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1. Good morning

2. Blood Vessels of Head and Neck Mr.pullanna

3. Introduction • Artery- • Common carotid artery • Subclavian artery • Veins- • Subclavian vein • Internal jugular vein

4. Arch of aorta • 3 branches • Left common carotid • Left subclavian • Brachiocephalic trunk • Right common carotid • Right subclavian

5. SUBCLAVIAN ARTERY

6. Subclavian Artery • Origin: • Rt. Side – brachiocephalic trunk • Lt. Side – direct branch from the arch of aorta. • Course: • Arches laterally in the root of the neck in front of the apex of the lung. • Passes over the superior surface of the first rib. • Ends at the outer border of the first rib & continue as Axillary artery

7. Subclavian Artery • Parts: divided by the scalenus Anterior muscle. • Frist part medial to the muscle • Vertebral artery. • Internal thoracic artery. • Thyrocervical trunk. • Second part deep to the muscle. • Costocervical trunk. • Third part distal to the muscle. • Dorsal scapular artery.

9. Relations of the first part • Anterior • Common carotid artery • Internal jugular vein • Vagus & its cardiac branches • Subclavian vein • Sternothyroid and Sternohyoid muscles. • Sternocleidomastoid muscle. • Posterior • Suprapleural membrane • Cervical pleura • Apex of lung

11. Relations of the second part • Anterior • Scalenus anterior • Right phrenic nerve • Sternocleidomastoid • Posterior • Suprapleural membrane • Cervical pleura • Apex of lung

12. Relations of the third part

13. Vertebral Artery

14. Vertebral artery

15. branches • Cervical branches: • Cervial part of spinal cord. • Muscles –Prevertebral region. • Suboccipital region • Cranial branches; • Meninges • Ant spinal artery • Post spinal artery • post Inf Cerebellar artery • Medulla

16. Internal thoracic artery • First part – subclavian artery • Descends in the anterior thoracic wall • Ends 6th intercostal space by dividing into • Superior epigastric artery • Musculophrenic artery • Upper 6 intercostal spaces – 2 anterior intercostal arteries • Artery to the mammary gland

17. Thyrocervical trunk

19. Costocervical trunk

20. Dorsal scapular artery

21. Applied anatomy • Subclavian steal syndrome • Right subclavian artey-descending thoracic aorta-behind the oesophagus- compress- dysphagia Lusoria. • Cervical rib – compress- Subclavian artery-diminish radial pulse. • Aneurysms-compress-brachial plexus.

23. Carotid system • CAROTID SYSTEM • Common carotid artery • Internal carotid artery • External carotid artery

24. COMMON CAROTID ARTERY Origin: Right- from the brachiocephalic trunk (Sterno clavicular joint) Left- Arch of aorta (Manubrium sterni) Termination: Upper border of lamina of thyroid cartilage divides into external and internal carotid.– carotid triangle (C3 & C4 vertebra).

25. relations

27. Internal carotid artery • It does not give any branch in the neck. • It ascends in the neck within the carotid sheath and enters the skull through carotid canal. • It supplies the BRAIN.

28. External Carotid Artery • Terminal branch of the common carotid artery. • Level of the upper border of the thyroid cartilage. • Terminates within the parotid gland at the level of the neck of the mandible.

30. External Carotid Artery Branches: • Ascending Pharyngeal artery. • Superior thyroid artery. • Lingual artery • Facial artery • Posterior auricular artery • Occipital artery • Superficial temporal artery • Maxillary artery

32. External Carotid Artery • Ascending pharyngeal artery: • Ascends the wall of the pharynx. • Supplies pharynx and palatine tonsil. • Branches: • Meningeal. • Pharyngeal • Tonsillar • tympanic

33. Superior thyroid artery: • Passes along with the external laryngeal nerve. • Supplies thyroid gland. • Gives superior laryngeal artery. • Branches : • Infrahyoid • Sup laryngeal. • Sternocleidomastoid • cricothyroid • Glandular branches.

34. External Carotid Artery • Lingual artery: • Passes towards the tongue deep to the hyoglossus muscle. • Divided into three parts. Branches : suprahyoid, sup lingual, deep lingual and sublingual.

35. External Carotid Artery • Facial Artery: • Course. • Ascends deep to the posterior belly of the digastric muscle. • Winds around the superficial part of the submandibular salivary. • Enters the face through the antero-inferior part of the masseter muscle. • Reaches the lateral angle of the mouth • Ascends along the lateral side of the nose. • Terminates along the medial angle of the eye.

36. Facial Artery • Branches in the neck. • Ascending palatine artery. • Tonsillar artery • Submental artery • Glandular branches to submandibular gland. • Branches in the face. • Inferior labial artery. • Superior labial artery. • Lateral nasal artery.

37. External Carotid Artery • Posterior auricular artery: • Passes posteriorly along the upper border of the posterior belly of the digastric muscle. • Supplies the external ear and posteior quadrant of the scalp. • Branches : • Stylomastoid • Stapedial • Auricular • Occipital • Parotid

38. Occipital artery: • Passes posteriorly along the lower border of the posterior belly of the digastric muscle. • Supplies posterior quadrant of the scalp. • Branches: • sternocleidomastoid • meningeal • occipital • auricular • descending

39. External Carotid Artery • Superficial temporal artery: • Terminal branch of the external carotid artery • Gives the transverse facial artery which appears on the face. • Supplies the temporal region and anterior quadrant of the scalp.

40. branches • transverse facial • Middle temporal(zygomatico-orbital) • anterior auricular • frontal • parietal

41. External Carotid Artery • Maxillary Artery: • Terminal branch of the external carotid artery. • Passes anteriorly in the infratemporal fossa. • Divided into 3 parts but the lateral pterygoid muscle.

42. Maxillary artery • Terminal branch • Divided into 3 parts lateral pterygoid muscle • First part • Deep auricular artery – supplies external ear • Anterior tympanic artery – supplies the middle ear • Middle meningeal artery – supplies the meninges. • Accessary meningeal artery – supplies the meninges. • Inferior alveolar artery – supplies all the lower teeth and mandible.

43. Second part • Deep temporal artery • Buccal artery • Pterygoid artery masseteric artery • Third part • Posterior superior alveolar artery – upper & premolar teeth • Infra orbital artery – it terminates on the face • Greater palatine artery – supplies palate & nasal cavity • Pharyngeal artery – supplies the Nasopharynx and auditory tube • Artery of the pterygoid canal – supplies nasopharynx, auditory tube, middle ear cavity. • Spheno-palatine artery – posterior part of the lateral wall of the nasal cavity & nasal septum

44. Applied anatomy • Carotid sinus-Baroreceptor • Carotid body-chemoreceptor • Common carotid artery can be felt on the ant tubercle of 6th cervical vertebra.

45. Veins • Subclavian vein • Internal Jugular vein. • External Jugular vein.

46. Subclavian vein

47. Internal Jugular vein • Continuation of the sigmoid sinus. • Descends along with the internal carotid , common carotid artery and the vagus nerve. • Terminates by joining the subclavian vein to form brachicephalic vein • Tributaries: • Inferior petrosal sinus • Pharyngeal vein. • Common facial vein • Superior thyroid vein • Middle thyroid vein • Deep lingual vein.

48. Cavernous sinus Tributaries:

49. Applied anatomy • Internal Jugular vein-accessible-supraclavicular fossa-easily canulated. • Venous pluse recordings. • Deep cervical lymphnodes-adherent-Internal Jugular vein-malignancy-excised with lymphnodes.

50. Thank You.