18 main arteries & veins of neck for anaesthesia

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18 main arteries & veins of neck for anaesthesia

  1. 1. Main Arteries and VeinsMain Arteries and Veins of Neckof Neck Dr. Riyas ADr. Riyas A Dr.SMCSI KARAKONAMDr.SMCSI KARAKONAM
  2. 2. Common Carotid ArteryCommon Carotid Artery  The right common carotid artery arises from theThe right common carotid artery arises from the brachiocephalic artery behind the rightbrachiocephalic artery behind the right sternoclavicular jointsternoclavicular joint  The left artery arises from the arch of aorta inThe left artery arises from the arch of aorta in the superior mediastenumthe superior mediastenum  Runs upward through the neckRuns upward through the neck  Divides into external and internal carotid arteriesDivides into external and internal carotid arteries
  3. 3. Common Carotid ArteryCommon Carotid Artery  It is embedded in the carotid sheathIt is embedded in the carotid sheath throughout its coursethroughout its course  Closely related with the internal jugularClosely related with the internal jugular vein and vagus nervevein and vagus nerve  Apart from the two terminal branches, theApart from the two terminal branches, the common carotid artery gives off no branchcommon carotid artery gives off no branch in the neckin the neck
  4. 4. RelationsRelations  Anterolaterally: The skin, fascia,Anterolaterally: The skin, fascia, sternocleidomastoid, sternohyoid,sternocleidomastoid, sternohyoid, sternothyroid, and posterior belly ofsternothyroid, and posterior belly of omohyoidomohyoid  Posteriorly: The transverse processes ofPosteriorly: The transverse processes of lower four cervical vertebrae, thelower four cervical vertebrae, the prevertebral muscles, sympathetic trunk,prevertebral muscles, sympathetic trunk, vertebral vessels in the lower part of thevertebral vessels in the lower part of the neckneck
  5. 5. RelationsRelations  Medially: The larynx, pharynx, and belowMedially: The larynx, pharynx, and below these, the trachea and esophagus, thethese, the trachea and esophagus, the lobe of thyroid glandlobe of thyroid gland  Laterally: The internal jugular vein, andLaterally: The internal jugular vein, and posterolaterally, the vagus nerveposterolaterally, the vagus nerve
  6. 6. External Carotid ArteryExternal Carotid Artery  It is one of the terminal branches of the commonIt is one of the terminal branches of the common carotid arterycarotid artery  It supplies the structures in the neck, face, scalp,It supplies the structures in the neck, face, scalp, tongue and maxillatongue and maxilla  Begins at the level of the upper border of theBegins at the level of the upper border of the thyroid cartilagethyroid cartilage  Terminates in the substance of the parotid glandTerminates in the substance of the parotid gland by dividing into superficial temporal andby dividing into superficial temporal and maxillary arteriesmaxillary arteries
  7. 7. External Carotid ArteryExternal Carotid Artery  At its origin, where its pulsation can beAt its origin, where its pulsation can be felt, the artery lies within the carotidfelt, the artery lies within the carotid triangletriangle  At first, it lies medial to the internal carotidAt first, it lies medial to the internal carotid arteryartery  It is crossed by the posterior belly of theIt is crossed by the posterior belly of the digastric and the stylohyoiddigastric and the stylohyoid
  8. 8. RelationsRelations  Anterolaterally: overlapped byAnterolaterally: overlapped by sternocleidomastoid muscle, fascia andsternocleidomastoid muscle, fascia and skin, it is crossed by the hypoglossalskin, it is crossed by the hypoglossal nerve the posterior belly of the digastricnerve the posterior belly of the digastric muscle and the stylohyoid, crossed by themuscle and the stylohyoid, crossed by the facial nerve within the parotid glandfacial nerve within the parotid gland  The internal jugular vein first lie anterior toThe internal jugular vein first lie anterior to the artery then posterior to itthe artery then posterior to it
