Main Arteries and Veins Main Arteries and Veins of Neckof Neck

Dr. Riyas ADr. Riyas A

Dr.SMCSI KARAKONAMDr.SMCSI KARAKONAM

Common Carotid ArteryCommon Carotid Artery

The right common carotid artery arises from the The right common carotid artery arises from the brachiocephalic artery behind the right brachiocephalic artery behind the right sternoclavicular jointsternoclavicular joint

The left artery arises from the arch of aorta in The left artery arises from the arch of aorta in the superior mediastenumthe superior mediastenum

Runs upward through the neckRuns upward through the neck

Divides into external and internal carotid arteriesDivides into external and internal carotid arteries

Common Carotid ArteryCommon Carotid Artery

It is embedded in the carotid sheath It is embedded in the carotid sheath throughout its coursethroughout its course

Closely related with the internal jugular Closely related with the internal jugular vein and vagus nervevein and vagus nerve

Apart from the two terminal branches, the Apart from the two terminal branches, the common carotid artery gives off no branch common carotid artery gives off no branch in the neckin the neck

RelationsRelations

Anterolaterally: The skin, fascia, Anterolaterally: The skin, fascia, sternocleidomastoid, sternohyoid, sternocleidomastoid, sternohyoid, sternothyroid, and posterior belly of sternothyroid, and posterior belly of omohyoidomohyoid

Posteriorly: The transverse processes of Posteriorly: The transverse processes of lower four cervical vertebrae, the lower four cervical vertebrae, the prevertebral muscles, sympathetic trunk, prevertebral muscles, sympathetic trunk, vertebral vessels in the lower part of the vertebral vessels in the lower part of the neck neck

RelationsRelations

Medially: The larynx, pharynx, and below Medially: The larynx, pharynx, and below these, the trachea and esophagus, the these, the trachea and esophagus, the lobe of thyroid glandlobe of thyroid gland

Laterally: The internal jugular vein, and Laterally: The internal jugular vein, and posterolaterally, the vagus nerveposterolaterally, the vagus nerve

External Carotid ArteryExternal Carotid Artery

It is one of the terminal branches of the common It is one of the terminal branches of the common carotid arterycarotid artery

It supplies the structures in the neck, face, scalp, It supplies the structures in the neck, face, scalp, tongue and maxillatongue and maxilla

Begins at the level of the upper border of the Begins at the level of the upper border of the thyroid cartilage thyroid cartilage

Terminates in the substance of the parotid gland Terminates in the substance of the parotid gland by dividing into superficial temporal and by dividing into superficial temporal and maxillary arteriesmaxillary arteries

External Carotid ArteryExternal Carotid Artery

At its origin, where its pulsation can be felt, At its origin, where its pulsation can be felt, the artery lies within the carotid trianglethe artery lies within the carotid triangle

At first, it lies medial to the internal carotid At first, it lies medial to the internal carotid arteryartery

It is crossed by the posterior belly of the It is crossed by the posterior belly of the digastric and the stylohyoiddigastric and the stylohyoid

RelationsRelations

Anterolaterally: overlapped by Anterolaterally: overlapped by sternocleidomastoid muscle, fascia and sternocleidomastoid muscle, fascia and skin, it is crossed by the hypoglossal skin, it is crossed by the hypoglossal nerve the posterior belly of the digastric nerve the posterior belly of the digastric muscle and the stylohyoid, crossed by the muscle and the stylohyoid, crossed by the facial nerve within the parotid glandfacial nerve within the parotid gland

The internal jugular vein first lie anterior to The internal jugular vein first lie anterior to the artery then posterior to itthe artery then posterior to it

RelationsRelations

Medially: the wall of the pharynx, internal Medially: the wall of the pharynx, internal carotid arterycarotid artery

The stylopharyngeus muscle, the The stylopharyngeus muscle, the glossopharyngeal nerve, and pharyngeal glossopharyngeal nerve, and pharyngeal branch of the vagus pass between the branch of the vagus pass between the external and internal carotid arteriesexternal and internal carotid arteries

BranchesBranches

Superior thyroid arterySuperior thyroid artery Ascending pharyngeal arteryAscending pharyngeal artery Lingual arteryLingual artery Facial arteryFacial artery Occipital arteryOccipital artery Posterior auricular arteryPosterior auricular artery Superficial temporal arterySuperficial temporal artery Maxillary arteryMaxillary artery

Internal Carotid arteryInternal Carotid artery

It is one of the terminal branches of the common It is one of the terminal branches of the common carotid arterycarotid artery

It supplies the brain, the eye, the forehead, and It supplies the brain, the eye, the forehead, and the part of nosethe part of nose

It begins at the level of the upper border of the It begins at the level of the upper border of the thyroid cartilagethyroid cartilage

Ascends in the neck to the base of the skull Ascends in the neck to the base of the skull

Internal Carotid arteryInternal Carotid artery

It enters the cranial cavity through the It enters the cranial cavity through the carotid canal in the petrous part of the carotid canal in the petrous part of the temporal bonetemporal bone

It lies embedded in the carotid sheath with It lies embedded in the carotid sheath with the internal jugular vein and vagus nervethe internal jugular vein and vagus nerve

It gives off no branches in the neck It gives off no branches in the neck

RelationsRelations

Anterolaterally: Below the digastric lie the skin, Anterolaterally: Below the digastric lie the skin, the fascia, anterior border of the fascia, anterior border of sternocleidomastoid and the hypoglossal nervesternocleidomastoid and the hypoglossal nerve

