16. 16
Aorta
• Trunk of the arterial tree conveying oxygenated blood
• Aorta can be divided into
17. 17
Ascending aorta
• 5 cm long, begins at the base of the left ventricle
• From 3rd left costal cartilage to 2nd left costal cartilage
Branches:
– Supply the heart-
• Right and Left coronary arteries
Ascending Aorta
Aorta
18. 18
Arch of Aorta
• Origin: Originates slightly to right at the level of upper
border of 2nd right sternocostal joint
• Descends left of the 4th thoracic vertebral body-
continuing as Descending aorta
Branches:
– Brachiocephalic trunk
– Left common carotid
– Left subclavian
Arch of Aorta
20. 20
Common Carotid Artery
• Carotid - to put to sleep
• Large bilateral vessel supplying Head and Neck
Common carotid artery
Right Left
21. 21
Right common
carotid artery
Left common
carotid artery
Origin Bifurcation of the
brachiocephalic
trunk
Arch of aotra
Termination At the level of upper border of
thyroid cartilage
Common carotid artery
23. 23
Relations of thoracic part
Anterior:
• Sternothyroid and
sternohyoid muscles
• Left pleura and lung
• Left brachiocephalic vein
• Thymic remnants
Posterior
• Trachea , left border of
oesophagus
• Left subclavian artery
• Left recurrent laryngeal
nerve
• Thoracic duct
Common carotid artery
24. 24
Relations of thoracic part
Right
• Below- the brachiocephalic trunk
• Above-the trachea
inferior thyroid veins
thymic veins
Left
• Left vagus nerve
• Phrenic nerve
• Left pleura and lung
Common carotid artery
25. 25
Cervical part of common carotid artery
• Both right and left have similar course
• At the level of upper border of thyroid cartilage divides-
– External carotid- exterior of head, face and neck
– Internal carotid- cranial and orbital contents
• Carotid body and Carotid sinus
Common carotid artery
26. 26
Carotid sinus
• At the bifurcation of
common carotid artery
• Responsive to changes
in the arterial blood
pressure
• Its position accounts-
baroreceptor-- controls
intra cranial pressure
Common carotid artery
27. 27
Carotid body
• Small, ellipsoid reddish-
brown structure
• Acts as chemoreceptor-
• Although the main role is
certain, which component
acts is obscure
Common carotid artery
28. 28
Relations of cervical part
Common carotid artery
Anterolaterally
• Tendon of omohyoid
• Skin, superficial fascia, platysma, deep cervical fascia,
sternocleidomastoid, sternohyoid and sternothyroid
Posterior
• 4th and 6th cervical transverse process --- longus colli,
longus capitis, scalenus anterior
• Sympathetic trunk and ascending cervical artery
33. 33
Course:ECA
Superficial temporal artery
Maxillary artery
• In the substance of parotid gland
• Ascends slightly forwards and inclines backwards---
midway between mastoid tip and angle of the mandible
External carotid artery
36. 36
Above the carotid triangle- lies deep to the parotid gland
Within the parotid gland-
• Superficially to retromandibular vein, facial vein
• Deep – internal carotid artery
• Superior laryngeal nerve; superior cervical sympathetic
ganglion
External carotid artery
44. 44
Applied anatomy
• Its relationship to the external laryngeal nerve is
important during thyroid surgeries.
• The artery and the nerve very close to each other higher
up but diverge near the gland.
Superior thyroid artery
45. 45
Lingual artery
• Origin – anteromedial part of external carotid artery at tip
of greater cornu of hyoid bone between superior thyroid
and facial arteries.
• Course – after short course lies deep to hyglossus
muscle, finally leaves the muscle in the tongue to
anastomose with the fellow of oposite side
• Hyoglossus – three parts
Lingual artery
47. 47
First part of lingual artery:
• From origin to posterior
border of hyoglossus
Relations:
-skin, superficial fascia,
platysma and deep
fascia
-lies on middle
constrictor
- loop of artery is crossed
by hypoglossal nerve.
Lingual artery
48. 48
Second part:
• Lies deep to the
hyoglossus, runs along
upper border of hyoid bone
Relations:
- covered by
hyoglossus, tendon of
digastric, stylohyoid and
posterior part of mylohyoid
muscle
Lingual artery
49. 49
Third part
• Extends from anterior
border of hyglossus to the
tip of tongue
• Arteria profunda linguae
Relations:
• Medial- genioglossus
• Lateral – longitudinalis
linguae inferior
• Below – lingual mucous
membrane
Lingual artery
Branches
50. 50
Facial artery
• External maxillary artery
• Origin – anterior aspect of external carotid artery
• Course – runs upwards in neck, then on face; tortuous in
both places
• Two parts-
– Cervical part
– Facial part
Facial artery
54. 54
Occipital artery
• Origin – posteriorly from
the external carotid, 2 cm
from its origin
• Course – Runs backwards
and upwards deep to lower
border of posterior belly of
digastric ends
posteriorly in scalp
Occipital artery
56. 56
Posterior auricular artery
• Origin- retromandibular fossa above stylohyoid muscle
• Course – follows upper border of stylohyoid muscle,
anterior border of styloid process reaches groove
between cartilage of outer ear and mastoid process.
• Distributes branches partly to ear and partly to the
scalp.
