The document discusses the arterial blood supply to the head and neck. It begins with an overview of the general principles and then describes the specific arteries - the aorta, common carotid arteries, external carotid artery, internal carotid artery, and subclavian artery. For each artery, it outlines their course, branches, and anatomical relationships. The external carotid artery and its branches receive the most detailed description.
VENOUS DRAINAGE OF HEAD, FACE, NECK AND BRAINDrVishal2
THIS SEMINAR ON VENOUS DRAINAGE OF HEAD, FACE, NECK AND BRAIN ENCOMPASSES ALL THE POSSIBLE DETAILED EXPLANATION ALONG WITH DIAGRAMMATIC ILLUSTRATIONS OF THE SAME. APPLIED AND SURGICAL ANATOMY ALONG WITH RECENT MODALITIES HAS BEEN ADDED HEREIN..
VENOUS DRAINAGE OF HEAD, FACE, NECK AND BRAINDrVishal2
THIS SEMINAR ON VENOUS DRAINAGE OF HEAD, FACE, NECK AND BRAIN ENCOMPASSES ALL THE POSSIBLE DETAILED EXPLANATION ALONG WITH DIAGRAMMATIC ILLUSTRATIONS OF THE SAME. APPLIED AND SURGICAL ANATOMY ALONG WITH RECENT MODALITIES HAS BEEN ADDED HEREIN..
Muscles of mastication are the group of muscles that help in movement of the mandible as during chewing and speech. We need to study these muscles as they control the opening & closing the mouth & their role in the equilibrium created within the mouth. They also play a role in the configuration of face.
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Muscles of mastication are the group of muscles that help in movement of the mandible as during chewing and speech. We need to study these muscles as they control the opening & closing the mouth & their role in the equilibrium created within the mouth. They also play a role in the configuration of face.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Seminar presentation on arterial supply of human head & neck - carotid artery, maxillary artery, ophthalmic artery
post-graduate level
MDS- oral & maxillofacial surgery
INTRODUCTION
EMBRYOLOGY AND DEVELOPMENT
HISTOLOGY OF ARTERIES
ARCH OF AORTA
SUBCLAVIAN ARTERY
Origin
Course and termination
Parts and clinical significance
Branches
Subclavian steal syndrome
CAROTID SYSTEM OF ARTERIES
Origin and termination
Branches
Surface marking
Ligation
Carotid sinus, carotid body and carotid pulse
EXTERNAL CAROTID ARTERY
Course
Branches
Relations
Surface marking
Ligation
BRANCHES OF ECA IN DETAIL
INTERNAL CAROTID ARTERY
Course and termination
Parts and branches
Clinical significance
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
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Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
4. GENERAL PRINCIPLES OF ARTERIAL
SUPPLY
• Arteries carry blood away from the heart.
• All arteries, carry oxygenated blood
• except the pulmonary and umbilical arteries, which carry
deoxygenated blood to the lungs (postnatal) and to the placenta
(prenatal) respectively
• The flow of blood depends on the pumping action of the heart.
• There are no valves in the arteries.
• The branches of arteries supplying adjacent areas normally
• anastomose with one another freely providing backup routes for
blood to flow if one link is blocked.
4
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5. AORTA
• It is the largest artery in the body.
• Originates from the left ventricle.
• It is divided into 3 parts.
• It carries oxygenated blood to all parts of the body.
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6. ARCH OF AORTA
Branches of Arch of
Aorta
1. Left Subclavian artery.
2. Left Common Carotid artery.
3. Brachiocephalic trunk.
-Right subclavian artery.
-Right common carotid artery.
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7. COMMON CAROTID ARTERY
– The right common
carotid artery arises
from the
brachiocephalic artery
behind the
sternoclavicular joint.
-- The left artery arises
directly from the arch
of aorta behind the
manubrium sternum.
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8. COMMON CAROTID
ARTERY
– In the neck, each CCA extends
upwards & laterally with in the
carotid sheath to the level of
upper border of lamina of
thyroid cartilage.
-- The bifurcation takes place in
carotid triangle opposite the
disc between c3 & c4 vertebra.
