ARTERIAL SUPPLY, VENOUS & LYMPHATIC DRAINAGE OF HEAD,
NECK AND FACE
Netika TharwaniMDS Part 2
CARDIOVASCULAR SYSTEM
OCarries nutrients, oxygen, hormones, etc throughout body.
OBlood circulates within a fast, high capacity system made up of heart, which is the central pump.
OARTERIES: lead away from the heart, carry the blood to the peripheral parts of the body.
OVEINS: return the blood to the heart.
OHeart can be thought of as a pair of muscular pumps,
O1) feeding a minor loop (PULMONARY) – serves lungs and oxygenates the blood
O2) feeding a major loop (SYSTEMIC) – serves the rest of the body
OEach system is a closed system of tubes, so that blood does not leave the circulation
OFrom the center to periphery, the vascular tree shows 3 modifications:
1) The arteries in number by sending out bifurcations.
2) The arteries in diameter .
3) Blood flow is faster near the heart than at the periphery.
OFunctionally, 3 main vessels are described:
1) Resistance vessels ( arteries, mainly arterioles)
2) Exchange vessels ( capillaries, sinusoids)
3) Capacitance vessels (veins)
RESISTANCE VESSELS
Mainly arterioles
Provide main source of peripheral resistance to blood flow
EXCHANGE VESSELS
OThey allow exchange between blood and the interstitial fluid
HISTOLOGY OF BLOOD VESSSELS
O3 concentric layers ( tunicae)1) Tunica intima - innermost
layer2) Tunica media – contains
muscle tissue, elastic fibres, collagen. Thickest in arteries and ansent in capillaries, Thin in veins.
3) Tunica adventitia – outer coat of the vessel
AV ANASTOMOSESODirect communications between
smaller arteries and veins.ONotable in the skin of nose lips,
ears, nasal mucosae, tongue, etc.OIn newborn, there are few AV
anastomoses but develop rapidly.OIn old age, they atrophy, sclerose
and diminish.
ARTERIAL SUPPLY OF HEAD AND NECK
AORTA
AORTA
Ascending aorta begins at the base
of left ventricle,
continues as aortic arch.
BRANCHES FROM THE ARCH
O3 Branches arise from convex aspect of arch:
1)Brachiocephalic trunk2)Left Common Carotid
Artery3)Left Subclavian Artery
APPLIED
OCoarctation of Aorta:OCongenital onditionOThe ductus arterioses remains patent, but rarely compensates.
CAROTID SINUSOAt the point of division, the
terminal part of CCA or beginning of ICA shows a localized dilatation.
OThe tunica media of the sinus is thinner, but adventitia is thicker.
OServes as a reflex pressure receptor.
O in BP causes slowing of heart and vasodilatation of arterioles
CAROTID BODY
OSmall structure that lies posterior to the point of bifurcation of CCA.
OGlossopharyngeal nOChemoreceptor : sensitive
to CO2 and O2 in blood.OHence, produces a rise in
BP and HR.
COMMON CAROTID ARTERY
RIGHT CCA LEFT CCA
ORIGIN FROM THE BRACHIOCEPHALIC ARTERY
DIRECTLY FROM THE ARCH OF AORTA
TERMINATION
AT THE LEVEL OF THE UPPER BORDER OF THYROID CARTILAGE
ORight CCA has only a cervical part while left CCA has cervical and thoracic parts.
OCCA ascends diverging laterally, where it divides to form EXTERNAL & INTERNAL CAROTID ARTERIES.
OAt the level of upper border of thyroid cartilage. (C3, C4 junction)
RELATIONS
OANTEROLATERALLY:OSkinOFasciaOSternocleidomastoi
dOSternohyoidOSternothyroidOSuperior belly of
omohyoid
OPOSTERIORLY:OTransverse
processes of the lower four cervical vertebrae
OPrevertebral muscles
RELATIONS
OMEDIALLY:OLarynxOPharynxOTrachea OOesophagusOLobe of thyroid
gland
• LATERALLY:• Internal
jugular vein• Vagus nerve
(posterolaterally)
APPLIED
OThe bifurcation of the CCA into the ICA and ECA at the ant border of SCM at the superior border of thyroid cartilage.
OCarotid pulse
EXTERNAL CAROTID A
OSupplies face, neck and scalpOOrigin: at the upper border of
thyroid cartilage and terminates in parotid gland by dividing into terminal branches superficial temporal and maxillary arteries.
RELATIONSOANTEROLATERA
LLY:
OSCMOHypoglossal
nerveOStylohyoid
muscleOFacial nerve
( parotid)O IJV
OMEDIALLY:
OWall of pharynx
OICAOGlossopharyn
geal n
BRANCHESAnterior : Superior thyroid Lingual Facial Posterior: Occipital Posterior auricular Medial: Ascending pharyngeal Terminal: Maxillary Superficial temporal
SUPERIOR THYROID ARTERY
OArises at the level of the greater cornu of hyoid bone.
