Terminal branches of the carotid artery. Branches of the external carotid artery

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ARTERY

ARTERY Rabbi Moshe Ephraim, grandson of the Baal Shem, was an opponent of the Polish Hasidim, because he heard that they mortify their flesh too harshly and destroy the image of God in themselves, instead of making all parts of their body perfect and uniting them with the soul into one

The materials are published for informational purposes only and are not a prescription for treatment! We recommend that you consult a hematologist at your medical institution!

The system of arteries of the head, neck and face includes large branches. They arise from the convex surfaces of the arteries that make up the aortic arch: the innominate (brachiocephalic trunk), and on the left - from the common carotid and subclavian.

The arteries of the head and neck are large vessels that arise from the aortic arch and carry blood to the organs of the neck, head and face.

Anatomy of arteries

At the level of the cartilage of the second rib on the right, the brachiocephalic trunk extends from the aorta after the trachea and to the brachiocephalic vein on the right. It moves to the right and upward and divides at the sternoclavicular joint on the right into 2 arteries: the right common carotid and subclavian.

Branches of the aortic arch: 1 - aortic arch; 2 - brachiocephalic trunk; 3 - left common carotid artery; 4 - left subclavian artery.

The right cervical artery is 20-25 mm shorter than the left common carotid artery. The common artery is located behind the muscles: sternocleidomastoid, hyoid-scapular and the muscles that cover the middle fascia of the neck. It moves vertically up to the transverse processes of the vertebrae of the neck, without dividing into branches. On top of the thyroid cartilage, both carotid arteries (right and left) are divided into internal and external with almost the same diameter.

The large subclavian artery consists of the right one, which arises from the brachiocephalic trunk, and the left one, which arises from the aortic arch. The length of the left subclavian artery is 2-2.5 cm longer than the right one.

Important. The artery under the clavicle is responsible for the blood supply to the brain from the back of the head, the cerebellum, the brain of the back in the cervical region, the muscles and organs of the neck (partially), the shoulder girdle and the upper limb.

Arteries of the neck, head and face

Photo 2 shows the dislocation of the arteries of the head and neck:

1. Superficial temporal and its branches.
2. Deep temporal.
3. Maxillary.
4. Posterior ear.
5. Occipital.
6. Orbital.
7. Average meningeal.
8. Inferior alveolar.
9. External carotid.
10. Facial.
11. Lingual.
12. Internal sleepy.
13. Superior thyroid.
14. General sleepiness.

Arteries of the brain

1. Anterior cerebral artery.
2. Middle cerebral artery.
3. Sleepy internal.
4. Posterior communicating artery.
5. Posterior brain.
6. Cerebellar superior.
7. Main.
8. Cerebellar anterior inferior.
9. Vertebrate.
10. Cerebellar posterior inferior.

Functions of arteries

The arteries of the head, neck and face transport blood, nutrients: trace elements, vitamins and oxygen to controlled areas.

Let's take a closer look.

Common carotid artery

The paired artery extends into the sternocleidomastoid muscle, omohyoid muscle, trachea, esophagus, pharynx and larynx. The endings of the artery are located in the carotid triangle, next to the thyroid cartilage of the larynx, where the branches are divided into external and internal - the terminal carotid arteries.

External carotid artery

It stretches along the carotid and submandibular triangle, the submandibular fossa (inside the parotid gland). Consists of anterior, posterior, medial and terminal groups of branches. It ends with two terminal branches near the neck of the lower jaw.

1. Anterior branch group
2. The thyroid anterior superior artery is divided into the subhyoid branch and the superior laryngeal branch. Responsible for blood supply to the hyoid muscle and thyroid gland. Anastomosis (connection or anastomosis of vessels) with the thyroid inferior artery.

• The lingual artery consists of branches:
• suprahyoid, supplying blood to the bone under the tongue, suprahyoid muscles;
• sublingual, supplying blood to the gland under the tongue, the mucous membrane of the floor of the mouth, gums, and the jaw muscle under the tongue;

the dorsal branch and deep artery of the tongue, supplying the tongue.

1. Anastomosis with the mental artery.

• The facial artery is divided into:
• ascending palatine - supplies blood to the pharynx and palatine tonsil;
• tonsil branches - blood flows to the tonsil of the palate and the root of the tongue;
• mental - supplies blood to: the floor of the mouth, digastric and mylohyoid muscles, the gland under the tongue;
• upper labial - upper lip;
• lower labial - lower lip;

Anastomosis occurs between: ascending palatine and descending palatine, ascending pharyngeal arteries; submental and sublingual; angular and dorsal nasal (from the ophthalmic) artery.

