TASHKENT STATE DENTAL INSTITUTE PEDIATRIC MAXILLOFACIAL SURGERY DEPARTMENT Title: ???7Carotid artery externa ???? INAMJANOVA I. - презентация

1 TASHKENT STATE DENTAL INSTITUTE PEDIATRIC MAXILLOFACIAL SURGERY DEPARTMENT Title: ???7Carotid artery externa ???? INAMJANOVA I

2 The external carotid artery is a major artery of the head and neck. It arises from the common carotid artery when it bifurcates into the external and internal carotid artery.arterycommon carotid arteryinternal carotid artery

3 The external carotid artery begins at the level of the upper border of thyroid cartilage, and, taking a slightly curved course, passes upward and forward, and then inclines backward to the space behind the neck of the mandible, where it divides into the superficial temporal and maxillary artery within the parotid gland.thyroid cartilagesuperficial temporalmaxillary arteryparotid gland It rapidly diminishes in size in its course up the neck, owing to the number and large size of the branches given off from it.

4 Carry the top thyroid, lingual, and facial artery to forward branches of an external carotid. The superior thyroid artery arises from the external carotid artery just below the level of the greater cornu of the hyoid bone and ends in the thyroid glandexternal carotid arteryhyoid bonethyroid gland From its origin under the anterior border of the Sternocleidomastoideus it runs upward and forward for a short distance in the carotid triangle, where it is covered by the skin, Platysma, and fascia; it then arches downward beneath the Omohyoideus, Sternohyoideus, and Sternothyreoideus.Sternocleidomastoideuscarotid trianglePlatysma OmohyoideusSternohyoideusSternothyreoideus To its medial side are the Constrictor pharyngis inferior and the external branch of the superior laryngeal nerve.Constrictor pharyngis inferiorsuperior laryngeal nerve It distributes twigs to the adjacent muscles, and numerous branches to the thyroid gland, anastomosing with its fellow of the opposite side, and with theinferior thyroid arteries.inferior thyroid arteries The branches to the gland are generally two in number;branches to the gland Besides the arteries distributed to the muscles and to the thyroid gland, the branches of the superior thyroid are: [1] [1] Hyoid (infrahyoid) artery Sternocleidomastoid artery Superior laryngeal artery Cricothyroid artery This artery must be ligated at the thyroid when conducting a thyroidectomy. If the artery is severed, but not ligated, it will bleed profusely. In order to gain control of the bleeding the surgeon may need to extend the original incision laterally to gain access to its origin from the external carotid artery and ligate it there.thyroidectomysurgeonexternal carotid artery

5 superior thyroid artery

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7 The lingual artery arises from the external carotid between the superior thyroid artery and facial artery. It can be located easily in the tongue.external carotidsuperior thyroid arteryfacial arterytongue It first runs obliquely upward and medialward to the greater cornu of the hyoid bone.greater cornuhyoid bone It then curves downward and forward, forming a loop which is crossed by thehypoglossal nerve, and passing beneath the Digastricus and Stylohyoideus it runs horizontally forward, beneath the Hyoglossus, and finally, ascending almost perpendicularly to the tongue, turns forward on its lower surface as far as the tip, under the name of the deep lingual artery (profunda linguae ).hypoglossal nerveDigastricusStylohyoideusHyoglossusprofunda linguae

8 Deep lingual artery The deep lingual artery (or ranine artery) is the terminal portion of thelingual artery after the sublingual artery is given off. As seen in the picture, it travels superiorly in a tortuous course along the under (ventral) surface of the tongue, below the Longitudinalis inferior, and above themucous membrane.sublingual arterytongueLongitudinalis inferiormucous membrane It lies on the lateral side of the Genioglossus, the main large extrinsic tongue muscle, accompanied by the lingual nerve. However, as seen in the picture, the deep lingual artery passes inferior to the hyoglossus (the cut muscle on the bottom) while the lingual nerve (not pictured) passes superior to it (for a comparison, the hypoglossal nerve, pictured, passes superior to the hyoglossus). At the tip of the tongue, it is said to anastomose with the artery of the opposite side, but this is denied by Hyrtl. [citation needed] In the mouth, these vessels are placed one on either side of the frenulum linguæ.Genioglossuslingual nerveHyrtlcitation neededfrenulum linguæ

