This presentation gives a thorough description of arterial supply of head and neck

1. Arterial supply of head
and neck and its
surgical implication
GUIDED BY : DR. PALLAVI SRIVASTAVA
PRESENTED BY: GAURI BARGOTI

2. Contents
Introduction
Common carotid artery
External carotid artery
Internal carotid artery
References

3. Introduction
The arteries of head and neck apart from few exceptions are supplied by
branches of external carotid artery
Only nasal cavity and upper part of the face is supplied by branches of internal
carotid artery
External carotid artery is termed as facial artery
Internal carotid artery is cerebral artery

4. Common Carotid Artery
On right side arises from brachiocephalic artery
On left side arises directly from aortic arch.
Divides at upper border of thyroid cartilage.

5. Course of CCA

6. External Carotid Artery
Arises under the cover of sternocleidomastoid muscle
Terminates in the parotid gland behind the neck of mandible.
Covered by investing layer of deep cervical fascia; platysma; subcutaneous
tissue and skin.
It is superficially located shortly after its origin

7. Course of ECA

8. Ligation of ECA
 Can be done at two sites
 Inthecarotidtriangle-atitsoriginfromthe commoncarotid(abovetheoriginofsuperior thyroidartery)
 Intheretromandibularfossa,ligated behindtheangleofmandible(controlsthe haemorrhagefromoneofthe
branchesof maxillaryartery)

9. Branches of ECA
Anterior Branches Posterior Branches Medial Branches Terminal Branches
Superior thyroid artery Occipital Artery Ascending pharyngeal
artery
Maxillary artery
Lingual artery Posterior auricular artery Superficial temporal
Facial artery

10. Superior thyroid artery
Arises from ECA at or immediately above the bifurcation of common carotid
After reaching thyroid gland divides into anterior and posterior branch
Aside from muscular branch it also gives 2 extraglandular branches : laryngeal branch
and cricothyroid artery

11. Lingual artery
Lingual Artery arises from the ECA opposite the tip of greater cornu of the
hyoid bone.
Frequently have common origin with facial artery.
After origin courses horizontally forward to posterior border of hypoglossal
muscle.

12. Branches of Lingual Artery
 SuprahyoidArtery
 DorsalLingual Artery
 Deep LingualArtery
 Sublingual Artery

13. Ligation of lingual artery
 Incision – circling the posterior pole of submandibular gland.
 Skin, platysma, deep fascia incised, submandibular is gland exposed and lifted, tendon of
digastric becomes visible.
 Digastric tendon pulled downwards –enlarges the digastric triangle, hyoglossus muscle
visible.
 Muscle divided bluntly, in the gap of its vertical fibers lingual artery found & ligated.

14. Facial Artery
Arises at ECA just below the posterior belly of digastric muscle.
It has two parts, cervical part in the neck and facial part.
It enters the face by winding around the base of the mandible at
the anteroinferior angle of masseter muscle.

15. Branches of facial artery
Cervical Part Supply Facial part Supply
1. Ascending palatine
artery
It supplies to root of tongue
& tonsil.
1. Superior labial- supplies to upper lip &
antero-inferior part of
nasal septum.
2. Tonsillarartery 2. Inferior labial-
supplies to lower lip.
3 Submentalartery
it is a large artery which
accompanies the mylohyoid
nerve, and supplies the
submental triangle and sub
lingual salivarygland.
3 .Lateral nasal
to the ala & dorsum of
nose.
4. Glandularbranches
supplies submandibular
salivary gland and submental
lymphnodes.
4. Angular supplies the lacrimal sac
and orbicularis oculi.

16. Applied anatomy of facial nerve
 Facial Artery compression:
 Applying pressure to the facial artery as it passes over the inferior border of the mandible
just anterior to the angle will diminish blood flow to that side.
In mandibular 1st molar region care must be taken not to injure the facial artery while
extending the vertical incision down the vestibule during surgical extraction of mandibular
impaction. So it is recommended that vertical incision should be started from the vestibule in
upward direction.

17. Occipital artery
Takes origin at same level as facial artery
Lower or higher origin is not rare
Gives its branches in posterior part of the scalp.

18. Posterior auricular artery
Arises in retromandibular fossa just above stylohyoid muscle.
Distributes its branches partly to the inner ear and partly to adjacent area of
scalp.
A small branch of this artery : stylomastoid artery contribute to supply of
tympanic cavity.

19. Ascending Pharyngeal Artery
Only medial branch of ECA
Arises at medial or posteromedial wall of ECA just above the division of ECA.

20. Superficial Temporal Artery
Continues the course of ECA in retromandibular fossa and ascending vertically crosses the
posterior root of zygomatic arch
Its pulse can be felt Infront of outer ear as it is superficial and covered only by superficial fascia
and skin.

21. Maxillary artery
Arises from ECA, just below the level of mandibular neck embedded in parotid
gland.
Arises at right angle of ECA, is phylogenetically and embryologically
continuation of ECA.

22. Parts of maxillary artery
First part (mandibular part): extends from neck of the mandible to the sphenomandibular
ligament. Runs along the lower border of lateral pterygoid.
Second part (pterygoid part): runs upwards and forwards either superficial or deep to the lower
head of the lateral pterygoid muscle.
Third part : In relation to posterior surface of maxilla.
Forth part (pterygopalatine part): passes between the two heads of lateral pterygoid muscle
and the enters pterygopalatine fossa by passing through the pterygo-maxillary fissure.

23. Branches Of Maxillary Artery

24. Applied Anatomy of maxillary
artery
 Surgeries involving condyle of mandible-Avoid injury to maxillary artery as it lies medial
to condyle.
Following a blow on the pterion region, the anterior branch of middle meningeal artery is often
torn resulting in formation of extradural hematoma which may compress the motor area
(precentral gyrus) of cerebral cortex leading to paralysis of opposite half of the body.

25. Pterygoid Plexus
The pterygoid venous plexus is a venous network that surrounds the pterygoid
segment of the maxillary artery. It is located within the infratemporal fossa, lying
partly between temporal and lateral pterygoid muscle, and partly between the
lateral and medial pterygoid muscles.
The function of the pterygoid venous plexus is to collect the blood from
the palate, nasal cavity, paranasal sinuses, nasopharynx, and auditory tube

26. Internal Carotid Artery
Origin: It begins at the upper border of the lamina of thyroid cartilage (level of disc between C3
and c4 vertebra).
Ascends from its origin along the lateral wall of pharynx to base of skull.
Divided into cervical and cranial part with cervical part being branchless.
Termination: It terminates in the cranial cavity at the base of brain by dividing into its terminal
branches viz. anterior and middle cerebral arteries.

27. Course of ICA

28. Branches Of ICA

29. Ophthalmic Artery
Supplies eyeball and its muscle, lacrimal gland and sends of its supply to eyelids and upper part
of face.

30. Applied anatomy of ICA
 The internal carotid arteries are of vital importance for blood supply to the brain. Severe
stenosis of the internal carotid artery is a significant cause of stroke and it is one of the
most common causes of death worldwide and the most common cause of long-term
disability.
 The posterior communicating branch of internal carotid artery connects it with the
posterior cerebral artery, a branch of vertebrobasilar system and forms the Circle of
Willis. This arterial circle forms an important collateral circulation to brain in the
event of obstruction

31. References
Sicher and DuBRUL’S Oral anatomy by E.LLOYD DuBRUL (8th edition)
Anatomy for surgeons: Volume 1 The head and neck by W. Henry Hollinshead (3rd edition)