  9. 9. RelationsRelations  Medially: the wall of the pharynx, internalMedially: the wall of the pharynx, internal carotid arterycarotid artery  The stylopharyngeus muscle, theThe stylopharyngeus muscle, the glossopharyngeal nerve, and pharyngealglossopharyngeal nerve, and pharyngeal branch of the vagus pass between thebranch of the vagus pass between the external and internal carotid arteriesexternal and internal carotid arteries
  10. 10. BranchesBranches  Superior thyroid arterySuperior thyroid artery  Ascending pharyngeal arteryAscending pharyngeal artery  Lingual arteryLingual artery  Facial arteryFacial artery  Occipital arteryOccipital artery  Posterior auricular arteryPosterior auricular artery  Superficial temporal arterySuperficial temporal artery  Maxillary arteryMaxillary artery
  11. 11. Internal Carotid arteryInternal Carotid artery  It is one of the terminal branches of the commonIt is one of the terminal branches of the common carotid arterycarotid artery  It supplies the brain, the eye, the forehead, andIt supplies the brain, the eye, the forehead, and the part of nosethe part of nose  It begins at the level of the upper border of theIt begins at the level of the upper border of the thyroid cartilagethyroid cartilage  Ascends in the neck to the base of the skullAscends in the neck to the base of the skull
  12. 12. Internal Carotid arteryInternal Carotid artery  It enters the cranial cavity through theIt enters the cranial cavity through the carotid canal in the petrous part of thecarotid canal in the petrous part of the temporal bonetemporal bone  It lies embedded in the carotid sheath withIt lies embedded in the carotid sheath with the internal jugular vein and vagus nervethe internal jugular vein and vagus nerve  It gives off no branches in the neckIt gives off no branches in the neck
  13. 13. RelationsRelations  Anterolaterally: Below the digastric lie the skin,Anterolaterally: Below the digastric lie the skin, the fascia, anterior border ofthe fascia, anterior border of sternocleidomastoid and the hypoglossal nervesternocleidomastoid and the hypoglossal nerve  Above the digastric lie the stylohyoid and theAbove the digastric lie the stylohyoid and the stylopharyngeus muscles, the glossopharyngealstylopharyngeus muscles, the glossopharyngeal nerve, the pharyngeal branch of vagus nerve,nerve, the pharyngeal branch of vagus nerve, the parotid gland and the external carotid arterythe parotid gland and the external carotid artery
  14. 14. RelationsRelations  Posteriorly: The sympathetic trunk, longusPosteriorly: The sympathetic trunk, longus capitis muscle, and the transverse processes ofcapitis muscle, and the transverse processes of the upper three cervical vertebraethe upper three cervical vertebrae  Medially: The pharyngeal wall and the superiorMedially: The pharyngeal wall and the superior laryngeal nervelaryngeal nerve  Laterally: The internal jugular vein and the vagusLaterally: The internal jugular vein and the vagus nervenerve
  15. 15. Veins of the NeckVeins of the Neck
  16. 16. External Jugular VeinExternal Jugular Vein  The external jugular vein is formed behind theThe external jugular vein is formed behind the angle of the jaw by the union of the posteriorangle of the jaw by the union of the posterior auricular vein with the posterior division of theauricular vein with the posterior division of the retromandibular veinretromandibular vein  It descends across the sternocleidomastoidIt descends across the sternocleidomastoid muscle and beneath the platysma musclemuscle and beneath the platysma muscle  It drains into the subclavian vein behind theIt drains into the subclavian vein behind the middle of the claviclemiddle of the clavicle
  17. 17. Anterior Jugular VeinAnterior Jugular Vein  The anterior jugular vein descends in theThe anterior jugular vein descends in the front of the neck close to the midlinefront of the neck close to the midline  Just above the sternum, it is joined to theJust above the sternum, it is joined to the opposite vein by the jugular archopposite vein by the jugular arch  It joins the external jugular vein deep toIt joins the external jugular vein deep to the sternocleidomastoid musclethe sternocleidomastoid muscle
