Dr Ahmed Fathalla Ibrahim ARTERIES OF NECK Dr

Dr. Ahmed Fathalla Ibrahim

ARTERIES OF NECK Dr. Ahmed Fathalla Ibrahim

COMMON CAROTID ARTERY • Origin: 1. Right: branch of brachiocephalic artery (behind the right sternoclavicular joint) 2. Left: branch of arch of aorta • Course: ascends in carotid sheath • Termination: divides into external & internal carotid arteries, at the level of disc between C 3 & C 4 (level of upper border of thyroid cartilage) Dr. Ahmed Fathalla Ibrahim

COMMON CAROTID ARTERY • Carotid sinus: a localized dilatation in the termination of common carotid or in the beginning of internal carotid artery (thinner tunica media & thicker tunica adventitia), supplied by glossopharyngeal nerve and is a presseoreceptor • Carotid body: a small structure posterior to bifurcation of common carotid artery, supplied by glossopharyngeal nerve and is a chemoreceptor Dr. Ahmed Fathalla Ibrahim

EXTERNAL CAROTID ARTERY Dr. Ahmed Fathalla Ibrahim

EXTERNAL CAROTID ARTERY • Course: 1. Ascends in carotid triangle 2. Crossed by posterior belly of digastric & stylohyoid muscles, hypoglossal nerve • Termination: inside parotid gland (behind neck of mandible) by dividing into superficial temporal & maxillary arteries Dr. Ahmed Fathalla Ibrahim

EXTERNAL CAROTID ARTERY • 1. 2. 3. 4. 5. 6. 7. 8. Branches: Superior thyroid Ascending pharyngeal Lingual Facial Occipital Posterior auricular Superficial temporal Maxillary Dr. Ahmed Fathalla Ibrahim

INTERNAL CAROTID ARTERY • In the neck: 1. Ascends in carotid triangle then deep to parotid gland 2. Enters cranial cavity through carotid canal (in petrous temporal bone) 3. Does not give branches in neck • Inside cavernous sinus: 1. Passes through floor of sinus 2. Gives branches to pituitary gland • In the cranial cavity (after emergence from cavernous sinus): 1. Gives ophthalmic artery 2. Supplies brain. Dr. Ahmed Fathalla Ibrahim

SUBCLAVIAN ARTERY • Origin: 1. Right: branch of brachiocephalic artery (behind the right sternoclavicular joint) 2. Left: branch of arch of aorta • Course: divided into 3 parts: 1. First part: part medial to scalenus anterior 2. Second part: part behind scalenus anterior 3. Third part: part lateral to scalenus anterior (in posterior triangle of neck) Dr. Ahmed Fathalla Ibrahim

SUBCLAVIAN ARTERY Dr. Ahmed Fathalla Ibrahim

SUBCLAVIAN ARTERY Dr. Ahmed Fathalla Ibrahim

SUBCLAVIAN ARTERY • 1. 2. 3. • • • Branches of 1 st part: Vertebral Internal thoracic Thyrocervical trunk: divides into: Inferior thyroid Superficial (transverse) cervical Suprascapular Dr. Ahmed Fathalla Ibrahim

VERTEBRAL ARTERY • Origin: branch of 1 st part subclavian artery • Course: It is divided into 4 parts: • 1 st part: Ascends in the neck, behind common carotid artery, in front of transverse process of C 7 • 2 nd part: Passes through foramina transversaria of C 6 till C 1 (surrounded by vertebral plexuses of vein & sympathetic fibers) • 3 rd part: Runs above posterior arch of atlas (in suboccipital triangle) • 4 th part: Passes through foramen magnum & continues inside cranial cavity • Branches of 1 st, 2 nd & 3 rd parts: muscular & spinal Dr. Ahmed Fathalla Ibrahim

INFERIOR THYROID ARTERY • Origin: branch of thyrocervical trunk of 1 st part subclavian artery • Course: Ascends behind internal jugular vein then curves medially (opposite C 6) crossing vertebral artery to reach the lower pole of thyroid gland • Important branches: glandular, inferior laryngeal, tracheal, pharyngeal, oesophageal Dr. Ahmed Fathalla Ibrahim

