The presentation of origin of Common carotid artery and its branaches and course.

1. Arterial Blood Supply of Head,
Neck and Face
Presented By: Dr. Rahul Thanvi (MDS Part 1)
Department of Oral and Maxillofacial Surgery

2. -NetterORIGIN

4. -Grey’s Anatomy

6.  The arteries of the oral apparatus and
adjacent regions are, with few exceptions,
branches of the external carotid artery.
 Only parts of the nasal cavity and the upper
parts of face are supplied by the internal
carotid artery.
 The external carotid artery sometimes termed
as facial carotid while internal carotid artery is
termed as cerebral carotid.
Introduction

7. -Grey’s Anatomy

8. Carotid Sinus
 Carotid sinus acts as a baroreceptor or a pressure
receptor and regulates blood pressure.
Carotid Body
 It acts a chemoreceptor and responds to the changes
in the oxygen and carbon dioxide and pH content of
the blood.

9. Carotid Sheath
 the common carotid artery as well as the internal carotid artery.
 internal jugular vein.
 the vagus nerve.
 the deep cervical lymph nodes

12. -Journal of Applied Anatomy

14. Under the cover of anterior border of sternocleidomastoid muscle
Lateral wall of the pharynx
Submandibular traingle and retromandibular fossa
Parotid gland and neck of the mandible
Maxillary artery, Superficial Temporal artery

15. Anterior Posterior Medial Terminal
Superior thyroid Occipital Artery Ascending Superficial
artery Posterior auricular pharyngeal temporal
Lingual artery artery artery artery
Facial artery
Maxillary artey
External Carotid Artery

16. -Netter

18. Superior Thyroid Artery
This artery arises from external carotid artery at or
immediately above the bifurcation of the common
carotid artery.Arising at some distance above the upper
pole of the thyroid gland it curves anteriorly and
downward to reach thyroid gland.
This arch of superior thyroid artery is a characteristic
and can serve as a diagnostic landmark in the surgical
exposure of the external carotid artery.
Anterior Branches

19. -Netter

20. Cricothyroid artery
Superior laryngeal artery
Muscular and hyoid branch
Anterior and posterior branches
Superior thyroid artery

21.  It arises from the external carotid artery at the level of
greater horn of the hyoid bone. Frequently it has a
common origin with facial artery which is called as
linguofacial trunk.
Lingual Artery

23. Linguofacial Trunk
International Journal of Morphology
versión On-line ISSN 0717-9502
Int. J. Morphol. v.23 n.3 Temuco 2005

24. -Grey’s Anatomy

25. Deep Lingual Artery
Sublingual artery
Dorsal lingual artery
Hyoid branch
Lingual Artery

26. Facial Artery
The branches of facial artery can be divided into two sets
Cervical Facial

27. -Duke’s Anatomy

28. Most importatnt cervical branches are:
a)Ascending palatine Artery
b)Submental Artery
Ascending Palatine Artery
Supply:
 Soft palate
 Small branches to pharyngeal muscles and mucous
membrane of pharynx
 Tonsillar artery (main artery to palatine tonsils)

29. Submental Artery
Supply:
Lymph nodes in submandibular triangle.
Anterior belly of digastric muscle.
Mylohyoid muscle.
Anastomoses:
Sublingual artery.
Inferior labial artery.

30. Facial part of the Facial Artery
Angular artery
Lateral nasal branches
Inferior and superior labial arteries

31. Anastomoses
 Inferior labial artery anastomoses with
branches of the mental artery of the
inferior alveolar artery of the maxillary
artery.
 Also inferior labial artery anastomoses
with submental artery.
 Angular artery anastomoses with with
branches of opthalmic artery.

32. Posterior branches of the external
carotid artery
Occipital
Artery
Posterior
Auricular
Artery

33. Relations:
 Posterior belly of digastric muscle
 Atlas and mastoid process
 Trapezius and sternocleidomastoid muscle
Supply:
 Deep musculatures of neck
 Sternocleidomastoid Artery
Occipital Artery

34. -Grey’s Anatomy

35. -Netter

36. Anastomoses:
Descending branch of the occipital artery
anastomoses with branches of deep cervical
artery of the costocervical trunkof the
subclavian artery.

37.  It arises in the retromandibular fossa just above the stylohyoid
muscle.
Supply:
 Outer ear and adjacent area of the scalp.
 Stylomastoid artery to tympanic cavity.
Anastomoses:
 It anastomoses with the branches of the occipital artery and
with the auricular branches of superficial temporal artery.
Posterior Auricular Artery

38. -Grey’s Anatomy

39. Ascending Pharyngeal Artery
 It is the only medial branch of the external
carotid artery.It supplies:
1. Wall of the pharynx
2. Stylopharyngeus, the tensor and levator palati
muscles
3. Deep muscles in front of the vertebral column
Medial Branches of the external
carotid artery

40. -Grey’s Anatomy

41. Ascending pharyngeal artery anastomoses
with the:
 Ascending palatine artery
 Ascending cervical artery of the thyrocervical
trunk
 Pterygoid artery of the maxillary artery
Anastomoses

