Arteries of the head neck The face receives

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 supraorbital from the internal carotid artery 2/27/2021

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 2/27/2021

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 2/27/2021

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 2/27/2021

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 2/27/2021

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

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 2/27/2021

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 2/27/2021

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 2/27/2021

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 2/27/2021

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 sternocleidomastoid muscle. 2/27/2021

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 2/27/2021

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 cross the inferior border of the mandible at the anterior border of the masseter 2/27/2021

Arteries of the head & neck – 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 2/27/2021 Facial artery:

Arteries of the head & neck • 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. 2/27/2021 Facial artery:

Arteries of the head & neck • 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 2/27/2021 Facial artery:

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 2/27/2021

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 2/27/2021

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 2/27/2021

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. 2/27/2021

Arteries of the head & neck • Pass between the two heads of lateral pterygoid muscle deep into the pterygomaxillary fissure and enter the pterygopalatine fossa • Leaves the fossa through the foramen and become the sphenopalatine artery to the nose 2/27/2021 Maxillary artery:

Arteries of the head & neck • 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 2/27/2021 Maxillary artery:

Arteries of the head & neck • • 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 ID canal supplying the body – • • • 2/27/2021 Dental branches supply lower teeth Mental branch supply the lip and skin Atrophies in old age when the bone resorb Maxillary artery:

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: • 2/27/2021 Join the anastomosis around the tympanic membrane

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 2/27/2021

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 2/27/2021

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 2/27/2021

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 2/27/2021

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 2/27/2021

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 2/27/2021

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 2/27/2021