Anatomy - Left carotid bifurcation eversion endarterectomy (EEA) in symptomatic carotid bifurcation stenosis – Vascular Surgery

Origin

• Left: aortic arch
• Right: brachiocephalic trunk

Course

• Ascends posteriad to the sternocleidomastoid muscle
• Within the carotid sheath

Division

• Carotid bifurcation: divides into internal and external carotid artery

Distribution

1. Internal carotid artery

• Brain
• Eye
• Forehead
• Anterior nasal cavity

2. External carotid artery

• Extracranial structures of the head and neck

Origin

• Branch of the common carotid artery (carotid bifurcation)

Caudocephalad course

1. Cervical part

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

2. Petrous part

• Courses in the petrous portion of the temporal bone
• Minor branches to the tympanic cavity and pterygoid canal

3. Cerebral part

• Courses in the subarachnoid space
• Passes through the dura mater
• Divides into anterior and middle cerebral artery
• Anterior cerebral artery communicates via the anterior communicating artery with the contralateral anterior cerebral artery

Branches (cranial -→ caudal)

Branches

Area supplied

Thyroid artery

• Infrahyoid branch
• Cricothyreoid branch
• Sternocleidomastoid branch

• Homonymous muscles

• Superior laryngeal artery

• Inner larynx

• Glandular branches

• Thyroid gland

Lingual artery

• Suprahyoid branch

• Hyoid bone

• Dorsal lingual branches

• 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 canthus

Branches (cranial -→ caudal)

Branches

Area supplied

Ascending pharyngeal artery

• Pharyngeal branches

• Pharynx

• Inferior tympanic artery

• Tympanic cavity

• Posterior meningeal artery

• Dura mater

Branches (cranial -→ caudal)

Branches

Area supplied

Occipital artery

• Mastoid branch

• Mastoid cells

• Occipital branches

• Occipital region

• Meningeal branch

• Dura mater

Posterior auricular artery

• Auricular branch

• External ear

• Occipital branch

• Occipital region

• Stylomastoid artery

• Facial nerve
• Tympanic cavity
• Mastoid cells

• Posterior tympanic arteries

• Tympanic cavity
• Mastoid cells

• Pharyngeal branches

• Pharynx

• Parotid branch

• Parotid gland

• Parotid branch

• Parotid gland

Branches (cranial -→ caudal)

Area supplied

Superficial temporal artery

• Transverse facial artery

• Face

• Zygomatico-orbital artery

• Lateral canthus

• Middle temporal artery

• Temporalis muscle

• Frontal branch

• Scalp

Maxillary artery

Mandibular part

• Deep auricular artery

• Temporomandibular joint
• External acoustic meatus

• Anterior tympanic artery

• Tympanic cavity

• Inferior alveolar artery

• Teeth
• Mandibula
• Mylohyoid branch: floor of mouth
• Mental branch: chin

• Middle meningeal artery

• Meninges

Pterygoid part

• Masseteric artery

• Masseter muscle

• Pterygoid branches

• Pterygoid muscles

• Deep temporal arteries

• Temporalis 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