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Anatomy - Carotid artery shortening for high-grade kinking stenosis of the right internal carotid artery, Type I/III

  1. Common carotid artery

    Common carotid artery
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    Origin

    • Left: aortic arch
    • Right: brachiocephalic trunk

    Course

    • Ascends posterior to the sternocleidomastoid muscle
    • Within the carotid sheath (vagina carotica)

    Bifurcation

    • Carotid bifurcation (bifurcatio carotidis): division into the internal and external carotid artery

    Supplies

    1. Internal carotid artery

    • Brain
    • Eye
    • Forehead
    • Anterior nasal cavity

    2. External carotid artery

    • Extracranial structures of the head and neck
  2. Internal carotid artery

    Origin

    • Branch of the common carotid artery (bifurcatio carotidis)

    Caudocephalad course

    1. Cervical portion (pars cervicalis)

    • Segment between the origin of the common carotid artery and the base of the skull
    • Enters the cranial cavity via the carotid canal
    • Does not give off any branches

    2. Petrosal portion (pars petrosa)

    • Courses in the petrosal portion of the temporal bone
    • Gives off smaller branches to the tympanic cavity and pterygoid canal

    3. Cerebral portion (pars cerebralis)

    • Courses in the subarachnoid space
    • Perforates the dura mater
    • Branches into the anterior and middle cerebral arteries
    • The anterior cerebral artery communicates with its contralateral counterpart via the anterior communicating artery

    The circulus arteriosus cerebri (of Willis) is an arterial vascular ring at the base of the brain and supplies blood to the brain. It comprises the following vessels – from anterior to posterior:

    • Anterior communicating artery (azygous)
    • Anterior cerebral artery (left and right)
    • Internal carotid artery (left and right) and its direct extension, the middle cerebral artery
    • Posterior communicating artery (left and right)
    • Posterior cerebral artery (left and right; both arising from the basilar artery)

    However, the circle of Willis shows numerous variants in terms of branch caliber and anastomoses (hypoplasia of individual branches or even agenesis of some segments). This is clinically relevant for the collateral blood supply in stenoses.

  3. External carotid artery

    The region supplied by the external carotid artery can be divided into four groups according to their localization: anterior, middle, and posterior group and terminal branches.

    1. Anterior group

    Branches (cranial -> caudal)

    Branches/Rami

    Supply

    Thyroid artery

    • R. infrahyoideus
    • R. cricothyreoideus
    • R. sternocleidomastoideus
    • Homonymous muscles
    • Superior laryngeal artery
    • Laryngeal interior
    • Rr. glandulares
    • Thyroid

    Lingual artery

    • R. suprahyoideus
    • Hyoid
    • Rr. dorsales linguae
    • Dorsum of tongue
    • Sublingual artery
    • Sublingual gland
    • Deep lingual artery
    • Tip of tongue

    Facial artery

    • Ascending palatine artery
    • Soft palate
    • Tonsils
    • Pharynx
    • Submental artery
    • Submandibular gland
    • Suprahyoid muscles
    • Inferior labial artery
    • Lower lip
    • Superior labial artery
    • Upper lip
    • Angular artery
    • Medial angle of eye
    2. Middle group

    Branches (cranial -> caudal)

    Branches/rami

    Supply

    Ascending pharyngeal artery

    • Rr. pharyngeales
    • Pharynx
    • Inferior tympanic artery
    • Tympanic cavity
    • Posterior meningeal artery
    • Dura mater
    3. Posterior group

    Branches (cranial -> caudal)

    Branches/rami

    Supply

    Occipital artery

    • R. mastoideus
    • Mastoid cells
    • Rr. occipitales
    • Occipital region
    • R. meningeus
    • Dura mater

    Posterior auricular artery

    • R. auricularis
    • External ear
    • R. occipitalis
    • Occipital region
    • Stylomastoid artery
    • Facial nerve
    • Tympanic cavity
    • Mastoid cells
    • Posterior tympanic artery
    • Tympanic cavity
    • Mastoid cells
    • Rr. pharyngeales
    • Pharynx
    • R. parotideus
    • Parotid gland
    4. Terminal branches

    Branches (cranial -> caudal)

    Supply

    Superficial temporal artery

    • Transverse facial artery
    • Face
    • Zygomatico-orbital artery
    • Lateral angle of eye
    • Middle temporal artery
    • Temporal muscle
    • R. frontalis
    • Scalp

    Maxillary artery

    Pars mandibularis

    • Deep auricular artery
    • Temporomandibular joint
    • External auditory canal
    • Anterior tympanic artery
    • Tympanic cavity
    • Inferior alveolar artery
    • Teeth
    • Mandibula
    • R. mylohyoideus: floor of mouth
    • R. mentalis: chin
    • Middle meningeal artery
    • Meninges

    Pars pterygoidea

    • Masseteric artery
    • Masseter muscle
    • Rr. pterygoidei
    • Pterygoid muscles
    • Deep temporal arteries
    • Temporal muscle
    • Buccal artery
    • Buccinator muscle

    Pars pterygopalatina

    • Posterior superior alveolar artery
    • Teeth
    • Maxilla
    • Infraorbital artery
    • Maxilla
    • Descending palatine artery
    • Tonsils
    • Soft palate
    • Sphenopalatine artery
    • Nasal cavity
    • Nasal septum
    • Artery of pterygoid canal
    • Pharynx
    • Tympanic cavity
Venous system

The brachiocephalic vein is formed by the confluence of the superficial and deep venous systems at

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