BLOOD AND NERVE SUPPLY TO HEAD & NECK

Great blood vessels of the Head & Neck The carotid system of arteries forms the major arterial trunk of the Head and Neck, and the internal jugular vein acts as the main venous channel.

It comprises the common carotid and two terminal branches: Carotid system: It comprises the common carotid and two terminal branches: External Internal carotid arteries

COMMON CAROTID ARTERY:

COURSE OF COMMON CAROTID ARTERY: IN THE NECK:

IN LOWER PART OF NECK: SUPERIOR BELLY OF OMOHYOID STERNOHYOID STERNOTHYROID STERNOMASTOID

External Carotid Artery: It is one of the terminal branch of common carotid artery, and extends from the level of upper border of the lamina of thyroid cartilage to a point behind the neck of the mandible

Superficial temporal artery Maxillary artery

At the origin: Stylohyoid muscle Posterior belly of digastric

Branches of External carotid artery: It provides eight branches: 1. One from medial side: Ascending pharyngeal 2. Three from front: Superior thyroid, Facial and Lingual 3. Two from behind: Occipital and Posterior auricular 4. Two terminal: Maxillary and Superficial temporal

Branches of External Carotid artery

Ascending pharyngeal artery It is the first branch arising from the medial side of external carotid artery Ascending pharyngeal artery

Pharyngeal branch: Supplies the wall of the pharynx, the tonsil, part of auditory tube and soft palate Inferior tympanic branch: Supplies the medial wall of tympanic cavity Meningeal branch: Supplies the dura mater

Superior thyroid artery It usually arises from the front of the external carotid artery below the tip of greater cornu of hyoid bone Superior thyroid artery

Superior thyroid artery omohyoid Sternothyroid Sternohyoid

Superior thyroid artery Thyroid gland

Branches of superior thyroid artery: Infrahyoid Superior laryngeal Cricothyroid branch Sternomastoid branch Glandular branches : Divides into anterior and posterior branches

The artery is divided into three parts by the hyoglossus muscle 3. Lingual artery: It is the principal artery of tongue and arises from the front of the external carotid artery opposite the tip of the greater cornu of the hyoid bone The artery is divided into three parts by the hyoglossus muscle

III (Arteria profunda linguae) Hyoglossus muscle II

Branches of Lingual artery: Suprahyoid Dorsal lingual arteries Sublingual artery

Dorsal lingual arteries Sublingual artery Suprahyoid artery Dorsal lingual arteries

The artery is divided into two parts cervical and facial 4. Facial artery: It arises from the front of external carotid artery in carotid triangle just above the tip of the greater cornu of hyoid bone and terminates at the medial angle of the eye as the angular artery The artery is divided into two parts cervical and facial

Posterior belly of digastric Course of facial artery in the neck: Stylohyoid muscle Posterior belly of digastric Facial artery

Facial artery Submandibular gland

Course of facial artery in the face: Angular artery Facial artery

Branches of facial artery from cervical part: Ascending palatine artery Tonsillar artery Glandular branches Submental artery

Ascending palatine artery Tonsillar artery Facial artery Submental artery

Branches of facial artery from facial part: Inferior labial artery Superior labial artery Lateral nasal artery

Superior labial artery Inferior labial artery Lateral nasal artery Superior labial artery Inferior labial artery

5. Occipital artery: It arises in the carotid triangle from the posterior aspect of the external carotid opposite the origin of the facial artery.

External carotid artery Occipital artery Accessory nerve Hypoglossal nerve External carotid artery

Branches of Occipital artery: Sternomastoid branches Mastoid branches Meningeal branches Muscular branches Descending branch Occipital branches

Posterior auricular artery It arises from the posterior aspect of external carotid artery above the origin of occipital artery Posterior auricular artery

Branches of posterior auricular artery Stylomastoid artery: It enters the stylomastoid foramen and supplies the facial nerve, tympanic cavity, mastoid air cells and semicircular canals Auricular branch Occipital branch

Superficial temporal artery It is the smaller terminal branch of external carotid artery and arises within the parotid gland behind the neck of mandible Superficial temporal artery

Branches of Superficial temporal artery: Transverse facial artery: It arises with the parotid gland and passes forward between the zygomatic arch and the parotid duct and supplies the parotid gland and its duct, temporomandibular joint, masseter muscle and its overlying structures

Transverse facial artery Parotid duct

Branches of Superficial temporal artery: Anterior auricular artery Zygomatico-orbital artery Middle temporal artery Anterior/Frontal branch Posterior/ Parietal branch

Anterior/frontal branch Posterior/parietal branch Zygomatico-orbital artery Anterior auricular

8. Maxillary artery: It is the larger terminal branch of the external carotid artery and arises with in the parotid gland behind the neck of the mandible The artery is divided into three parts by the lower head of lateral pterygoid muscle Branches of first and second parts accompany the branches of mandibular and branches of third part accompany with the branches of maxillary nerve

Internal Carotid Artery: It arises from the bifurcation of the common carotid artery, at the level of the upper border of thyroid cartilage opposite to C3 and C4 The entire course of internal carotid artery is divided into four parts: Cervical Petrous Cavernous Cerebral

Internal carotid artery Carotid sinus

Cervical part of internal carotid artery

2. Petrous part:

3. Cavernous part:

Anterior cerebral artery Middle cerebral artery 3. Cerebral part: Anterior cerebral artery Middle cerebral artery

Anterior cerebral artery Middle cerebral artery

Branches of internal carotid artery: From petrous part: Caratico-tympanic branches Branches to pterygoid canal From the cavernous part 3. Inferior hypophysial arteries 4. Meningeal branch

From the cerebral part: 5. Superior hypophysial arteries 6. Ophthalmic arteries 7. Posterior communicating artery 8. Anterior choroid artery 9. Anterior cerebral artery 10. Middle cerebral artery

JUGULAR VEINS Internal jugular vein - External jugular vein

Internal jugular vein: The internal jugular vein collects the blood from the brain, superficial part of the face and the neck It begins as a continuation of sigmoid sinus at the base of the skull in the posterior compartment of the jugular foramen

Internal & External jugular veins

Tributaries of Internal Jugular Vein: Inferior petrosal sinus Pharyngeal veins Common facial vein Lingual vein Superior thyroid vein Middle thyroid vein Sometimes occipital vein Thoracic duct on the left side/Right lymphatic duct on the contralateral side

Inferior petrosal sinus

Communications: With external jugular vein in the upper part of neck by means oblique jugular vein With cavernous sinus through inferior petrosal sinus and a plexus of veins around internal carotid artery

Sensory & Motor supply of the face

The trigeminal nerve The trigeminal nerve is the largest and most complex of the 12 cranial nerves (CNs). It supplies sensations to the face, mucous membranes, and other structures of the head. It is the motor nerve for the muscles of mastication and contains proprioceptive fibers

Cutaneous innervation of neck:

Sensory supply of the face: Three divisions of the trigeminal nerve, ophthalmic, maxillary and mandibular supply major part of the skin of the face and forehead in three distinct territories Cutaneous branches of trigeminal are altogether eleven in number: a. Five from Ophthalmic b. Three from Maxillary c. Three from Mandibular

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