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9. BRANCHES OF COMMON CAROTID
ARTERY
External Carotid
Artery
Internal Carotid
Artery
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10. EXTERNAL CAROTID ARTERY
It lies anterior to ICA and is the chief arterial supply to
structures in front of neck and face. Under cover of anterior
border of sternocleidomastoid
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11. Course
At the origin- Artery lies in the
carotid triangle, antero-
medial to ICA.
Begins lateral to the upper
border of the thyroid
cartilage, at level with the
disc b/w c3 & c4 .
A little curved & with a
gentle spiral, it first ascends
slightly forward & then
backwards & a little
laterally to pass b/w
mastoid tip & mandibular
angle and lies lateral to the
ICA. 11
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12. Terminates in the
substance of the
parotid gland behind
the neck of mandible
by dividing into:
Superficial temporal
artery
Maxillary artery
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13. Relations
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• Superficial- In carotid
triangle
• Skin, superficial fascia
• Loop b/w the facial nr,
cervical branch & transverse
cutaneous nr. of neck.
• Deep fascia & ant. margin of
sternocleidomastoid.
14. Crossed by-
Hypoglossal nr & its vena comitans.
Lingual, facial, sup. Thyroid vein.
After leaving triangle-
Crossed by-
• Posterior belly of digastric &
stylohyoid
• Posteromedial surface of parotid
gland.
Lying medial to- facial nr., superficial
temporal & maxillary veins.
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15. • Medial-
• Pharyngeal wall
• Sup. Larngeal nr.
• Asc. Pharngeal art.
• ICA separated from ECA by
• Styloid process
• Styloglossus &
stylopharyngeus
• Glossopharyngeal nr.
• Pharyngeal br. Of vagus nr.
• Part of parotid gland
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17. SUPERIOR THYROID ARTERY
COURSE:
arises from the front of
ECA below the tip of
greater cornu of hyoid
bone.
Dividing into terminal
branches at the apex of the
thyroid lobe i.e ant. & post.
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18. Relations
• From origin- under
sternocleidomastoid
muscle descends
forward in triangle.
• Along lateral border
• thyrohyoid
• omohyoid
• sternothyroid
• sternohyoid
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19. • Medial to artery-
• constrictor pharyngis
• external laryngeal nr.
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20. Branches
• Infrahyoid artery-
runs along the lower
border of the hyoid
deep to thyrohyoid
anastomose with its
fellow.
• Sternocleidomastoid
artery- descends
laterally along carotid
sheath.
• superior laryngeal
artery- accompanying
the internal laryngeal
nr. deep to
thyrohyoid.
Supply- larynx.
Anastomose with its
fellow & inf. larngeal
br. of inf. thyroid art.
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21. Branches
• Cricothyroid artery- crosses
high on cricothyroid ligament
anastomose with its fellow.
• Glandular branches-
• Anterior- along the medial
side of the upper pole of the
lateral lobe, supplying mainly
ant. surface by crossing
above isthmus to
anastomose with its fellow.
• Posterior- descending on
post. border. Supplying the
medial & lateral surfaces &
anastomosing with the inf.
thyroid art.
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22. LINGUAL ARTERY
Introduction:
Principal artery of tongue
Arises anteromedially from
ECA opposite the tip of
greater cornu of hyoid bone
b/w thyroid & facial art.
Divided into 3 parts by
hyoglossus muscle.
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23.
FIRST PART – In carotid triangle, extends
from origin to the posterior border of
hyoglossus.
• Rests on the middle constrictor, crossed
by hypoglossal nerve.
SECOND PART – Deep to hyoglossus, runs
horizontally forward along the upper
border of hyoid bone between hyoglossus
laterally and middle constrictor,
stylohyoid ligament medially.
accompanied with lingual vein.
Relations:-
Superficial-
hyoglossus muscle
tendon of digastric, stylohyoid
lower pat of submandibular gland
posterior part of mylohyoid.
Medially-
middle pharyngeal constrictor
stylohyoid ligament
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24. THIRD PART – [ arteria profunda
linguae],ascends along the
anterior Border of hyoglossus,
then horizontally forward on the
undersurface of tongue on each
side of frenum linguae.
In vertical course, lies b/t the
genioglossus medially & inferior
constrictor of tongue laterally.
Horizontal part is accompanied by
lingual nerve.
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25. Branches
• Suprahyoid artery- small, runs
along hyoid’s upper border to
anastomose contralateral art.