OSupplies thyroid gland and some adjacent skin
OBranches
LINGUAL ARTERYOArises anteromedially from ECA
opposite to the tip of the greater cornu of hyoid bone.
OShort course lies deep to hyoglossus muscle, finally leaves the muscle in the tongue to anastomose with the fellow of opposite side.
OSupplies the floor of the mouth and tongue
BRANCHESO IN THE FLOOR OF MOUTH:
dorsal Lingual arteriesSublingualDeep lingual artery
SUPRAHYOID ARTERY: runs along the upper border of hyoid bone
FACIAL ARTERYOOrigin – branch of external carotid
artery just above the tip of greater cornu of hyoid bone.
OCourse – runs upwards in neck, then on face; tortuous in both places
OTwo parts-O Cervical partO Facial part
• Cervical branches– Ascending
palatine artery
– Tonsillar artery
– Glandular branches
– Submental
• Facial branches– Inferior
labial artery
– Superior labial artery
– Lateral nasal artery
OCCIPITAL ARTERY• Origin – posteriorly from the
external carotid, 2 cm from its origin
• Course – Runs backwards and upwards deep to lower border of posterior belly of digastric and ends posteriorly in scalp
SUPPLIES the occipital belly of occipitofrontalis and skin and pericranium associated with the scalp
POSTERIOR AURICULAR
• Origin- arises from the posterior part of ECA just above the posterior belly of digastric in the retromandibular fossa above stylohyoid muscle
• Course – follows upper border of stylohyoid muscle, anterior border of styloid process reaches groove between cartilage of outer ear and mastoid process.
• Distributes branches partly to ear and scalp.
ASCENDING PHARYNGEAL ARTERY
OSmallest branch
OMedially arises from the ECA
MAXILLARY ARTERYOVaried region of blood supply:1) External and middle ear, auditory
tube2) Dura mater3) Upper and lower jaws4) Muscles of temporal and
infratemporal regions5) Nose and paranasal air sinuses6) Palate7) Root of pharynx
O3 parts:1) Mandibular part
2) Pterygoid part
3) Pterygopalatine part
Mandibular part
1) Deep auricular2) Anterior tympanic3) Middle meningeal4) Accessory meningeal5) Inferior alveolar
Pterygoid partO Supplies the muscles of mastication1) Deep temporal2) Pterygoid3) Masster4) Buccal
Pterygopalatine part
1) Posterior Superior Alveolar2) Infraorbital3) Greater palatine4) Pharyngeal5) Artery of pterygoid canal6) Sphenopalatine artery
LITTLE’S AREA
• Antero-inferior part of nasal septum
• Form plexus of Kiesselbach.
SUPERFICIAL TEMPORAL ARTERY
O Arises in the parotid gland behind the neck of the mandible
1) Transverse Facial2) Auricular artery3) Zygomatico- orbital artery4) Middle temporal5) Frontal6) Parital
INTERNAL CAROTID ARTERY
Divided into-
OCervical
OPetrous
OCavernous
OCerebral
O CERVICAL part: has no branches
PETROUS PART
OCaroticotympanic branch or artery:-
anastomosis with
anterior tympanic artery
OPterygoid artery :-anastomosis with branch of greater palatine
CAVERNOUS PART
OWithin the cavernous sinusOBranches:1) Cavernous branches to the
trigeminal ganglion2) The superior and inferior
hypophyseal branches to hypophysis cerebri.
CEREBRAL PARTO Lies at the base of brainafter
emerging from cavernous sinusO Branches:
1) Ophthalmic2) Anterior cerebral3) Middle cerebral4) Posterior communicating5) Anterior choroidal
Enters through the optic canal
dividing into supratrochlear
and dorsal nasal branches
• Circulus arteriosus – polygonal
O Lies at base of brainO Br. Of ICAO Vertebral Arteries
THANK YOU
ARTERIAL SUPPLY, VENOUS & LYMPHATIC DRAINAGE OF HEAD,
NECK AND FACE
Netika TharwaniMDS Part 2
VENOUS DRAINAGE OF SCALP
OSUPRATROCHLEAR and SUPRAORBITAL veins unite to form ANGULAR vein continues down as FACIAL vein.
OThe SUPERFICIAL TEMPORAL VEIN joins the MANDIBULAR VEIN to form the RETROMANDIBULAR vein unites with FACIAL vein to form COMMON FACIAL vein which drains into IJV.
OThe POST AURICULAR vein and POST DIVISION OF RETROMANDIBULAR vein to form EXT JUGULAR vein and drains into SUBCLAVIAN.