Anatomy of the Vessels and Nerves of the Head and Neck (Angioneurolohy) - Chornokulskyi S.T. 2009

Arteries of the Head and Neck. Vessels of the Systemic Circulation
Internal Carotid Artery

(a. carotis interna) [Fig. 12, 13, 14 a]

It is a direct continuation of the common carotid artery. The initial part of the a. carotis interna lies laterally and posteriorly to the External Carotid Artery, forming the first curve.

According to its topography, it is divided into 4 parts:

— cervical part (pars cervicalis);

— petrous part (pars petrosa) within the canalis caroticus;

— cavernous part (pars cavernosa) within the cavernous sinus;

— cerebral part (pars cerebralis) at the level of the optic canal (Fig. 14 a)

Each part of the a. carotis interna exhibits a curve, presenting an overall tortuous course, which is considered an adaptation to dampen the pulse wave (damper function). The cervical part gives off no branches and is a component of the neurovascular bundle of the neck.

Branches of the internal carotid artery:

✵ In the pars petrosa:

1 — caroticotympanic Arteries (aa. caroticotympanicae) pass into the tympanic cavity through the corresponding canaliculi, completing the list of arteries supplying the walls of the tympanic cavity.

✵ In the pars cavernosa:

2 — inferior hypophysial artery (a. hypophysialis inferior) (Fig. 23);

3 — tentorial branches (rr. tentorii);

4 — meningeal branch (r. meningeus).

✵ In the pars cerebralis [Fig. 13 (18)].

I (5). Ophthalmic artery (a. ophthalmica) (14 a) enters the Orbit together with the Optic nerve through the optic canal. The artery runs along the medial wall of the orbit, giving off the following branches:

6 — posterior ethmoidal artery (a. ethmoidalis posterior), reaching the mucosa of the posterior ethmoidal Cells through the foramen of the same name;

7 — anterior ethmoidal artery (a. ethmoidalis anterior), which passes through the corresponding foramen into the anterior cranial fossa, where it gives off the anterior meningeal branch (r. meningeus anterior) running through the cribriform plate to the mucosa of the ethmoidal cells, lateral wall, and nasal septum;

8 — supratrochlear artery (a. supratrochlearis), running through the frontal notch to the Muscles and Skin of the forehead, while the a. supraorbitalis passes here through the f. supraorbitale;

9 — dorsal nasal artery (a. dorsalis nasi), descending along the dorsum of the Nose, where it anastomoses with the angular artery (from the a. facialis);

10 — medial palpebral arteries (aa. palpebrales mediales), which anastomose with the lateral palpebral arteries, forming the superior and inferior palpebral arches (arcus palpebrales superior et inferior).

Along the lateral wall of the orbit, it branches into:

11 — lacrimal artery (a. lacrimalis) supplying the lacrimal gland and also giving off

12 — lateral palpebral arteries (aa. palpebrales laterales).

Middle group of branches of the ophthalmic artery:

13 — posterior long and short ciliary arteries (aa. ciliares posteriores longae et breves) supplying the choroid of the Eyeball;

14 — central artery of the retina (a. centralis retinae) reaching the retina by piercing the substance of the optic nerve along its length;

15 — anterior ciliary arteries (aa. ciliares anteriores), which give off:

✵ episcleral arteries (aa. episclerales) and

✵ anterior conjunctival arteries (aa. conjunctivales anteriores) and

✵ muscular arteries (aa. musculares) — supplying the superior group of extraocular muscles.

II. Anterior cerebral artery (a. cerebri anterior) (Fig. 17) branches off above the ophthalmic artery, converges with the corresponding contralateral branch, and anastomoses with it via the anterior communicating artery (a. communicans anterior). The a. cerebri anterior curves around the corpus callosum within the sulcus corporis callosi, reaching the occipital lobe. It supplies the Medial surface of the frontal, parietal, and partly the occipital lobes, the olfactory bulbs, tracts, striatum, and internal capsule. Cortical (rr. corticales) and central (rr. centrales) branches pass to the Brain.

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Fig. 14 a. Topographic relations of the internal carotid artery, cavernous sinus, ophthalmic and maxillary nerves (cranial nerve V), and Cranial Nerves III, IV, and VI (right side):

1 - ophthalmic nerve (n. ophthalmicus);

2 - ophthalmic artery (a. ophthalmica);

3, 23 - Trochlear nerve (n. trochlearis);

4 - lacrimal nerve (n. lacrimalis);

5 - frontal nerve (n. frontalis);

6, 24 - Oculomotor nerve (n. oculomotorius);

6 - r. superior;

7 - nasociliary nerve (n. nasociliaris);

8, 22 - Abducens nerve (n. abducens);

9 - oculomotor nerve, inferior branch (n. oculomotorius - r. inferior);

10 - orbital branches (rr. orbitales);

11 - ganglionic branches (rr. ganglionares);

12 - posterior superior alveolar nerves (nn. alveolares superiores posteriores);

13 - pterygopalatine ganglion (ganglion pterygopalatinum);

14 - maxillary nerve (n. maxillaris);

15 - nerve of pterygoid canal (n. canalis pterygoidei);

16 - mandibular nerve (n. mandibularis);

17 - internal carotid artery (a. carotis interna);

18 - tympanic nerve (n. tympanicus);

19 - geniculate ganglion (ganglion geniculatum);

20 - greater petrosal nerve (n. petrosus major);

21 - trigeminal ganglion (ganglion trigeminale)

III. Middle cerebral artery (a. cerebri media) is the largest branch of the a. carotis interna. It runs towards the lateral sulcus of the brain, supplying the insula, basal nuclei, and most of the cortex on the Superolateral surface of the cerebral hemisphere via its cortical and central branches.

IV. Posterior communicating artery (a. communicans posterior) runs toward the Pons and, near its anterior border, joins the posterior cerebral artery (a branch of the Basilar artery originating from the Subclavian Artery system), thereby completing the cerebral arterial circle (circulus arteriosus cerebri [Willisii]) (Fig. 17).

V. Anterior choroidal artery (a. choroidea anterior) penetrates the walls of the inferior horn of the lateral ventricle and subsequently the Third ventricle. Branches to the choroid plexuses of the lateral and third ventricles (rr. choroidei ventriculi lateralis et tertii) form their choroid plexuses, which produce CEREBROSPINAL FLUID. The anterior choroidal artery also supplies the optic tract, tuber cinereum, basal nuclei, internal capsule, substantia nigra, and the red Nucleus of the Midbrain.

The superior hypophysial artery (a. hypophysialis superior) supplying the hypophysis and Hypothalamus also branches off the cerebral part of the a. carotis interna.