• Dorsal lingual artery- medial to
hyoglossus. Supply:-
• mucous mem. Of tongue
• palatoglossal arch
• Tonsil, soft palate & epiglottis
• Sublingual artery- arise from
anterior margin of hyoglossus
goes forward b/w genioglossus
& mylohyoid to sublingual
gland.
• Supply-
• sublingual gland
• mylohyoid
• buccal and gingival mucous mem.
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26. Facial Artery
Arises anteriorly from the ECA
just above the tip of greater
cornu of hyoid bone.
Tortuous course—
on neck-- allows free
movements of pharynx
during deglutition
on face -- free movements of
mandible , lips, & cheek
during mastication & facial
expressions, escapes traction
& pressure during
movements.
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27. • Course:
Runs upwards on superior constrictor of
pharynx deep to the, posterior belly of
digastric with stylohyoid & to the ramus of
mandible
Grooves the posterior border of
submandibular gland
Makes S-bend [2 loops] 1st winding down
over submandibular reaching the surface
of the mandible it curves round its inf.
border, ant. to masseter to enter the face.
Ascends forward across the mandible and
buccinator to traverse a cleft in the
modiolus near the buccal angle.
Ascends side of nose & ends at the medial
palpebral commisure.
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29. Cervical Branches
• Ascending palatine artery- arise
near facial origin, ascending b/w
the styloglossus & stylopharyngeus
to side of pharnx.
Supply-
• pharynx
• soft palate
• tonsil
• auditory tube
• Tonsilar artery- supply tonsil
• Glandular branch- supply
submandibular gland & lymph
nodes.
• Submental artery- largest cervical
br. Runs forward along lower
border of mandible( over the
mylohyoid mus.). It supplies
muscles of the region including
those of chin & lower lip.
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30. • Inferior labial artery- arises near the buccal angle, pass up & forward
under the depressor anguli oris, b/w the orbicularis oris and mucous
mem.
• Supply- inf. labial glands, mucous mem. & muscles.
• Superior labial- more tortuous course along sup. labial margin.
• Lateral nasal artery- ascends the side of the nose. Supply- nasal ala &
dorsum.
• Angular artery- terminal part.
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31. Occipital Artery
• Arises in carotid triangle from
posterior aspect of ECA 2 cm from
its origin.
• Passes backward, upward along &
under cover of post. Belly of
diagastric , crossing superficial to
contents of carotid sheath,
hypoglossal & accessory nerve.
• Appears in the sub occipital
region , rests on the rectus
capitis ,obliqus capitis superior
&semispinalis capitis, crosses the
apex of post. triangle of neck,
finally piercing trapezius and
sternocleidomastoid.
• Ascends tortuously in the dense
superficial fascia of the scalp and
divides into many branches.
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32. Branches
• Sternomastoid branch – two in no. upper &
lower, supply sternomastoid m.
• Mastoid branch – enters cranial cavity
through mastoid foramen, supplies mastoid
air cells in the dura. Sometimes absent.
• Meningeal branch – enters the skull through
jugular foramen & condylar canal, supplies
dura & bone of posterior cranial fossa.
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33. • Muscular branch- supply adj. muscles. Digastric, stylohyoid,
splenius, longissimus capitis.
• Occasional auricular branch supplies cranial surface of auricle.
• Descending branch- superficial --anastamoses with sup.br. of
transverse cervical art.; deep br.anastamoses with vertebral &
deep cervical art.(costocervical trunk)
• Occipital br. – supply the scalp upto vertex.
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34. Ascending Pharyngeal Artery
• Smallest, posteriorly near the
ECA.
• Ascends to base of skull
between wall of pharynx & ICA.
• Relations- crossed by
styloglossus, stylopharyngeus.
• Supply-
• Sympathetic trunk
• Hypoglossal
• Glossopharyngeal
• Vagus nr.
• Cervical lymph nodes
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35. Branches
• Pharyngeal br. – supply:-
• Constrictors & stylopharyngeus
• Soft palate
• Tonsil
• part of auditory tube.
• Inferior tympanic branch –
supply:-
• medial wall of tympanic cavity
• Tympanic br. of
glossopharyngeal nr.
• Meningeal br. –supply:-
• dura mater & adj. bones.
