Anatomy - Dolichoarteriopathy – Severe kinking with luminal narrowing type I/III of the right internal carotid artery

Anatomy Perioperative management Technique Complications Evidence Total Video

Common carotid artery

Origin	Left: Aortic arch Right: Brachiocephalic trunk
Course	Ascends posterior to the sternocleidomastoid muscle Within the carotid sheath of cervical fascia
Bifurcation	Carotid bifurcation (bifurcatio carotidis): Bifurcation into external and internal carotid artery
Supplies	1. Internal carotid artery Brain Eye Forehead Anterior nasal cavity 2. External carotid artery Extracranial structures on head and neck

Internal carotid artery

Origin

Branch of the common carotid artery (bifurcatio carotidis)

Caudocephalad course

1. Cervical portion

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

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

3. Cerebral portion

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 circle 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 is quite variant in terms of branch caliber and anastomoses (hypoplasia of some branches and even agenesis in some segments). This is clinically important for the collateral blood supply in stenoses.

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 glands 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 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 artery of face Face Zygomatico-orbital artery Lateral corner of the eye Middle temporal artery Temporal muscle R. frontalis Scalp
Maxillary artery	Mandibular part	Deep auricular artery Temporomandibular joint External auditory canal Inferior tympanic artery Tympanic cavity Inferior alveolar artery Teeth Mandibula R. mylohyoideus: Floor of mouth R. mentalis: Chin Middle meningeal artery Meninges
	Pterygoid part	Masseteric artery Masseter muscle Rr. pterygoidei Pterygoid muscles Deep temporal arteries Temporal muscle Buccal artery Buccinator muscle
	Pterygopalatine part	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 system in t

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Common carotid artery
Internal carotid artery
External carotid artery
Venous system
Lymphatics
Nervous system