SUBCLAVIAN ARTERY • Branches of 2 nd part: costocervical trunk: divides into: 1. Superior intercostal 2. Deep cervical • Branches of 3 rd part: may give dorsal scapular artery Dr. Ahmed Fathalla Ibrahim

RELATONS OF 1 ST PART SUBCLAVIAN ARTERY • Anterior: Skin, fasciae, sternomastoid, sternohyoid, sternothyroid, common carotid artery, vagus nerve, internal jugular vein, ansa subclavia, thoracic duct (left side) • Posterior & inferior: ansa subclavia, cervical pleura & apex of lung • Medial: trachea, oesophagus, thyroid gland Dr. Ahmed Fathalla Ibrahim

VEINS Dr. Ahmed Fathalla Ibrahim Subclavian vein Brachiocephalic vein

DEEP VEINS INTERNAL JUGULAR: • Beginning: continuation of sigmoid sinus at margin of jugular foramen • Course: descends in carotid sheath • Termination: joins subclavian vein behind the sternal end of clavicle to form brachiocephalic vein Dr. Ahmed Fathalla Ibrahim

DEEP VEINS • Tributaries of internal jugular vein: 1. Inferior petrosal sinus 2. Facial vein 3. Lingual vein 4. Superior thyroid vein 5. Middle thyroid vein 6. Pharyngeal veins Dr. Ahmed Fathalla Ibrahim

DEEP VEINS SUBCLAVIAN VEIN: • Beginning: continuation of axillary vein, at outer border of first rib • Course: runs behind clavicle; in front of scalenus anterior (separating it from subclavian artery) • Termination: joins internal jugular vein behind the sternal end of clavicle to form brachiocephalic vein • Tributary: external jugular vein Dr. Ahmed Fathalla Ibrahim

SUPERFICIAL VEINS EXTERNAL JUGULAR: • Beginning: by union of posterior branch of retromandibular vein & posterior auricular vein, behind & below angle of mandible • Course: 1. Descends in superficial fascia, superficial to sternomastoid 2. Crosses backward & pierces deep Dr. Ahmed Fathalla Ibrahim fascia of posterior triangle of neck

SUPERFICIAL VEINS • Termination: ends in subclavian vein • Tributaries: 1. Anterior jugular vein 2. Superficial cervical vein 3. Suprascapular vein 4. Posterior external jugular vein Dr. Ahmed Fathalla Ibrahim

RELATIONS Dr. Ahmed Fathalla Ibrahim

ANTEROLATERAL RELATIONS Skin, fasciae, sternomastoid + • Common carotid & internal jugular: superior belly of omohyoid, sternothyroid • External carotid, internal carotid & internal jugular: posterior belly of digastric • External carotid, internal carotid: hypoglossal nerve • Internal jugular: spinal root of accessory nerve Dr. Ahmed Fathalla Ibrahim

POSTERIOR RELATIONS Prevertebral muscles, transverse processes of: • Internal jugular: all cervical vertebrae • Common carotid: lower 4 cervical • Internal carotid: upper 4 cervical • Internal jugular & common carotid: 1 st part subclavian artery + its branches Dr. Ahmed Fathalla Ibrahim

MEDIAL RELATIONS Larynx, pharynx + • Internal jugular & common carotid: trachea oesophagus, thryoid gland • Internal carotid: X Dr. Ahmed Fathalla Ibrahim

STRUCTURES BETWEEN INTERNAL & EXTERNAL CAROTID ARTERIES • • • Styloglossus Stylopharyngeus Glossopharyngeal nerve Pharyngeal branch of vagus nerve A part of parotid gland Dr. Ahmed Fathalla Ibrahim

LAST 4 CRANIAL NERVES Dr. Ahmed Fathalla Ibrahim

GLOSSOPHARYNGEAL NERVE Dr. Ahmed Fathalla Ibrahim

VAGUS NERVE Dr. Ahmed Fathalla Ibrahim

ACCESSORY NERVE Dr. Ahmed Fathalla Ibrahim