Chewing apparatus arteries. The arteries of the masticatory apparatus come from the carotid arteries. The common carotid arteries originate from the right side of the brachycephalic trunk bifurcation and to the left directly from the aortic arch, both arteries ascend behind the sternoclavicular joint, vertically to the upper edge of the thyroid cartilage, where it divides into its terminal branches .
On their way to the neck , they are located in front of the transverse processes of the cervical vertebrae , being able to be compressed against the anterior tubercle of the C6 vertebra, outside the trachea , esophagus and pharynx . Behind the lobe of the thyroid gland and the homohyoid and sternocleidomasteoid muscles (satellite artery muscle) and inside the internal jugular vein .
The carotid inside together with the internal jugular vein, outside and behind the vagus nerve between them , are surrounded by a facial lamina called the carotid vascular sheath and all the structures contained in the sheath constitute the neurovascular package of the neck.
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- 1 Terminal branches of the carotid
- 2 External carotid
- 3 Relationships
- 4 Lingual artery
- 1 Collateral branches
- 2 Terminal branches
- 5 Facial artery
- 1 Collateral branches on the neck
- 2 Facial collateral branches
- 3 Terminal branch of the facial
- 6 Ascending pharyngeal artery
- 7 Parotid arteries
- 8 Terminal branches of the external carotid
- 1 Superficial temporal artery
- 9 Maxillary artery
- 1 Mandibular segment
- 10 Sources
Terminal branches of the carotid
They are the external and internal carotid. At the terminal end of the common carotid, a dilation is observed which can be prolonged to the beginning of the internal carotid called the carotid sinus, which has abundant innervation.
The carotid glomo, is the gland or paraganglion of the French anatomists, is located between the two terminal branches of the common carotid, is made up of specific cells of the glomo, connective tissue and contains a large number of vessels and nerves .
The internal carotid is intended to irrigate part of the brain and the contents of the orbital cavity and small areas of the nasal mucosa .
It extends from the fiburcation of the common carotid to the level of the neck of the mandibular condyle. From its origin it rises vertically by 1 or 2 cm, then it is directed slightly outwards, rising vertically again until its completion in the thickness of the parotid gland.
Ahead is the sternocleidomastoid muscle , the thyro-linguofacial venous trunk , behind the internal carotid, inside the pharynx , outside the digastric and stylohyoid muscles , the stylomandibular ligaments and the hyoglossal nerve . The collateral branches of the external carotid are superior thyroid, lingual, ascending pharyngeal, posterior atrial facial, occipital, and parotid.
It originates above the superior thyroid, applied to the mid-pharyngeal contractor, it is directed upwards, it passes over the greater horn of the hyoid bone , it is introduced into the root of the tongue inside the hyoglossus, going obliquely, it reaches the edge anterior of this muscle, where it is divided into its terminal branches: sublingual and ranina or deep lingual.
- Suprahyoid: it goes to the upper edge of the body of the hyoid bone, anastomoses with that of the opposite side and supplies the hyoid and the muscles that are inserted into it.
- Dorsal of the tongue: it goes back and up until it reaches the mucosa of the dorsal sideof the tongue, it is distributed over the tongue, the palatal arch, palatine tonsil and mucosa of the epiglottis.
- Sublingual: it is directed forward through the face of the sublingual gland and above the mylohyoid muscleto which it nourishes, it is also distributed through the mucosa of the alveololingual sulcus, the frenulum of the tongue , the branch pierces the mylohyoid muscle and anastomoses with the branch Submental of the facial, some twigs penetrate through the holes around the chin and through the alveolar hole to distribute in the thickness of the jaw.
- Lingual deep: it is directed forward to the tip of the tongue, being located between the lower longitudinal and the genioglossus, it is distributed through the muscles and mucosa of the tongue.
It detaches from the anterior face of the external carotid above the lingual, it goes up and forward attached to the pharynx, passing inside the digastric and stylohyoid muscles to the submandibular cell, contoured to the gland on its medial and superolateral, it reaches the lower edge of the mandible at the level of the anteroinferior angle of the masseter and from there it goes towards the labial commissure, ascends deeply into the masogenian sulcus to the internal angle of the eye , where it anastomoses with the nasal artery of the ophthalmic, in its path is very sinuous, being attached to the elevator buccaneer of the corner and to the lip and nose elevators.
Collateral branches on the neck
- Ascending palatine: originates 4 or 5 millimeters from its origin, ascends through the lateral wall of the pharynx to the level of the pharyngeal orifice of the auditory tube, is distributed over the styloglossal, pharyngeal-style muscles, pharyngeal walls, tosila palate and mucosa of the jaws and base of the tongue.
- Pterygoid: penetrates through the deep face into the medial pterygoid muscle, sometimes this branch arises from the ascending palatine.
- Glandular: in variable number (3 or 4) it is distributed throughout the submandibular gland.
- Tonsilar: it perforates the superior constrictor muscle of the pharynx and ends with several twigs in the palatine tonsil, pharynx and root of the tongue.
- Submental: it is a thick branch, it originates from the facial at the level of the submandibular gland, it goes forward between the mylohyoid and the anterior belly of the digastric until reaching the chin, it is distributed by the muscles that accompany it on its way, skin and muscles of the chin and lower lip.
Collateral facial branches
- Maseteric: it originates above the lower edge of the mandible, and it goes back and up in the superficial aspect of the masseter muscle where it ends, it also emits some twigs for the diver.
- Lower lip: originates at the level of the lip commissure and is directed inward in the thickness of the lower lip.