60. 60
Maxillary artery
• Origin – larger terminal branch of external carotid,
arises behind and below the mandibular neck, in
substance of parotid gland
• Course –
– Mandibular part
– Pterygoid part
– Pterygopalatine part
65. 65
Superficial temporal artery
• Origin: smaller of the two
terminal branches, begins in
the parotid gland behind
mandible’s neck
• Course: crosses the posterior
root of zygomatic process of
temporal bone, divides into
anterior and posterior branches
66. 66
Relations:
• In the parotid gland- temporal and zygomatic branches
facial nerve
• In the scalp- corresponding veins, posterior to the
auriculotemporal nerve
Superficial temporal artery
68. 68
Applied anatomy
• Control of temporal haemorrhage
• Anastomose freely; partially detached with scalp also
heal with reasonable hope even if one vessel is intact
• Placement of incisions in craniotomy
• In reduction of zygomatic arch fractures – Gilli’s
approach
Superficial temporal artery
69. 69
Internal carotid artery
• Origin - similar to that of ECA
• Course- broadest outline
– Vertically upwards – neck
– Horizontally forwards and medially- petrous carotid canal
– Upwards – foramen lacerum
– Horizontally forwards – cavernous sinus
– Vertically upwards medial- anterior clinoid process
– Backwards and upwards – to its terminal branches
74. 74
Cavernous part
• Ascends to the posterior
clinoid process
• Emerges through the dorsal
roof of the cavernous sinus
Branches
• Cavernous branches
• Hypophyseal branches
• Meningeal branches
Internal carotid artery
75. 75
Cerebral part
Lies at base of the brain.Divides
into Anterior and Middle
cerebral arteries.
• Gives off 5 branches:
• Ophthalmic artery
• Anterior cerebral artery
• Middle cerebral artery
• Posterior communicating
artery
• Anterior choroid artery
Internal carotid artery
76. 76
Ophthalmic artery
• Artery enters the orbit
through optic canal.
• Terminates near the
medial angle of the
eye, dividing into
supratrochlear and
dorsal nasal branches
Internal carotid artery
78. 78
Circle of Willis
• Circulus arteriosus – polygonal
• Anterior cerebral arteries through anterior
communicating arteries
Basilar artery
Posterior cerebral arteries each joins the ipsilateral
internal carotid artery by a posterior communicating
artery
87. 87
Facial vein
• Origin: largest vein of face, begins as angular vein
• Course: downwards and backwards behind facial artery,
but with a straighter course
• Joins anterior division of retromandibular vein--- common
facial vein
Tributaries :
– Connects with superior ophthalmic vein
– Cavernous sinus
– On the face
– Below mandible
104. 104
CAVERNOUS SINUS
• Location: Large venous
space, in middle cranial
fossa
• Anteriorly upto – medial
end of superior orbital
fissure
• Posteriorly – apex of
petrous temporal bone
108. 108
Tributaries – incoming channels
From the orbit
• Superior and inferior ophthalmic veins
• Central vein of retina
From the brain
• Superficial middle cerebral vein
• Inferior cerebral vein
From the meninges
• Sphenoparietal sinus
• Frontal trunk of middle meningeal vein
Cavernous sinus
111. 111
Communications – Draining channels
THROUGH INTO
Superior petrosal sinus Transverse sinus
Inferior petrosal sinus Internal jugular vein
Emissary veins Pterygoid plexus of veins
Superior ophthalmic vein Facial vein
Anterior and posterior
intercavernous sinuses
Communicates with the
opposite side
Cavernous sinus
113. 113
Transverse sinus
• Convex upwards, above Reid’s base line; Large sinuses,
right larger than left
• Extends from internal occipital protuberance to
posteroinferior angle of parietal bone
Tributaries
• Superior petrosal sinus
• Inferior cerebral veins
• Inferior cerebellar veins
• Diploic vein
• Inferior anastomotic vein
114. 114
Straight sinus
• Location: Lies in median plane within junction of falx
cerebri and tentorium cerebelli
• Formed by union of inferior sagittal sinus with great
cerebral vein
• Terminates at internal occipital protruberance
Applied anatomy- ball valve mechanism
115. 115
Superior Sagittal sinus
• Location: upper convex attached margin of falx cerebri
• Extends from crista galli to internal occipital
protruberance; usually continues as right transverse
sinus
• Confluence of sinuses
117. 117
Applied anatomy
• Thrombosis
– Rise in intracranial tension
– Delirium
– Convulsions
– Paraplegia of upper motor neuron type
Superior sagittal sinus
118. 118
Inferior sagittal sinus
• Location small channel, posterior 2 /3rds of falx cerebri
• Ends by joining great cerebral vein to form the straight
sinus.
119. 119
Sigmoid sinus
• S- shaped; direct contiuation of transverse sinus
• Extends from posteroinferior angle of parietal bone to
bulb of internal jugular vein
• Grooves mastoid process of temporal bone
121. 121
Occipital sinus
• Small, attached to margin
of falx cerebri
• Begins near foramen
magnum and ends in
confluence of sinus
Sphenoparietal sinus
• Lie along posterior free
margin of lesser wing of
sphenoid
• Drain to anteior
cavernous sinus
122. 122
Superior petrosal sinus
• Anterior part of
tentorium cerebelli
Inferior petrosal sinus
• Lie in petro-occipital
fissure
• Drain cavernous sinus ---
internal jugular vein
Tributaries
• Labrynthine veins
• Veins from medulla, pons,
cerebellum