Group of posterior branches

1. The occipital artery supplies blood to the sternocleidomastoid and muscles of the cervical back, the back of the head, including the skin under the hair, and the auricle.
2. The auricular artery gives off a branch - the posterior tympanic artery and supplies blood to the occipital skin and muscles, the auricle, the mastoid process with its cells, and the tympanic cavity. It connects (anastomosis) with the occipital artery and the superficial temporal.

Blood supply to facial tissues

The function of blood supply to the soft tissues of the face is performed by the branches of the arteries:

• ophthalmic (frontal, eyelid, dorsal, nasal and supraorbital arteries);
• external carotid (lingual, facial, submental, sublingual);
• temporal superficial (transverse facial, zygomatic orbital);
• maxillary (infraorbital and mental).

The orbit is supplied with blood by arteries: the ophthalmic (branch) and the middle meningeal (branch of the maxillary artery) through the lacrimal artery of the anastomatic branch.

The oral cavity is supplied by the lingual branch, which belongs to the external carotid artery. The hypoglossal branch refers to the lingual artery, which belongs to the external carotid. The cheeks and lips are supplied with blood by the facial artery. The floor of the mouth and the area under the chin are fed by the submental artery (from the facial branch). The floor of the oral cavity is supplied with blood from the mylohyoid branch (from the inferior alveolar artery). The mucous membrane of the gums is supplied with blood by the alveolar artery with dental branches. The cheeks are supplied with blood by the buccal branch of the maxillary artery.

Blood flows to the maxillary gums from the anterior superior alveolar arteries. Blood flows to the palate, tonsils and gums from the descending palatine artery, a branch of the maxillary artery. The blood supply to the tongue is carried out by arteries: the lingual (external carotid branch) and the facial (tonsilal branch).

The salivary glands are supplied with blood by arteries:

• gland under the tongue - sublingual and submental;
• parotid gland - branches of the temporal superficial, transverse facial;
• gland under the lower jaw - the facial artery.

The nasal cavity is supplied by arteries: the anterior ethmoidal, posterior ethmoidal (branches of the ophthalmic artery), posterior lateral nasal (branches of the palatine sphenoid artery), posterior artery of the nasal septum (branches of the palatine sphenoid artery).

The maxillary teeth receive blood from the arteries: the posterior and anterior superior alveolar. The mandibular teeth are supplied with blood from the inferior alveolar artery.

Diseases of the blood arteries

Among diseases of the arteries of the head, neck, and face, the following are considered dangerous:

1. Cerebral aneurysm: cerebral, intracranial.

They are characterized by protrusion of the walls of the arteries and the absence of their three-layer structure. When a cerebral aneurysm ruptures, subarachnoid hemorrhage is possible with blood penetrating into the subarachnoid space of the brain.

An aneurysm can be arteriovenous or arterial and often occurs at the site of arterial branching. The shape is: saccular aneurysm (for example, anterior communicating artery, bifurcation of the middle cerebral artery), internal fusiform and fusiform.

1. Atherosclerosis.

Narrowing of the cervical arteries and brain or atherosclerosis is accompanied by frequent attacks of unbearable headaches, which reduce memory. Vessels narrow when cholesterol plaques are deposited and accumulate on the walls, reducing the lumen. The speed of blood flow decreases, so the vessels pass less blood, and with it nutrition and oxygen.

Important. Atherosclerotic plaques form in cracks in the walls of arteries during pathological conditions. They lose their elasticity with an increase in cholesterol levels in the blood, which leads to the appearance of cracks.

Plaques attract platelets, which promote blood clotting and the formation of blood clots. With acute narrowing of blood vessels, a stroke can occur, speech is impaired and vision decreases. A pre-infarction condition, cerebral infarction or hemorrhage is possible if blood circulation is suddenly disrupted.

1. Hypoplasia.

Hypoplasia (often congenital) of the vertebral artery impairs hemodynamics (blood circulation), especially in the posterior parts of the brain. This leads to dysfunction of the heart and circulatory system, internal organs and vestibular apparatus. To diagnose and check the artery, study its functional state, and circuitous blood flow, angiography is performed - a contrast X-ray study. At the same time, they will find out how long the pathological process has lasted.

When blood flow in two, right or left, vertebral arteries is weakened, blood circulation in the central nervous system worsens. These arteries provide 30-32% of the blood flow to the brain. With osteochondrosis, blood flow decreases and posterior cervical sympathetic syndrome occurs, with symptoms similar to migraines. For diagnosis, Doppler ultrasound, neck X-ray, and MRI are performed.