- Superior labial: originates at the level of the labial commissure, is directed towards the anastomosis with the one on the opposite side, emitting a branch for the nasal subtabique. Both labial arteries when anastomosing with those of the opposite side, form the labial arterial ring, are distributed by the lips.
- From the wing of the nose: it is born from the facial level of the nasal wing, it is divided into several branches for the nasal wing, dorsum and the nasal lobe.
Terminal branch of facial
It is the angular one that anastomoses with the nasal of the ophthalmic emits several twigs for the skin and muscles of the nose .
Ascending pharyngeal artery
It arises from the medial aspect of the external carotid, it goes up the lateral wall of the pharynx to the base of the skull. On its way it emits the branches:
- Pharyngeal: those that are distributed by the walls of the pharynx, palatine tonsil and soft palate.
- Prevertebral: intended for this muscle group.
- Tympanic: for the eardrumbox .
- Posterior meningeal: which penetrates the cranial cavity through the jugular foramen, is distributed along its path by the hypogeal, vagus, superior cervical ganglion and dura nerves.
They are thin branches and variable in number, they originate from the external carotid in its path through the parotid gland, in addition small branches can also originate at the beginning of the occipital and posterior auricular.
Terminal branches of the external carotid
There are two terminal branches of the external carotid: the superficial temporal and the maxillary.
Superficial temporal artery
The direction of the external carotid continues, it exits through the upper end of the parotid gland, between the retroarticular tubercle and the external acoustic meatus, reaching the temporal region where it divides into its terminal branches, in this region it is superficially covered by the skin .
On its way it issues the following collateral branches:
- Parotid: variable number of thin branches, emitting in the thickness of the parotid gland.
- Transverse of the face: it is born at the level of the condyle of the mandible, it is directed forward following the lower edge of the zygomatic arch until it reaches the buccinator muscle, on its way it emits branches for the masseter muscle, parotid duct, muscle of facial mimicry and soft parts of the cheek.
- Articular: They are thin branches destined for the temporomandibular joint.
- Posterior deep temporal: it is directed upwards, crosses the zygomatic arch, pierces the temporal fascia and this muscle until it is located between the muscle and the cranial wall, it is distributed by the posterior part of the muscle.
- Earphones anterior: in variable number they go backwards and they are distributed by the pinna of the ear.
- Zygomatic-orbital: it is directed forward above the zygomatic arch until it reaches the lateral part of the orbicularis oculi muscle.
The terminal branches:
- Frontal: it is directed towards the forehead region, through which it is distributed.
- Parietal: it is directed backwards and upwards to the parietal region, it is distributed in addition to the skin of this region, by the temporal skin.
It extends from the parotid region to the pterygopalatine fossa, where it ends up continuing with the sphenopalatine.
From its origin it is directed forwards around the neck of the condyle of the mandible, passing through the retrocondylar eyelet, it continues its journey from inside to outside along the lower edge of the lateral pterygoid, attaching itself to the lateral aspect of the muscle, then it is directed upwards , in front and inside to the highest part of the maxillary tuberosity, then curl inwards, penetrating into the pterygopalatine fossa. As a variant in its path, the maxillary artery can be located on the deep aspect of the lateral pterygoid, crossing between the two fascicles of the muscle, at its anterior end from the inside out, to penetrate by bending into the pterygopalatine fossa.
The collateral branches according to the maxillary path are divided into three groups: those originating from the mandibular, pterygoid and pterygopalatine segments.
Deep auricular: It is directed back and up and is distributed by the articular capsule of the temporomandibular joint and the lower wall of the external acoustic meatus. Tympanic: thin branch, is directed upwards, penetrates through the petrotympanic fissure, distributing through the mucosa of the eardrum.
Articular: thin branches variable in number from one to three, with a scenario direction for the temporomandibular joint.
Inferior alveolar: it originates close to the neck of the condyle, from its origin it goes downwards and forwards, it penetrates through the mandibular hole in the homonymous duct and runs all the way to the lower lip and vestibular gingiva from premolars to incisors, and the incisor branch that continues the direction of the inferior alveolar and is distributed by the canine, incisors and bone .
On its lower alveolar path it emits collaterals:
- Milohyoidea: it originates before the alveolar one, it penetrates into the mandibular canal, descends through the mylohyoid groove and is distributed through the mylohyoid musclesand the anterior belly of the digastric.
- Dental: they arise from the alveolar in its path in the mandibular canal for molars, premolars and their support elements.
- Bones: they are multiple branches for the mandibular bone.
Branches of the pterygoid portion of the maxilla:
- Middle meningeal: it is the thickest collateral, it runs vertically from its beginning, it passes between the roots of the auriculotemporal nerve, passing through the spinous hole to the cranial cavity, giving branches for the meninges, trigeminal ganglion, orbital, for the box of the eardrum and anastomotic branch, for the stylomastoid, before entering the cranial cavity, it emits an interpterygoid branch from which arterioles for the pterygoid muscles arise.
- Minor or accessory meningeal: passes into the cranial cavity through the oval hole, previously giving some thin branches for the lateral pterygoid and palatal veil, and in the cranial cavity it is distributed by the dura mater next to the cavernous sinus and trigeminal ganglion.
- Temporal deep medial: it arises from the maxilla at the level of the mandibular notch, ascends outside the lateral pterygoid and enters the deep aspect of the temporal muscle.
- Anterior deep temporal: it is born next to the maxillary tuberosity in an ascending direction, it is placed on the deep aspect of the temporal. The three deep temporal arteries establish anastomoses between them.
- Mesheteric: It is directed outwards from its origin, crossing in front of the temporomandibular joint and through the mandibular notch, penetrating the masseter through its deep face, in its path of articular branches. Sometimes it originates from a common trunk with a deep medial temporal.