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36. Posterior Auricular Artery
• Branches posteriorly from
external carotid just above
the digastic & stylohyoid.
• Ascends b/w the parotid
gland & styloid process to
the groove b/w the
auricular cartilage &
mastoid process.
• Dividing into auricular &
occipital branches.
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37. Branches
• Stylomastoid- enter stylomastoid
foramen.
• Supply- facial nr., tympanic cavity,
mastoid antrum, air cells &
semicircular canals.
• Auricular branch- supply lateral
aspect.
• Occipital branch- supply occipital
belly of the occipitofrontalis &
scalp above and behind the ear.
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38. Superficial temporal artery
• Smaller terminal br. of ECA.
• Begins in the parotid gland
behind the mandible neck,
crosses the post. root of the
zygomatic process of the
temporal bone.
• About 5cm above this divides
into ant. & post. branches.
• Relations—
• Zygoma-covered by auricularis ant.
• Parotid gland- temporal & zygomatic
br. of facial nr. cross it.
• Scalp-accompanied by occipital vein &
post. to it lies the auriculotemporal nr.
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39. Branches
• Transverse facial artery- arise
within the substance of parotid
gland.
• Supply- parotid gland & duct, masseter
& skin.
• Anterior auricular branch
• supply to lobule & ant part of auricle,
external acoustic meatus.
• Zygomatico-orbital artery– runs
forward along upper border of
zygomatic arch up to lateral
angle of the eye.
• Supply orbicularis oculi.
• Middle temporal artery
• temporalis
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40. • Frontal branch(ant.)- runs upward & forward in the part
of the scalp overlying temporal & frontal bone.
• Supply musscles, skin & pericranium.
• Parietal branch(post.)- runs backward in the scalp
overlying the temporal & parietal bones.
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41. 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
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42. Mandibular part ( first part)
Passes between the
mandibular neck and the
sphenomandibular ligament,
below auriculotemporal nerve
Branches:
◦ Deep auricular artery
◦ Anterior tympanic branch
◦ Middle meningeal artery
Frontal & Parietal
◦ Accessory meningeal
artery
◦ Inferior alveolar artery
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45. Pterygoid part (Second part)
• Ascends obliquely forwards medial to temporalis and
superficial to lower head of lateral pterygoid
• Branches:
• Deep temporal branches
• Pterygoid branches
• Massetric artery
• Buccal artery
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46. Pterygopalatine part
Passes between the heads of lateral pterygoid, through
pterygomaxillary fissure into the pterygopalatine fossa
Branches:
◦ PSA Artery
◦ Infraorbital
◦ Greater palatine
◦ Pharyngeal branch
◦ Artery of pterygoid canal
◦ Sphenopalatine artery
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47. Collateral Circulation
In occlusion of CCA -- anastamoses
between branches of SCA & ECA.
Achieved through :
1] Br. Of Right & left ECAs.,
2] between left & right ICA via circle of
willis.
3] superior thyroid A. with inferior thyroid A.
4] descending branch of occipital A. with
deep cervical & asc. Branch of transverse
cervical A.
5] vertebral A. may take over entire supply
of carotids with in skull.
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48. 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
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49. Internal Carotid Artery
Has no branches in the neck and
enters the cranial cavity.
Supplies structures inside skull.
Arises from the common carotid
at the level of the superior border
of the thyroid cartilage
It is embedded in the carotid
sheath with internal jugular vein
and vagus nerve.
It Supplies:
◦ Brain
◦ Nose
◦ Scalp
◦ Eye
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50. Course
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
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52. BRANCHES OF ICA :
From petrous part –
carotico-tympanic branches.
branches to pterygoid canal.
From cavernous part –
inferior hypophysial artery.
meningeal branch.
From cerebral part –
superior hypophyseal artery.
opthalmic artery.
posterior communicating artery.
anterior choriod artery.
anterior cerebral artery.
middle cerebral artery.
