Enzyme, Pharmaceutical Aids, Miscellaneous Last Part of Chapter no 5th.pdf
18 main arteries & veins of neck for anaesthesia
1. Main Arteries and VeinsMain Arteries and Veins
of Neckof Neck
Dr. Riyas ADr. Riyas A
Dr.SMCSI KARAKONAMDr.SMCSI KARAKONAM
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.
4. 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
5. 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
6. 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
7. 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
8.
9. 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
10. 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
11. 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
15. 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
16.
17. 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
18. 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
19. 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
21. 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
22.
23. 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
24. 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
25. 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
26.
27. 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
28. 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
31. 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
33. 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
34.
35. 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
38. 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
39. 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
41. 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