If cervical artery syndrome is confirmed, treatment is aimed at eliminating dizziness, darkening of the eyes, headache, auditory and visual disturbances, and arterial hypertension.

1. Rhesus conflict

Important. The speed of the middle cerebral artery is measured for a comparative assessment of the blood flow speed of fetuses if pregnant women have Rh immunization, gave birth to children with Rh (-) and Rh (+) blood, or the fetus or newborn has varying degrees of hemolytic disease.

Using ultrasound and Doppler blood flow in the middle cerebral artery of the fetus, you can easily diagnose the severity of HDP in case of Rhesus conflict, fetal diseases affecting hemodynamics, including anemic syndrome, and study the fetal blood circulation over time without using invasive technologies.

1. Superficial temporal artery, atemporalis superficialis. One or two terminal branches of the external carotid artery. Together with the auriculotemporal nerve they go in front of the auricle. Rice. A, B.
2. Branch of the parotid gland, ramus parotideus. Supplies blood to the gland of the same name. Rice. A.
3. Transverse artery of the face, a. transversa faciei (facialis). Passes below the zygomatic arch under the fascia of the parotid gland towards the cheek. Rice. A.
4. Anterior auricular branches, rami auriculares anteriores. Numerous branches to the auricle and external auditory canal. Rice. A.
5. Zygomaticoorbital artery, azygomaticoorbitalis. Passes above the zygomatic arch to the lateral edge of the orbit. Rice. A.
6. Middle temporal artery, a. temporalis media. It extends above the zygomatic arch and supplies blood to the muscle of the same name. Rice. A.
7. Frontal branch, ramus frontalis. Anterior branch of the superficial temporal artery. Anastomoses with the vessel of the same name on the opposite side, the supraorbital and supratrochlear arteries (branches of the internal carotid artery). Rice. A.
8. Parietal branch, ramus parietalis. Posterior branch of the superficial temporal artery. Anastomoses with the branch of the same name on the opposite side, the posterior auricular and occipital arteries. Rice. A.
9. Maxillary artery, a. maxillaris. Large terminal branch of the external carotid artery. It begins below the temporomandibular joint, passes from the outer or inner side of the lateral pterygoid muscle and branches in the pterygopalatine fossa. Rice. A, B.
10. Deep auricular artery, aauricularis profunda. It goes back and up to the temporomandibular joint, external auditory canal and eardrum. Rice. B.
11. Anterior tympanic artery, a. tympanica anterior. Accompanied by the chorda tympani, it enters the tympanic cavity through the petrotympanic fissure. Rice. B.
12. The inferior alveolar artery, a alveolaris inferior. Passes between the medial pterygoid muscle and the ramus of the mandible. The canalis mandibulae continues to the mental foramen. Rice. B.
13. Dental branches, rami demotes. They go to the roots of the teeth. Rice. B. 13a Periodental branches, rami peridentales.
14. Mylohyoid branch, ramus mylohyoideus. It begins in front of the opening of the lower jaw and with n.mylohioideus lies in the groove of the same name. Anastomoses with a.submentalis. Rice. B.
15. Mental branch, ramus mentalis. Terminal branch of the inferior alveolar artery. Supplies blood to the chin. Rice. B.
16. Middle meningeal artery, a. teningea media. It passes medially from the pterygoideus lat and through the foramen spinosum enters the middle cranial fossa, where it branches into terminal branches. Rice. B, V.
17. Accessory branch, ramus accessorius. It starts from the middle meningeal or maxillary artery and supplies the auditory tube and pterygoid muscles. Penetrates the skull through the foramen ovale and branches into the hard shell around the ganglion mgeminale.
18. Stony branch, ramus petrosus. It starts from the middle meningeal artery in the cranial cavity. Through the cleft canal, the greater petrosal nerve anastomoses with the stylomastoid artery. Rice. IN.
19. Superior tympanic artery, a. tympanica superior. It lies next to the stony branch and, together with n.petrosus minor, penetrates into the tympanic cavity. Rice. IN.
20. Frontal branch, ramus frontalis. Large terminal branch of the middle meningeal artery. Inside the skull it lies in a bony groove or canal at the edge of the lesser wings of the sphenoid bone. Rice. IN.
21. Parietal branch, ramus parietalis. Supplies blood to the posterior part of the dura mater in the area of ​​the cranial vault. Rice. IN.
22. Orbital branch, ramus orbitalis. Passes through the superior orbital fissure to the lacrimal gland. Rice. IN.
23. Anastomotic branch [[with lacrimal artery]], ramus anastomoricus []. Rice. B. 23a Pterygomeningeal artery, apterygomeningea. It starts from the maxillary or middle meningeal arteries and enters the skull through the foramen ovale. It supplies blood to the tensor velum palatini muscle, the pterygoid muscles, the auditory tube, the dura mater of the brain, and the trigeminal ganglion.
24. Masticatory artery, a. masseterica. It passes over the notch of the lower jaw and supplies blood to the muscle of the same name. Rice. B.
25. The anterior deep temporal artery, and temporalis profunda anterior. It goes up and enters the temporalis muscle. Rice. B. 25a Posterior temporal artery, a. temporalis profundae anterior.
26. Wing-shaped branches, rami pterygoidei. The pterygoid muscles supply blood. Rice. B.
27. Buccal artery, a. buccalis. Passes forward and downward along the buccal muscle. Supplies blood to the cheek and gum. Rice. B.
28. Posterior superior alveolar artery, a. alveolaris superior posterior. Its branches enter the alveolar canals and supply blood to the upper molars, gums and mucous membrane of the maxillary sinus. Rice. B.
29. Dental branches, rami dentales. They are directed to the roots of the maxillary molars. Rice. B. 29a Periodental branches, rami peridentales.

