Blood Supply of the Head and Neck

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From Common Carotid

  • divides into internal and external carotid arteries at level of C2 vertebra
    • internal supplies brain and orbit
    • external supplies face, neck front and sides of scalp
  • common carotid runs in carotid sheath which contains
    • internal jugular
    • vagus nerve
  • bifurcation at upper border of thyroid cartilage to internal and external carotid arteries
  • internal carotid
    • no branches in neck
    • enters carotid canal of petrous temporal bone
    • enters interior of skull through foramen lacerum
    • enters cavernous sinus
    • joins circle of Willis
  • external carotid
    • superior thyroid
    • lingual
    • facial and occipital
    • divides at neck of mandible to superficial temporal and maxillary branches
    • maxillary
      • originates in parotid gland
      • gives middle meningeal artery which runs extradural up inside of temple (liable to damage if pterion broken)
      • inferior alveolar artery

15.4 BLOOD SUPPLY [Morph] PLEASE NOTE OVERLAP with section Error! Reference source not found.

15.4.1 Arterial Supply [Morph]

15.4.1.1 Arterial supply to head (including the dura)

[OTFA 102–108]

 Identification on a prosection or an angiogram, and an understanding of the areas supplied, for the following arteries: common carotid, external carotid, middle meningeal, internal carotid; anterior, middle and posterior cerebral; vertebral, basilar. Circle of Willis. [OTFA 102–108] Arterial anastomoses.
Facial, lingual, maxillary, superficial temporal. (Named branches of maxillary artery not needed except middle meningeal).
Common carotid and its division into internal and external carotids; subclavian; superior and inferior thyroid.

15.4.1.2 Important relations

Middle meningeal artery to pterion.
Vertebral artery in cervical spine and entry into foramen magnum.
Internal carotid: middle ear, cavernous sinus.
Inferior thyroid arteries to recurrent laryngeal branches of vagus.

15.4.1.3 Pulse points

Carotid. Conduction of carotid bruit. Important anastomoses: across midline (lips).
Facial. Superficial temporal.

15.4.2 Venous Drainage [Morph]

15.4.2.1 Venous drainage of cranium into internal jugular vein

[OTFA 108–109]

 Venous sinuses of the cranium: superior and inferior sagittal, transverse, sigmoid, straight, cavernous. Drainage of cerebral veins into the sinuses. [OTFA 108–109]
Internal jugular vein. Position of valves.
Communication between cavernous sinus and extracranial veins in face. Anastomoses with vertebral and facial venous systems.
Cavernous sinus thrombosis: influence on cranial nerves.
Tracking of infection from face and scalp to intracranial sites. Emissary veins, including some in cranial nerve foramina

15.4.2.2 Venous drainage of face and scalp

Veins follow arteries.

15.4.2.3 Venous drainage of the neck

Internal and external jugular veins; anterior jugular vein; subclavian veins; the venous arch of the neck. [Thyroid veins. ?] Relations between veins, arteries and the recurrent laryngeal nerves.

15.4.2.4 Landmarks

Access to subclavian and jugular veins, for cannulation.
Jugular venous pulse.
Relations to fascial compartments.

15.4.3 Lymphatic Drainage [Morph]

Lymphatic channels following internal jugular (deep), anterior and external jugular (superficial).
Role of posterior triangle as lymphatic crossroads.
Lymphatic groups. Superficial: submental, submandibular, parotid, mastoid, occipital. Deep: upper and lower deep cervical. Paucity of lymphatics in central nervous system.
Lingual and palatine tonsils; retropharyngeal lymphatic tissue, adenoids.
Lymphatic drainage of tongue.
Right and left cervical trunks. Thoracic duct.
 

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