52
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53. Cervical part Relations
Posteriorly -sup cervical ganglion,sup
laryngeal nerve
Medially - ascending pharyngeal artery
Anterolaterally - sternocleidomastoid
muscle
Inferiorly-digastric, hypoglossal nerve
At the level of digastric - stylohyoid muscle,
posterior branches of ECA
Above the digastric - styloid process,deeper
part of parotid gland Internal carotid artery
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54. Petrous part Relations
Surounded by venous and sympathetic
plexuses
Posterolaterally-middle ear and cochlea
Anterolaterally- auditory tube and tensor
tympani
Superiorly- trigeminal ganglion Internal
carotid artery
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55. ICA
Cavernous part
◦ Ascends to the
posterior clinoid
process
◦ Emerges through the
dorsal roof of the
cavernous sinus
Branches
◦ Cavernous branches
◦ Hypophyseal branches
◦ Meningeal branches
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56. ICA
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
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57. ICA
Ophthalmic artery
Artery enters the
orbit through optic
canal.
Terminates near
the medial angle of
the eye, dividing
into supratrochlear
and dorsal nasal
branches
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59. The Subclavian System of
Arteries
ORIGIN –
• Right subclavian art. Arises from
the brachiocephalic trunk.
• Left subclavian art. arises from the
arch of aorta.
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61. Course:
Cervical part -- curved course with upward
convexity.
extends from the sternoclavicular joint to the
outer border of first rib, enters through the
apex of axilla & continued as axillary artery.
Each art. Arches over the cervical pleura n
apex of the lung, subdivided into 3 parts by
scalenus anterior muscle
1st part -- upto medial border of muscle, 2nd
part--- behind the muscle, 3rd---- lateral
border of muscle to the outer border of 1st
rib.
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63. Vertebral Artery
Origin-- from the upper
surface of the first part of SC
A.passes through-- foramina
transversaria of upper six
cervical vertebrae, winds
backward around the lateral
mass of atlas,enters the
cranial cavity through
foramen magnum, and at
the lower border of pons.
unites with similar artery of
opposite side forms-- the
basilar artery.
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64. Branches
Cervical branches –
◦ spinal branches – enter the
vertebral canal through
intervertebral foramina ;
supplies spinal cord,meninges,
vertebra.
◦ muscular branches – from 3rd
part ; supply sub-occipital
muscles.
B] cranial branches –
◦ meningeal branches
◦ posterior spinal artery
◦ ant. Spinal artery.,
◦ post. Inferior cerebellar artery,
◦ medullary arteries.
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65. Parts
First part:- extends from the origin of the
artery to the transverse process of c6.
Runs upwards and backwards in the triangular
space b/w scalenus anterior and longus colli
muscles called vertebral triangle
Second part– runs through the foramina
transverseria of upper C6.it course is vertical
upto the axis vertebrae
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66. Third part :Lies in the sub-occipital triangle
emerging from foramen tranversarium of atlas.
Enters the vertebral canal by passing deep to the
lower arched margin of the posterior atlanto-
occipital membrane .
Fourth part :Pierces the dura & arachnoid maters,&
passes upward & medially through the foramen
magnum in front of first tooth of ligamentum
denticulum.
At lower border of pons ,it unites with the fellow of
opp. Side to form basilar art.
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67. Internal Thoracic Artery
• Arises from the inferior surface
of 1st part of SCA, opposite the
origin of thyrocervical
trunk.,2cm above the sternal
end of clavicle.
• BRANCHES ---
• Pericardico-phrenic artery.
• Mediastinal branches.
• Pericardial branches
• Sternal branches
• Ant. Inter-costal artery.
• Perforating artery.
• Musculo-phrenic artery.
• Superior epigastric artery.
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68. Thyro Cervical Trunk
• Arises from the upper
surface of 1st part of SCA,
just distal to the origin of
vertebral art.
• 3 branches :
inferior thyroid art.
asc. Cervical art.
inf laryngeal art.
tracheal, oesophageal,
laryngeal br.
Transverse cervical art.
suprascapular art.
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69. Costo-Cervical Trunk
•Arises from the back of 1st part of SCA on
left side2nd part of same art. On rt. Side.
Branches –
• deep cervical artery
• superior intercostal art.
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70. Dorsal Scapular Artery
Arises from 3rd part of SCA. Passes laterally
b/w upper & middle or middle & lower trunks
of bracheal plexus. supply the rhomboids &
enters in formation of scapular anastamoses.
