ANATOMY OF BLOOD SUPPLY TO HEAD AND NECK

1. BLOOD
SUPPLY TO
HEAD
AND NECK
Dr. Shalini Singh(PG)

2. OBJECTIVES
• General Principles of Arterial Supply
• AORTA
• Common Carotid Arteries
• External Carotid Artery
• Internal Carotid Artery
• Subclavian Artery
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3. ARTERIAL SYSTEM
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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.
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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
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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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16. Branches
• Anterior :
• Superior thyroid
• Lingual
• Facial
• Posterior:
• Occipital
• Posterior auricular
• Medial:
• Ascending pharyngeal
• Terminal:
• Maxillary
• Superficial temporal
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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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28. Branches
• Cervical:
• Ascending palatine artery
• Tonsilar artery
• Submental artery
• Glandular branches
• Facial:
• Inferior labial artery
• Superior labial artery
• Lateral nasal branch to nasalis
muscle
• Angular artery- terminal branch
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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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51. Internal carotid artery
• Divided into-
• Cervical
• Petrous
• Cavernous
• Cerebral
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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.
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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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58. Ophthalmic artery
Branches
Central artery of retina
Lacrimal branch
Muscular branch
Ciliary arteries
Supraorbital artery
Posterior ethmoidal
artery
Anterior ethmoidal
artery
Meningeal artery
Medial palpebral artery
Supratrochlear artery
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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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60. Branches of Subclavian
• vertebral,
• internal thoracic
• thyrocervical trunk.
• costo cervical trunk.
• Dorsal scapular artery.
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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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62. BLOODSUPPLYTOHEAD
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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

84. 84
BLOODSUPPLYTOHEAD
ANDNECK

85. Thank You