43. Terminal Branches of External
Carotid Artery
Superficial
temporal
artery
Maxillary
artery

44.  It continues the course of external carotid artery in
retromandibular fossa and ascending vertically it crosses the
posterior root of zygomatic arch in front of outer ear and
pulse of the artery can be felt at this place.
Superficial temporal artery

47.  Transverse facial artery anastomose with palpebral
arteries.
 In the scalp branches of the temporal artery
anastomose with branches of posterior auricular and
occipital arteries.
 Zygomatico-orbital artery anastomoses with the
branches of lacrimal artery.
 Middle temporal artery anastomoses with branches
of the posterior deep temporal artery of the
maxillary artery.
Anastomoses

49.  It arises from the external carotid artery just below
the level of the mandibular neck in the substance of
the parotid gland.It is deeply situated on the inner
surface of the mandible and in relation to lateral
pterygoid muscle.
 Maxillary artery is divided into 4 parts…
1. Mandibular part.
2. Pterygoid/Muscular part.
3. Maxillary part.
4. Pterygopalatine part.
Maxillary Artery

50.  Mandibular part:
1. Middle meningeal artery
2. Inferior alveolar artery
 Pterygoid/Muscular part:
1. Muscular branches to the temporal, pterygoid
massetric and buccal arteries.
 Maxillary part:
1. Posterior superior alveolar artery
2. Infraorbital artery
 Pterygopalatine/sphenopalatine branch:
1. Sphenopalatine artery.
2. Descending palatine artery.

53. Inner surface of tympanic membrane
Anterior tympanic artery
Lining of external acoustic meatus and outer surface of
tympanic membrane
Deep auricular artery
Mandibular part

54. Inferior Alveolar Artery

55. Blood Vessels
Incisive branch
Mental Artery
Mylohyoid Artery
Inferior Alveolar Artery
Dental Arteries Alveolar arteries

56. -Grey’s Anatomy

57. Buccal artery
Pterygoid branches
Massetric Artery
Posterior and anterior deep temporal arteries
Muscular/Pterygoid part

59. Anterior superior alveolar artery
Towards the inferior muscles of eyeball and lower eyelid
Anterior part of the cheek and root of the upper lip
Infraorbital Artey

60. Nasopalatine branch
Major palatine artery
Inferior posterior nasal branches
Descending palatine artery

61. -Netter
Sphenopalatine Artery

62. -Duke’s Anatomy

63. Branch to the pharynx
Posterior septal artery
Posterior lateral nasal artery
Lateral and septal branches
Sphenopalatine artery

65.  The artery ascends from its origin along the lateral
wall of the pharynx to the base of the skull. In the
lateral wall of pharynx External and Internal carotid
arteries are separated by styloglossal and
stylopharyngeus muscles.
 At the base of the skull, the internal carotid artery
enters the carotid canal and passes through it into the
cranial cavity.
 Internal carotid artery can be divided as
Internal Carotid Artery
Cervical Cranial

69.  Internal carotid artery releases few branches while in the
carotid canal like
1. caraticoiotympanic branches to enter the tympanic cavity
2. Supplying dura matter around the cavernous sinus
3. Fine twigs to the opthalmic nerve and pituitary gland
Supply

70. Dosral nasal branch
Supraorbital and Supratrochlear branches
Anterior and Posterior ethmoidal arteries
Medial and Iateral palpebral branches
Lacrimal artery
Central artery of retina and cilliary arteries
Opthalmic artery

71. -Grey’s Anatomy

72. Anastomoses
 Supraorbital and frontal branches anastomose with each other
and with the anterior branch of superficial temporal artery.
 Dorsal nasal branch anatomoses with the angular and
infraorbital artery.

74. Ligation of Arteries

75.  Major arteries being accidently cut while operating
may lead to huge blood loss.
 Also clean and dry operating field is always preferred.
When to Ligate?
 Hemorrhages occurring during lancing of abscesses.
 Accidents during routine operations on the teeth or
injuries sustained by external force.
Why To Ligate?

76.  Three arteries are endangered during
minor surgical procedures:
1. Anterior Palatine artery
2. Sublingual artery
3. Facial artery
Arteries endangered during minor
surgical procedures or during dental
treatment

77.  The facial artery can be easily exposed at the point
where it crosses the lower border of the mandible to
pass from the submandibular region into the face.
 Contracted masseter muscle is used as a landmark to
feel the pulse.
Procedure
The incision is made at least half inch below the border
of the mandible and parallel to it.The skin, platysma
muscle, and deep fascia are cut, and then the soft
tissues are bluntly retracted upward until the palpating
finger can feel the pulse of the facial artery.The artery
then can be isolated, tied and cut.
Ligation of Facial Artery

82. Lingual Artery
 The exposure of lingual artery is done
in the submandibular triangle.
 The submandibular gland is palpated
through the skin and incision is given in
such a way that posterior part should
point toward the tip of the mastoid
process and the anterior part point
towards the chin.

84. The artery can be exposed in 2 areas
External Carotid Artery
Carotid Triangle Retromandibular
Fossa

85. Carotid Triangle

87. Retromandibular Approach