9 Sublingual artery] The Sublingual Artery arises at the anterior margin of the Hyoglossus, and runs forward between the Genioglossus andMylohyoideus to the sublingual gland.HyoglossusGenioglossusMylohyoideussublingual gland It supplies the gland and gives branches to the Mylohyoideus and neighboring muscles, and to the mucous membrane of themouth and gums.mouthgums One branch runs behind the alveolar process of the mandible in the substance of the gum to anastomose with a similar artery from the other side; another pierces the Mylohyoideus and anastomoses with the submental branch of the facial arteryalveolar processmandiblefacial artery

10 Other branches[ The suprahyoid branch of the lingual artery runs along the upper border of the hyoid bone, supplying oxygenated blood to the muscles attached to it and anastomosing with its fellow of the opposite side.hyoid boneoxygenated bloodanastomosingopposite side The dorsal lingual branches of lingual artery consist usually of two or three small branches which arise beneath the Hyoglossus. They ascend to the back part of the dorsum of the tongue, and supply the mucous membrane in this situation, the glossopalatine arch, the tonsil, soft palate, and epiglottis; anastomosing with the vessels of the opposite side.Hyoglossustongueglossopalatine archtonsilsoft palateepiglottis

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12 The facial artery (external maxillary artery in older texts) is a branch of theexternal carotid artery that supplies structures of the superficial faceexternal carotid artery The facial artery arises in the carotid triangle from the external carotid artery a little above the lingual artery and, sheltered by the ramus of the mandible, passes obliquely up beneath the digastric and stylohyoid muscles, over which it arches to enter a groove on the posterior surface of the submandibular gland.carotid triangleexternal carotid arterylingual arteryramus of the mandibledigastricstylohyoidsubmandibular gland It then curves upward over the body of the mandible at the antero-inferior angle of the masseter; passes forward and upward across the cheek to the angle of the mouth, then ascends along the side of the nose, and ends at the medial commissure of the eye, under the name of the angular artery.masseterangular artery The facial artery is remarkably tortuous. This is to accommodate itself to neck movements such as those of the pharynx in deglutition; and facial movements such as those of the mandible, lips, and cheeks.pharynxdeglutitionmandiblelipscheeks In the neck, its origin is superficial, being covered by the integument, platysma, and fascia; it then passes beneath the digastric and stylohyoid muscles and part of the submandibular gland, but superficial to the hypoglossal nerve.platysmadigastricstylohyoidsubmandibular glandhypoglossal nerve

13 The facial artery anastomoses with (among others) the dorsal nasal artery of the internal carotid artery.dorsal nasal arteryinternal carotid artery The branches of the facial artery are: cervical Ascending palatine artery Tonsillar branch Submental artery Glandular branches facial Inferior labial artery Superior labial artery Lateral nasal branch to nasalis muscle Lateral nasal branchnasalis muscle Angular artery - the terminal branch Angular artery

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15 Muscles supplied by the facial artery include: buccinator levator anguli oris levator labii superioris levator labii superioris alaeque nasi levator veli palatini masseter mentalis mylohyoid nasalis palatoglossus palatopharyngeus platysma procerus risorius styloglossus transverse portion of the nasalis transversenasalis

16 The occipital artery arises from the external carotid artery opposite the facial artery, its path is below the posterior belly of digastric to the occipital region. This artery supplies blood to the back of the scalp and sterno- mastoid muscles. Other muscles it supplies are deep muscles in the back and neck.external carotid arteryfacial arterydigastricoccipitalsterno- mastoid At its origin, it is covered by the posterior belly of the digastricus and thestylohyoideus, and the hypoglossal nerve winds around it from behind forward; higher up, it crosses the internal carotid artery, the internal jugular vein, and thevagus and accessory nerves.digastricusstylohyoideushypoglossal nerveinternal carotid arteryinternal jugular veinvagusaccessory nerves It next ascends to the interval between the transverse process of the atlas and the mastoid process of the temporal bone, and passes horizontally backward, grooving the surface of the latter bone, being covered by thesternocleidomastoideus, splenius capitis, longissimus capitis, and digastricus, and resting upon the rectus capitis lateralis, the obliquus superior, andsemispinalis capitis.atlasmastoid processtemporal bonesternocleidomastoideussplenius capitislongissimus capitisdigastricusrectus capitis lateralisobliquus superiorsemispinalis capitis It then changes its course and runs vertically upward, pierces the fascia connecting the cranial attachment of the trapezius with thesternocleidomastoideus, and ascends in a tortuous course in the superficial fascia of the scalp, where it divides into numerous branches, which reach as high as the vertex of the skull and anastomose with the posterior auricular andsuperficial temporal arteries.trapeziussternocleidomastoideusvertex of the skullanastomoseposterior auricularsuperficial temporal