  18. 18. IJVIJV  Surface marking:marked by joining twoSurface marking:marked by joining two pointspoints  11stst point:on the neck..medial to the lobulepoint:on the neck..medial to the lobule of the earof the ear  22ndnd point:medial end of the claviclepoint:medial end of the clavicle
  19. 19. Internal Jugular VeinInternal Jugular Vein  The internal jugular vein is a large veinThe internal jugular vein is a large vein that receives blood from the brain, face,that receives blood from the brain, face, and neckand neck  It starts as a continuation of the sigmoidIt starts as a continuation of the sigmoid sinus and leaves the skull through thesinus and leaves the skull through the jugular foramenjugular foramen
  20. 20. Internal Jugular VeinInternal Jugular Vein  It then descends through the neck in theIt then descends through the neck in the carotid sheath lateral to the vagus nervecarotid sheath lateral to the vagus nerve and the internal and common carotidand the internal and common carotid arteriesarteries  It ends by joining the subclavian veinIt ends by joining the subclavian vein behind the medial end of the clavicle tobehind the medial end of the clavicle to form the brachiocephalic veinform the brachiocephalic vein
  21. 21. Internal Jugular VeinInternal Jugular Vein  Throughout its course, it is closely relatedThroughout its course, it is closely related to the deep cervical lymph nodesto the deep cervical lymph nodes  The vein has a dilatation at its upper endThe vein has a dilatation at its upper end called the superior bulb and another nearcalled the superior bulb and another near its termination called the inferior bulbits termination called the inferior bulb  Directly above the inferior bulb is aDirectly above the inferior bulb is a bicuspid valvebicuspid valve
  22. 22. Tributaries of Internal JugularTributaries of Internal Jugular VeinVein  Inferior petrosal sinusInferior petrosal sinus  Facial veinFacial vein  Pharyngeal veinsPharyngeal veins  Lingual veinLingual vein  Superior thyroid veinSuperior thyroid vein  Middle thyroid veinMiddle thyroid vein
  23. 23. SUBCLAVIAN VEINSUBCLAVIAN VEIN  Surface marking: represented by broadSurface marking: represented by broad line joining along the clavicle extendingline joining along the clavicle extending from a little medial to its midpoint to medialfrom a little medial to its midpoint to medial endend
  24. 24. Subclavian veinSubclavian vein
  25. 25. Course and relationCourse and relation  Lies in front of the subclavian artery,rightLies in front of the subclavian artery,right phrenic nervephrenic nerve  Behind the clavicle and subclavius muscleBehind the clavicle and subclavius muscle  Above the first rib and pleuraAbove the first rib and pleura
  26. 26. tributariestributaries  EJVEJV  Dorsal scapular veinDorsal scapular vein  Thoracic duct on the left sideThoracic duct on the left side  Right lymphatic duct right sideRight lymphatic duct right side
  27. 27. Subclavein vein punctureSubclavein vein puncture
  28. 28. Subclavian vein punctureSubclavian vein puncture
  29. 29. Course and relationCourse and relation  Continuation of axillary veinContinuation of axillary vein  Begins at the outer border of the first ribBegins at the outer border of the first rib  Ends at the medial border scalenusEnds at the medial border scalenus anterior muscleanterior muscle  Join with ijv and form brachiocephalic veinJoin with ijv and form brachiocephalic vein
  30. 30. Femoral veinFemoral vein  Begins as the upward continuation ofBegins as the upward continuation of popliteal veinpopliteal vein  End by becoming continous with externalEnd by becoming continous with external iliac veiniliac vein
  31. 31. RelationRelation
  32. 32. Surface markingSurface marking  : it’s represented by the upper two 3: it’s represented by the upper two 3rdrd of aof a lining joining the 1 cm medial tolining joining the 1 cm medial to midinguinal point to the adductormidinguinal point to the adductor tubercle,the slightly flexed ,abducted andtubercle,the slightly flexed ,abducted and laterally rotatedlaterally rotated  Vein is medial to artery in the upper endVein is medial to artery in the upper end
  33. 33. Continuatio…Continuatio…
  34. 34. Thank youThank you

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