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71. APPLIED ANATOMY
CAROTID PULSE : CCA may be
compressed against the
carotid tubercle of transverse
process of C6 vertebra
( carotid tubercle of
chassaignac ) about 4cm
above the sternoclavicular
joint.
• Patency of carotid system
can be investigated by
angiography by injecting a
contrast medium into CCA.
72. APPLIED ANATOMY
• LIGATION OF ECA :
Done at 2 points
Artery exposed at its origin &
ligature above superior thyroid
artery
upper part of neck, superficial
& deep structures of neck
Ligation higher up, behind the
angle of lower jaw- maxillary
artery injuries
• UNILATERAL LIGATION – will
not stop hemorrhage
73. A] LIGATION OF ECA IN
CAROTID TRIANGLE:-
• Skin incision-- at the level of
angle of mandible behind anterior
border of sternocleidomastoid
muscle ,continued downward to the
level of cricoid cartilage.
-- Platysma, superficial sheath of
sternomastoid incised, muscle
exposed & retracted ,deep layer of
sternomastoid head is visible & IJV
through it.
-- Fascia in front of vein is cut to
expose the arteries.
74. LIGATION IN
RETROMANDIBULAR FOSSA
Skin incision--- at line starting
at the tip of mastoid process ,
circling the mandibular angle,
continuing forward below the
mandible one inch.
Passing scalpel through skin &
posterior fibers of platysma ,
the retromandibular vein or
EJV is located, tied & cut.
Branches of great auricular
nerve cut -- permit
mobilization of cervical lobe of
parotid gland.
75.
Attachment of parotid capsule to
the anterior border of
sternomastoid severed with scalpel.
Parotid gland retracted , post. Belly
of digastric ,stylohyoid muscle is
visible. Above this stylomandibular
ligament can be palpated if lower
jaw of the patient is pulled forward.
This movement--- widens the
entrance into retromandibular
fossa , tenses the stylomandibular
ligament.
Pulsations of ECA are felt , isolated
& tied.
76. sublingual artery --
injury occurs in
premolar & molar
region, when sharp
instrument or
rotating disks slips off
a lower molar &
injure the floor of
mouth.
77.
• Applied anatomy In surgical removal of tongue , first part of
artery is ligatured before it gives any branches to the tongue
or tonsil.
• sublingual artery -- injury occurs in premolar & molar region,
when sharp instrument or rotating disks slips off a lower
molar & injure the floor of mouth.
78. LIGATION OF LINGUAL ARTERY :
• Incision – circling the lower pole of submandibular gland.
• Posterior part – towards tip of mastoid ; anterior part – towards
chin.
• Skin, platysma, deep fascia incised, submandibular gland exposed ,
lifted,tendon of diagastric visible.
• Free border of mylohyoid muscle ascertained, hypoglossal nerve
identified.
• 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.
79. •
• VARIATIONS : May arise in common with lingual artery
constituting “linguo-facial trunk”. Occasionly ends by forming
submental artery& not infreqently extends only as high as the
angle of mouth or nose. Deficiency is compensated by
enlargement of one of neighbouring arteries.
• 3] facial artery – can be injured –during operative procedures
on lower premolars & molars, if instrument enters the cheek
at inferior vestibular fornix., also while attempt to open a
buccal abscess.
80. LIGATION OF FACIAL
ARTERY.• Exposed --at the point crossing the
lower border of mandible
• Using contracted masseter as a
landmark, pulse of facial artery felt at
point situated anterior to the
attachment of masseter.
• Artery is accompanied by facial vein &
crossed superficially by marginal
mandibular branch of facial nerve.
• Taking this into consideration, incision --
at least half inch below the border of
mandible & parallel to it.
• Skin, platysma, deep fascia are cut , soft
tissues retracted, pulse of facial artery
felt.
• Artery-- isolated, tied & cut.
81. • POSTERIOR SUPERIOR
ALVEOLAR ARTERY- APPLIED
SURGICAL ANATOMY site of
hematoma during PSA block. -
prevented by aspirating
before giving LA in the site.
• GREATER PALATINE AND
ANTERIOR PALATINE
ARTERY. case of abscess from
palatal root of first
molar,incision should be
made in a antero-posterior
direction ,then transversly.
Incision– made near free
margin of gingiva. Edge of
knife directed outward,
upward.
82. 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
83. 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