The middle meningeal artery (the Latin spelling interprets its name as A. meningeamedia) is part of the vertebral circulatory system and provides nutrition to the dura mater.

After penetration into the intracranial space it divides into four main branches:

• Upper drum. From the site of the branch it passes through the temporal region and nourishes the tympanic mucosa.
• Frontal. It passes to the lobe of the brain of the same name and supplies the frontal region of the dura mater.
• Parietal. It branches upward and provides blood flow to the parietal area of ​​the dura mater of the brain.
• Additional meningeal. It passes into the space of the skull through the foramen ovale and provides blood supply to the trigeminal ganglion, auditory tube, pterygoid muscles and part of the dura mater.

As part of the maxillary circulation, the meningeal vessels closely interact with the facial, orbital and auricular arteries, forming a reservoir with a developed collegial network.

Location

The middle meningeal artery is located between the pterygomaxillary ligament and the apex of the mandible. It rises along the outer surface of the medial pterygoid muscle to the endings of the auriculotemporal nerves to the foramen spinosum, through which it passes into the cranial space.

The groove of the scales of the temporal bone and the notch of the parietal region are the location of the vessel. It has an anostomy with the internal carotid arteries and is connected to the lacrimal network of vessels through the connecting duct. The artery gives a separate branch to the trigeminal ganglion and the mucous membrane of the tympanic cavity.

Pathologies

Violation of the normal degree of blood flow in the branches of the middle meningeal artery leads to the development of a disorder of the dura mater of the brain in the parietal and occipital regions. Chronic lack of oxygen and vital elements in the tissues of the membrane leads to disturbances in its structure and the occurrence of ischemia.

The most common disease that occurs due to hemodynamic disturbances in the branches of the meningeal arteries is ischemic stroke. This disease affects middle-aged and elderly people, but sometimes the age of the patient diagnosed with ischemic stroke of the frontal branch of the meningeal vessel can be very young.

In addition to stroke, the middle and anterior meningeal artery are susceptible to various types of infectious damage to the walls caused by inflammation of the dura mater or infection in the cavity of the eardrum. Arteritis provokes a sharp spasm of the affected branch of the artery with an immediate deterioration in resistance indicators.

A further lack of blood flow aggravates the situation - an infection that affects the dura mater spreads to certain areas of the convolutions and causes irreversible changes in their structure.

In the practice of vascular pathologies of the brain, the leader among the emerging pathological changes is the occurrence of an aneurysm of the arterial wall. WHO statistics state the fact that among other cerebrovascular accidents, hemorrhagic strokes associated with hemorrhage from a ruptured protrusion of the vessel wall take first place.

In total, stroke occurs in 1.5-2% of the adult population and practically leads to disability of the patient. In especially severe cases, the resulting hematoma causes irreparable damage to brain tissue and leads to the death of the patient.

Signs

Any disturbances in blood flow in the meningeal arteries lead to a sharp deterioration in a person’s health. With hemodynamic disturbances and the development of ischemia in the arteries, symptoms arise as pathology develops in the tissues supplied with blood through the meningeal vessels. In the event of a rupture of an aneurysm or acute infectious damage to the arterial walls, signs of pathology appear suddenly and quickly intensify.

