Main Arteries and Veins of Neck

1. Main Arteries and Veins of Neck Dr. Mujahid Khan

2. Common Carotid Artery • The right common carotid artery arises from the brachiocephalic artery behind the right sternoclavicular joint • The left artery arises from the arch of aorta in the superior mediastenum • Runs upward through the neck • Divides into external and internal carotid arteries

4. Carotid Sinus • At its point of division, the common carotid artery shows a localized dilatation, called carotid sinus • It serves as a reflex pressoreceptor mechanism • A rise in blood pressure causes a slowing of the heart rate and vasodilatation of the arterioles

5. Carotid Body • It is a small structure lies posterior to the point of bifurcation of the common carotid artery • It is innervated by glossopharyngeal nerve • It serves as a chemoreceptor • Sensitive to excess carbon dioxide and reduced oxygen tension in the blood • Stimulus reflexly produces a rise in blood pressure and heart rate and increase in respiratory movements

6. Common Carotid Artery • It is embedded in the carotid sheath throughout its course • Closely related with the internal jugular vein and vagus nerve • Apart from the two terminal branches, the common carotid artery gives off no branch in the neck

7. Relations • Anterolaterally: The skin, fascia, sternocleidomastoid, sternohyoid, sternothyroid, and posterior belly of omohyoid • Posteriorly: The transverse processes of lower four cervical vertebrae, the prevertebral muscles, sympathetic trunk, vertebral vessels in the lower part of the neck

8. Relations • Medially: The larynx, pharynx, and below these, the trachea and esophagus, the lobe of thyroid gland • Laterally: The internal jugular vein, and posterolaterally, the vagus nerve

9. External Carotid Artery • It is one of the terminal branches of the common carotid artery • It supplies the structures in the neck, face, scalp, tongue and maxilla • Begins at the level of the upper border of the thyroid cartilage • Terminates in the substance of the parotid gland by dividing into superficial temporal and maxillary arteries

11. External Carotid Artery • At its origin, where its pulsation can be felt, the artery lies within the carotid triangle • At first, it lies medial to the internal carotid artery • It is crossed by the posterior belly of the digastric and the stylohyoid

12. Relations • Anterolaterally: overlapped by sternocleidomastoid muscle, fascia and skin, it is crossed by the hypoglossal nerve the posterior belly of the digastric muscle and the stylohyoid, crossed by the facial nerve within the parotid gland • The internal jugular vein first lie anterior to the artery then posterior to it

13. Relations • Medially: the wall of the pharynx, internal carotid artery • The stylopharyngeus muscle, the glossopharyngeal nerve, and pharyngeal branch of the vagus pass between the external and internal carotid arteries

14. Branches • Superior thyroid artery • Ascending pharyngeal artery • Lingual artery • Facial artery • Occipital artery • Posterior auricular artery • Superficial temporal artery • Maxillary artery

15. Superior Thyroid Artery • Arises from the external carotid artery near its origin • Passes almost vertically downward • Reach the upper pole of thyroid gland • It gives off a branch to the sternocleidomastoid • The superior laryngeal artery pierces the thyrohyoid membrane with the internal laryngeal nerve

17. Ascending Pharyngeal Artery • It’s a long slender vessel that ascends on the wall of the pharynx, which it supplies

18. Lingual Artery • It arises from the external carotid artery, opposite the tip of the greater cornu of hyoid bone • It loops upward to enter the submandibular region • The loop of the artery is crossed superficially by the hypoglossal nerve • It supplies the tongue

19. Facial Artery • It arises from the external carotid artery, just above the level of the tip of the greater cornu of hyoid bone • It arches upward deep to reach the posterior part of the submandibular salivary gland • It supplies the face

21. Occipital Artery • It arises from the external carotid artery, opposite the facial artery • It passes upward and reaches the back of the scalp • Its terminal part accompanies branches of the greater occipital nerve to supply the back of scalp

22. Posterior Auricular Artery • It arises from the external carotid artery, at the level of the upper border of the posterior belly of the digastric muscle • It passes backward to reach the auricle

24. Superficial Temporal Artery • It is the smaller terminal branch of the external carotid artery • Ascends in front of the auricle in company with auriculotemporal nerve • It divides into anterior and posterior branches, which supply the skin over the frontal and temporal regions

26. Maxillary Artery • It is the larger terminal branch of the external carotid artery in the parotid gland • It arises behind the neck of the mandible • It runs upward and forward, leaves the infratemporal fossa by entering the pterygopalatine fossa

27. Branches of Maxillary Artery • Inferior alveolar artery • Middle meningeal artery • Small branches to the external auditory meatus and the tympanic membrane • Small muscular branches supply the muscles of mastication

28. Internal Carotid artery • It is one of the terminal branches of the common carotid artery • It supplies the brain, the eye, the forehead, and the part of nose • It begins at the level of the upper border of the thyroid cartilage • Ascends in the neck to the base of the skull

30. Internal Carotid artery • It enters the cranial cavity through the carotid canal in the petrous part of the temporal bone • It lies embedded in the carotid sheath with the internal jugular vein and vagus nerve • It gives off no branches in the neck

31. Relations • Anterolaterally: Below the digastric lie the skin, the fascia, anterior border of sternocleidomastoid and the hypoglossal nerve • Above the digastric lie the stylohyoid and the stylopharyngeus muscles, the glossopharyngeal nerve, the pharyngeal branch of vagus nerve, the parotid gland and the external carotid artery

32. Relations • Posteriorly: The sympathetic trunk, longus capitis muscle, and the transverse processes of the upper three cervical vertebrae • Medially: The pharyngeal wall and the superior laryngeal nerve • Laterally: The internal jugular vein and the vagus nerve

33. Veins of the Neck

34. External Jugular Vein • The external jugular vein is formed behind the angle of the jaw by the union of the posterior auricular vein with the posterior division of the retromandibular vein • It descends across the sternocleidomastoid muscle and beneath the platysma muscle • It drains into the subclavian vein behind the middle of the clavicle

36. Anterior Jugular Vein • The anterior jugular vein descends in the front of the neck close to the midline • Just above the sternum, it is joined to the opposite vein by the jugular arch • It joins the external jugular vein deep to the sternocleidomastoid muscle

37. Internal Jugular Vein • The internal jugular vein is a large vein that receives blood from the brain, face, and neck • It starts as a continuation of the sigmoid sinus and leaves the skull through the jugular foramen

39. Internal Jugular Vein • It then descends through the neck in the carotid sheath lateral to the vagus nerve and the internal and common carotid arteries • It ends by joining the subclavian vein behind the medial end of the clavicle to form the brachiocephalic vein

40. Internal Jugular Vein • Throughout its course, it is closely related to the deep cervical lymph nodes • The vein has a dilatation at its upper end called the superior bulb and another near its termination called the inferior bulb • Directly above the inferior bulb is a bicuspid valve

42. Tributaries of Internal Jugular Vein • Inferior petrosal sinus • Facial vein • Pharyngeal veins • Lingual vein • Superior thyroid vein • Middle thyroid vein

43. Thank you