygoid canal Pharyngeal artery Spenopalatine artery
Posterior Superior Alveolar artery
from the 3rd/Pterygopalatine part of the maxillary artery
traverses the alveolar foramen; supplies the maxillary molars, premolars, adjacent gingival tissue as well as the lining of the maxillary sinus
Infraorbital artery
from the 3rd/Pterygopalatine part of the maxillary artery
Passes through the inferior orbital fissure –> infraorbital groove–> infraorbital canal –> infraorbital foramen and supplies the inferior eyelid, lateral nose and superior upper lip; along its course gives rise to the anterior alveolar artery which supplies the maxillary canines and incisors
both the infraorbital and anterior alveolar arteries supply the maxillary sinus
anterior alveolar artery
branch off the Infraorbital artery (from 3rd part of maxillary artery) which supplies the maxillary canines and incisors. Both this and the infraorbital artery supply the maxillary sinus
Descending palatine artery
from the 3rd/Pterygopalatine part of the maxillary artery
descends through the GREATER PALATINE CANAL –> branches to the greater and lesser palatine arteries
these supply mucous membrane and glands of the palate and maxillary gingiva
greater and lesser palatine arteries
from the descending palatine artery from the 3rd/Pterygopalatine part of the maxillary artery
supplying mucous membrane and glands of the palate and maxillary gingiva
Artery of pterygoid canal
from the 3rd/Pterygopalatine part of the maxillary artery
passes through the pterygoid canal;
supplies the nasopharynx, pharyngotympanic tube and tympanic cavity
Pharyngeal Artery
from the 3rd/Pterygopalatine part of the maxillary artery
Passes through the palatovaginal canal
Supplies a portion of the nasopharynx
Spenopalantine Artery
from the 3rd/Pterygopalatine part of the maxillary artery
The terminal branch of the maxillary artery, it passes through the sphenopalatine foramen to reach the nasal cavity; supplies a portion of the nasal cavity, including the nasal septum, and anterior hard palate
Fact about all of the branches in the first part of the maxillary artery
GO INTO BONE
Fact about all of the branches in the second part of the maxillary artery
GO TO MUSCLE
Fact about all of the branches in the third part of the maxillary artery
GO TO BONE (like the first part off the maxillary)
Blood from the brain empties where
into dural venous sinuses
how does blood from the SCALP communicate with the dural venous sinuses
occurs via emissary veins
emissary veins
allow blood communication with the scalp into the dural venous sinuses
these pass through openings in the cranial wall
allow communication between veins OUTSIDE the skull and sinuses to INSIDE THE SKULL
diploic veins
occupy channels in the diploe of the cranial bones
potential spread of infection in the skull?
through the emissary veins –> these allow communication of blood from outside of the skull to inside in the dural venous sinuses
dural venous sinuses
these are endothelial- lined spaces between the periosteal and the meningeal layers of the dura
Superior sagittal sinus
occupies the convex superior attached border of the falx cerebri
Begins near the crista galli and ends near the internal occipital protruberance, at the CONFLUENCE OF SINUSES
Confluence of sinuses
union of several of the sinuses
inferior sagittal sinus
occupies the concave inferior free border of the falx cerebri
ends in the straight sinus
straight sinus
Formed by the UNION of the inferior sagittal sinus and great cerebral vein
Joins the confluence of sinuses
Located at the junction of the falx cerebri and tentorium cerebelli
Occipital Sinus
occupies the attached border of the falx cerebelli and ends superiorly in the confluence of sinuses
Communicates inferiorly with the internal venous plexus
Confluence of Sinuses
union of the superior sagittal, straight, occipital , and transverse sinuses
Transverse Sinus
Passes from the confluence of sinuses, laterally along the attached margin of the tentorium cerebelli
Laterally, where the sinus passes from the tentorium cerebelli, it becomes the SIGMOID SINUS
Sigmoid Sinus
Originates where the transverse sinus leaves the tentorium cerebelli
Follows a S-shaped courses as it descends and passes through in the posterior cranial fossa
Continues inferiorly as the INTERNAL JUGULAR VEIN after traversing the jugular foramen
Cavernous Sinus
Located on either side of the sella turcic (of the sphenoid)
Receives blood from the Opthalmic veins
Pterygoid venous plexus
The cavernous sinuses drains posterioinferiorly through the superior and inferior petrosal sinuses
Pterygoid venous plexus
Blood passes from the infratemporal fossa –> EMISSARY VEINS THAT PASS THROUGH EMISSARY FORAMINA, FORAMEN OVALE AND FORAMEN LACERUM ENTER THE CANVERNOUS SINUS
how does the cavernous sinus communicate with the pterygoid venous plexus?
via emissary veins
- network of veins in the infratemporal fossa
structures passing through the cavernous sinus
internal carotid artery
internal carotid plexus (sympathetic nerves)
CN III, IV, VI
V1 and V2
these structures are separated from blood in the sinus by endothelial cells
Superior Petrosal sinus
Located in the attached (anterior) margin of the tentorium cerebello
Passes from the posterior end of the cavernous sinus and terminates where it joins the transverse sinus
Inferior Petrosal sinus
originates at the posterior end of the cavernous sinus, passes inferiorly and empties into the proximal aspect of the internal jugular vein
superficial temporal vein
begins from a widespread network of veins in the scalp
Drains blood from the scalp in the region ANTERIOR to the auricle
Near the auricle, the superficial temporal vein ENTERS THE PAROTID GLAND
Maxillary Vein
from where
union?
The maxillary vein(s) are seen as a short trunk(s) accompanying the FIRST part of the maxillary artery
Derived from the confluence of veins of the pterygoid venous plexus (in the infratemporal fossa)
Union of the maxillary and superficial temporal veins occurs WITHIN the parotid gland and gives rise to the RETROMANDIBULAR VEIN
Retromandibular vein
union course and branches
formed by the union of the maxillary vein and the superficial temporal veins,
runs posterior to the ramus of the mandible and descends through the parotid gland, superficial to the external carotid artery and deep the facial nerve
divides into ANTERIOR AND POSTERIOR BRANCHES
posterior branch of the retromandibular vein
joins with the posterior auricular vein to form the EXTERNAL JUGUALR VEIN
this union occurs just AFTER exiting the parotid gland
external jugular vein joins from?
union of the posterior branch of the retromandibular vein and the posterior auricular vein
anterior branch of the retromandibular vein
joins with the facial vein which drains into the internal jugular vein – union is often referred to as the common facial vein
internal jugular vein forms from?
anterior branch of the retromandibular vein and the facial vein
sometimes called the common facial vein
Facial vein
formed from the union of the supraorbital and supratrochlear veins at the medial angle of the eye
commonly referred to as the angular vein (from its origin/ medial eye along the lateral aspect of the nose
receives several veins, including the superior labial, inferior labial and submental veins
deep facial veins
the facial vein also communicates with the pterygoid venus plexus via the DEEP FACIAL VEINS
the pterygoid venous plexus is a deep network of veins in the infratemporal fossa
communication between the deep and superficial veins
the facial vein communicates with the cavernous sinus by TWO ROUTES
Facial vein –>opthalmic vein–> cavernous sinus
- Facial vein –> deep facial vein–> pterygoid venous plexus –> emissary vein –> cavernous sinus
Do the facial veins have valves Implications
NO valves - therefore an infective thrombosis of the facial vein may pass into the intracranial venous sinuses
Danger Trinagle of the Face
Communication from out –> in
potential area of infection
route of an embolism from oral cavity
mandible to the facial and pterygoid plexus veins –> eventually to the superior vena cava and right atrium