The resulting hemorrhage under the dura mater is expressed by the following symptoms:

1. sharp and very severe headache in the parietal or frontal region, accompanied by uncontrollable vomiting;
2. dizziness with loss of the ability to maintain a vertical position;
3. disruption of the functioning of the hearing organs, ringing and loud noise appear in one ear;
4. There may be a partial speech disorder, the tongue is twisted;
5. heartbeat intensifies and becomes more frequent;
6. Fainting and sometimes coma may occur.

The presence of inflammatory processes on the walls of the arteries is often accompanied by hyperthermia and chills. Treatment should begin immediately when these symptoms appear, and an accurate examination of the patient is required to select the most effective method.

Diagnostics

Recognizing the occurrence of pathology in the meningeal vessels by analyzing the symptoms that have arisen is quite difficult, and often simply impossible. The signs of a developing blood flow disorder in the cerebral arteries are very similar to the symptoms of other diseases. To identify disorders and make an accurate diagnosis, instrumental diagnostic tools will help, giving a complete picture of the pathology clinic. In most cases, examination of the condition of the meningeal arteries is carried out using techniques such as:

• Transcranial Dopplerography. This ultrasound method makes it possible to obtain accurate information about the state of the circulatory system located in the intracranial space. Using TCD equipment, the doctor visually monitors the direction of blood movement through the vessels and has the opportunity to see the speed of its flow. The method allows you to identify stenosis of arterial walls, the degree of narrowing of the lumen between the vascular walls
• Magnetic resonance imaging. It is the most sensitive and accurate method for diagnosing meningeal arteries. With its help, even the most minor disorders of the cerebral vascular system and surrounding tissues will not go unnoticed by the doctor. Allows you to identify pathologies at the earliest stages of development and in the chronic and subacute course of the disease
• CT scan. Studying graphic images of areas along the meningeal arteries, made using a computed tomograph, the doctor identifies the location of pathologies in the vessels, the presence of hematomas, sclerotic formations on the walls. To study the condition of such small vessels as meningeal branches, the best result is obtained by converting the picture into a 3D color image
• Angiography. It is the most common way to assess the level of blood flow and measure its speed in individual branches of the cerebral vessels. It is based on the introduction of special tinting preparations into the bloodstream and subsequent radiography or ultrasound diagnostics. Contraindicated for use in patients who are intolerant to certain medications, in particular medications containing iodine.

The presence of inflammatory processes on the walls of the arteries and in the tissues that feed them is determined by a biochemical blood test. An increased level of leukocytes, in this case, will indicate an existing infectious lesion.

Treatment

After studying the diagnostic results, the doctor selects and prescribes the most effective and efficient method of helping the patient. This can be conservative treatment methods based on taking medications and undergoing treatment sessions in a physiotherapy room. In special cases, a microsurgical operation is performed, in which the doctor quickly eliminates the causes of insufficient blood supply to the dura mater and hematomas.

For drug treatment, the doctor prescribes the following medications:

• hemodynamic stimulating drugs;
• medications that prevent blood clots;
• agents that restore blood biochemistry;
• vitamin complexes.

Physiotherapeutic measures carried out after the main symptoms have been relieved include:

• exposure of the affected area to low UHF currents;
• ultraviolet irradiation of the affected area;
• application of applications using active drugs.

In case of unsatisfactory results of conservative treatment methods or if there is a threat to the patient’s life due to aneurysm rupture, a surgical operation can be performed, which consists of the following stages:

1. opening of the skull and dura mater;
2. elimination of the lesion;
3. closure of a surgical wound.

After surgical treatment, the patient undergoes rehabilitation stages in the hospital and then on an outpatient basis. During the recovery period, the patient is prescribed a course of medication, physiotherapy and physical therapy sessions.

It is important to remember that the consequences of a hemorrhagic stroke are caused by bleeding inside the meninges. It cannot be completely eliminated. The patient will need to follow the doctor’s recommendations for life and undergo regular preventive examinations.

Prevention

The occurrence of repeated manifestations of blood flow disturbances along the branches of the meningeal vascular system can be prevented by applying preventive measures recommended by a specialist. The goal of prevention is to exclude the occurrence of pathologies in the meningeal arteries and surrounding tissues. To do this you will need to do the following:

• undergo regular preventive examination of the condition of blood vessels, especially this procedure is mandatory for patients with existing congenital vascular pathologies;
• follow the regimen prescribed by the attending doctor;
• normalize night sleep, avoid stressful life situations;
• break with existing bad habits;
• maintain a healthy diet and monitor your own body weight;
• take timely measures to treat acute infections.

By following these rules, the patient will be able to avoid the occurrence of crisis exacerbations of pathologies of the meningeal arteries and maintain normal health. If the first signs of deterioration in cerebral circulation appear, the patient should immediately visit his doctor.