17 Branches[ Sternocleidomastoid branches: They are two in number and are given off in the carotid triangle. The upper branch accompanies the accessory nerve, and the lower branch arises near the origin of the occipital artery. Sternocleidomastoid branchescarotid triangle Auricular branch Mastoid branch Descending branches Occipital branches

18 The posterior auricular artery is a small artery and arises from the external carotid artery, above the Digastric muscle and Stylohyoid muscle, opposite the apex of the styloid process.external carotid arteryDigastric muscleStylohyoid musclestyloid process It ascends posteriorly beneath the parotid gland, along the styloid process of thetemporal bone, between the cartilage of the ear and the mastoid process of the temporal bone along the lateral side of the head. The posterior auricular artery supplies blood to the scalp posterior to the auricle and to the auricle itselfparotid glandstyloid processtemporal bonemastoid processauricle

19 The maxillary artery supplies deep structures of the face. It branches from theexternal carotid artery just deep to the neck of the mandible.external carotid artery The maxillary artery, the larger of the two terminal branches of the external carotid artery, arises behind the neck of the mandible, and is at first imbedded in the substance of the parotid gland; it passes forward between the ramus of the mandible and the sphenomandibular ligament, and then runs, either superficial or deep to the lateral pterygoid muscle, to the pterygopalatine fossa.external carotid arterymandibleparotid glandramus of the mandiblesphenomandibular ligamentlateral pterygoid musclepterygopalatine fossa It supplies the deep structures of the face, and may be divided into mandibular,pterygoid, and pterygopalatine portions.mandibularpterygoidpterygopalatine First portion[edit]edit The first or mandibular portion passes horizontally forward, between the neck of the mandible and the sphenomandibular ligament, where it lies parallel to and a little below the auriculotemporal nerve; it crosses the inferior alveolar nerve, and runs along the lower border of the lateral pterygoid muscle.auriculotemporal nerveinferior alveolar nervelateral pterygoid muscle Branches include:Deep auricular arteryDeep auricular artery Anterior tympanic artery Middle meningeal artery Inferior alveolar artery which gives off its mylohyoid branch just prior to entering the mandibular foramen Inferior alveolar arterymylohyoid branchmandibular foramen Accessory meningeal artery

20 Second portion The second or pterygoid portion runs obliquely forward and upward under cover of the ramus of the mandible and insertion of the temporalis, on the superficial (very frequently on the deep) surface of the lateral pterygoid muscle; it then passes between the two heads of origin of this muscle and enters the fossa.temporalislateral pterygoid muscle Branches include: Masseteric artery Pterygoid branches Deep temporal arteries (anterior and posterior) Deep temporal arteries Buccal artery

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22 The third or pterygomaxillary portion (source Kaja Hvitsand Lønn) lies in the pterygopalatine fossa in relation with thepterygopalatine ganglion. This is considered the terminal branch of the maxillary artery.pterygopalatine fossapterygopalatine ganglion Branches include: Sphenopalatine artery (Nasopalatine artery is the terminal branch of the Maxillary artery) Sphenopalatine artery Descending palatine artery Infraorbital artery Posterior superior alveolar artery Artery of pterygoid canal Pharyngeal artery Middle superior alveolar artery (a branch of the infraorbital artery) Middle superior alveolar artery Anterior superior alveolar arteries (a branch of the infraorbital artery) Anterior superior alveolar arteries Greater palatine artery

23 In human anatomy, the superficial temporal artery is a major artery of the head. It arises from the external carotid artery when it bifurcates into the superficial temporal artery and maxillary artery.human anatomyarteryheadexternal carotid arterymaxillary artery Its pulse is palpable superior to the zygomatic arch, anterior and superior to the tragus.pulsepalpablezygomatic archtragus The superficial temporal artery is the smaller of two terminal branches that bifurcate superiorly from the external carotid. Based on its direction, the superficial temporal artery appears to be a continuation of the external carotid.external carotid It begins in the substance of the parotid gland, behind the neck of the mandible, and passes superficially over the posterior root of the zygomatic process of the temporal bone; about 5 cm. above this process it divides into two branches, a frontal and a parietalparotid glandmandiblezygomatic processtemporal bonefrontalparietal

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27 Thank you for attention !!