Above the digastric lie the stylohyoid and the Above the digastric lie the stylohyoid and the stylopharyngeus muscles, the glossopharyngeal stylopharyngeus muscles, the glossopharyngeal nerve, the pharyngeal branch of vagus nerve, nerve, the pharyngeal branch of vagus nerve, the parotid gland and the external carotid artery the parotid gland and the external carotid artery

RelationsRelations

Posteriorly: The sympathetic trunk, longus Posteriorly: The sympathetic trunk, longus capitis muscle, and the transverse processes of capitis muscle, and the transverse processes of the upper three cervical vertebraethe upper three cervical vertebrae

Medially: The pharyngeal wall and the superior Medially: The pharyngeal wall and the superior laryngeal nervelaryngeal nerve

Laterally: The internal jugular vein and the vagus Laterally: The internal jugular vein and the vagus nervenerve

Veins of the NeckVeins of the Neck

External Jugular VeinExternal Jugular Vein

The external jugular vein is formed behind the The external jugular vein is formed behind the angle of the jaw by the union of the posterior angle of the jaw by the union of the posterior auricular vein with the posterior division of the auricular vein with the posterior division of the retromandibular veinretromandibular vein

It descends across the sternocleidomastoid It descends across the sternocleidomastoid muscle and beneath the platysma musclemuscle and beneath the platysma muscle

It drains into the subclavian vein behind the It drains into the subclavian vein behind the middle of the claviclemiddle of the clavicle

Anterior Jugular VeinAnterior Jugular Vein

The anterior jugular vein descends in the The anterior jugular vein descends in the front of the neck close to the midlinefront of the neck close to the midline

Just above the sternum, it is joined to the Just above the sternum, it is joined to the opposite vein by the jugular archopposite vein by the jugular arch

It joins the external jugular vein deep to It joins the external jugular vein deep to the sternocleidomastoid musclethe sternocleidomastoid muscle

IJVIJV

Surface marking:marked by joining two Surface marking:marked by joining two pointspoints

11stst point:on the neck..medial to the lobule point:on the neck..medial to the lobule of the earof the ear

22ndnd point:medial end of the clavicle point:medial end of the clavicle

Internal Jugular VeinInternal Jugular Vein

The internal jugular vein is a large vein The internal jugular vein is a large vein that receives blood from the brain, face, that receives blood from the brain, face, and neckand neck

It starts as a continuation of the sigmoid It starts as a continuation of the sigmoid sinus and leaves the skull through the sinus and leaves the skull through the jugular foramen jugular foramen

Internal Jugular VeinInternal Jugular Vein

It then descends through the neck in the It then descends through the neck in the carotid sheath lateral to the vagus nerve carotid sheath lateral to the vagus nerve and the internal and common carotid and the internal and common carotid arteriesarteries

It ends by joining the subclavian vein It ends by joining the subclavian vein behind the medial end of the clavicle to behind the medial end of the clavicle to form the brachiocephalic veinform the brachiocephalic vein

Internal Jugular VeinInternal Jugular Vein

Throughout its course, it is closely related to Throughout its course, it is closely related to the deep cervical lymph nodesthe deep cervical lymph nodes

The vein has a dilatation at its upper end The vein has a dilatation at its upper end called the superior bulb and another near its called the superior bulb and another near its termination called the inferior bulbtermination called the inferior bulb

Directly above the inferior bulb is a bicuspid Directly above the inferior bulb is a bicuspid valvevalve

Tributaries of Internal Jugular Tributaries of Internal Jugular VeinVein

Inferior petrosal sinusInferior petrosal sinus Facial veinFacial vein Pharyngeal veinsPharyngeal veins Lingual veinLingual vein Superior thyroid veinSuperior thyroid vein Middle thyroid veinMiddle thyroid vein

SUBCLAVIAN VEINSUBCLAVIAN VEIN

Surface marking: represented by broad Surface marking: represented by broad line joining along the clavicle extending line joining along the clavicle extending from a little medial to its midpoint to medial from a little medial to its midpoint to medial endend

Subclavian veinSubclavian vein

Course and relationCourse and relation

Lies in front of the subclavian artery,right Lies in front of the subclavian artery,right phrenic nervephrenic nerve

Behind the clavicle and subclavius muscleBehind the clavicle and subclavius muscle Above the first rib and pleuraAbove the first rib and pleura

tributariestributaries

EJVEJV Dorsal scapular veinDorsal scapular vein Thoracic duct on the left sideThoracic duct on the left side Right lymphatic duct right sideRight lymphatic duct right side

Subclavein vein punctureSubclavein vein puncture

Subclavian vein punctureSubclavian vein puncture

Course and relationCourse and relation

Continuation of axillary veinContinuation of axillary vein Begins at the outer border of the first ribBegins at the outer border of the first rib Ends at the medial border scalenus Ends at the medial border scalenus

anterior muscleanterior muscle Join with ijv and form brachiocephalic veinJoin with ijv and form brachiocephalic vein

Femoral veinFemoral vein

Begins as the upward continuation of Begins as the upward continuation of popliteal vein popliteal vein

End by becoming continous with external End by becoming continous with external iliac veiniliac vein

Relation Relation

Surface markingSurface marking

: it’s represented by the upper two 3: it’s represented by the upper two 3rdrd of a of a lining joining the 1 cm medial to lining joining the 1 cm medial to midinguinal point to the adductor midinguinal point to the adductor tubercle,the slightly flexed ,abducted and tubercle,the slightly flexed ,abducted and laterally rotatedlaterally rotated

Vein is medial to artery in the upper endVein is medial to artery in the upper end

Continuatio…Continuatio…

Thank youThank you