Arterias Carótidas: Cabeza y Cuello

• The document discusses the arteries of the head and neck, focusing on the carotid arteries and their branches.

Aortic Branches to the Head and Neck

• The brachiocephalic trunk is the largest vessel arising from the aortic arch.
• It originates where the ascending aorta transitions to the horizontal portion.
• It terminates behind the right sternoclavicular joint, dividing into the right subclavian and right common carotid arteries.
• The brachiocephalic trunk is slightly oblique, positioned in front of the innominate vein, sternum, left brachiocephalic vein, and the origins of the sternohyoid and sternothyroid muscles.
• Cardiac filaments of the vagus nerve descend along it.
• The trachea lies behind it, with the right lung and mediastinal pleura positioned outward.
• The left common carotid artery's origin is located inward, separating as it ascends.

Common Carotid Artery

• The common carotid artery supplies nutrients to the neck and head.
• There are two common carotid arteries, one on each side, with differing origins.
• The right common carotid originates from the brachiocephalic trunk alongside the subclavian artery.
• The left common carotid arises directly from the aortic arch.
• The different origins cause variations in trajectory and length.
• The left common carotid has an intrathoracic segment absent in the right.
• From the base of the neck, the common carotid ascends vertically, covered by the sternocleidomastoid muscle.
• Together with its contralateral counterpart, it forms the external limits of the central cervical space.
• It reaches the superior border of the thyroid cartilage of the larynx and divides into the external and internal carotid arteries.
• The right common carotid has a straight course, while the left initially curves upward and outward before straightening.
• The thoracic portion of the left common carotid occupies the space between the brachiocephalic trunk, which runs upward and to the right, and the left subclavian, which originates from the horizontal part of the arch, behind and to the left.
• The vessel is covered anteriorly by the left brachiocephalic vein and superior cardiac nerves of the vagus nerve on the same side.
• Posteriorly, it corresponds to the vertebral costal canal and the thoracic duct, and to the left subclavian artery.
• The trachea and the brachiocephalic artery lie to the right.
• Behind it lies the esophagus, the tracheoesophageal groove, and the left recurrent laryngeal nerve.
• The mediastinal pleura with the phrenic and vagus nerves is on the left, separating the vessel from the inner surface of the left lung.
• Above the thorax, the two common carotids share identical relationships.
• They form part of the neurovascular bundle with the internal jugular vein laterally and the vagus nerve attached at the posterior dihedral angle.
• These three structures are enclosed by the vascular sheath originating from the middle cervical aponeurosis.
• Relationships of the subclavian artery vary as the right branches off the trunk at an open angle upwards, while the left is positioned outward and behind.
• Anteriorly, on both sides, corresponds the the space formed between the two inferior insertion bundles of the sternocleidomastoid muscle.
• Inward is the trachea, somewhat closer to the right common carotid than the left.
• Posterior to the left common carotid, it rests on the anterior scalene muscle.
• The neurovascular bundle in the neck is located on each side of median visceral plane, within a triangular prismatic space known as the carotid region, named for the carotid artery's prominence there.
• This space's walls are posterior (prevertebral plane and scalene muscles, covered by aponeuroses), internal (trachea and esophagus with recurrent laryngeal nerves), and antero-external (platysma muscle).

Carotid Sheath

• The carotid sheath contains the internal jugular vein laterally, the common carotid artery medially, and the vagus nerve posteriorly.
• The presence of the omohyoid muscle divides the carotid into two portions: a deeper, inaccessible inferior portion and a more accessible superior portion.
• The superior portion contains the thyroid body, thyroid veins, the hypoglossal arch, upper cardiac nerves from the vagus and sympathetic nerves, and lymph nodes.
• Throughout its course, the common carotid maintains a uniform cylindrical caliber, except at its terminal portion where it dilates to form the carotid bulb or sinus.
• At the bifurcation point, posteriorly, there is a nervous formation of vegetative significance known as the retrocarotid corpuscle.
• The common carotid only gives off its two terminal branches.

External Carotid Artery

• The external carotid artery supplies nutritive blood to the neck and the corresponding half of the head in its extracranial and facial portion.
• This excludes the endocranial territory and orbital contents supplied by the internal carotid.
• It originates at the superior border of the thyroid cartilage, ascends outward, crosses the angle of the mandible internally, enters the parotid compartment, and advances to the neck of the mandibular condyle.
• It terminates by dividing into its two terminal branches: the superficial temporal and internal maxillary arteries.
• It emits a series of collateral branches destined to irrigate specific areas of the neck and face.
• The study of the external carotid artery is classically split into its cervical and cephalic portions according to its location.
• Superiorly, the external carotid has relationships within the carotid triangle.

Farabeuf's Triangle

• The carotid region, an area where the arteries are accompanied by veins and nerves of special interest.
• Farabeuf's triangle is defined by the internal jugular vein laterally, the hypoglossal nerve superiorly, and the collecting trunk of the thyrolinguofacial vein.
• As the hypoglossal nerve descends, it gives off branches to join the descending cervical plexus, above the intermediate tendon of the omohyoid muscle.
• In the area of Farabeuf's triangle, a lymph node is found that obscures the external carotid towards the front and inside.
• The dissection permits to see the external carotid artery which supplies its cervical branches.
• The internal carotid artery goes outwards and backwards and does not have any branches.
• The larger horn of the hyoid bone or the middle constrictor and the inferior constrictor of the pharynx are located in the internal neck region, and the posterior skeletal muscular wall remains the same.
• The cervical relations of the external carotid are identical to those of the internal carotid, which has the same course.
• Exiting Farabeuf's triangle, the two carotids cross externally to the posterior belly of the digastric that will follow towards its intermediate tendon.

External Carotid Branches

• The external carotid artery's branches are divided by their direction into three anterior, two posterior, and one internal.
• The anterior branches going from bottom to top include the superior thyroid, lingual and facial arteries.
• The posterior branches are the occipital and posterior auricular arteries and the internal branch is simply the inferior pharyngeal artery.
• The superior thyroid artery originates near the start of the external carotid and runs alongside the greater horn of the hyoid bone.
• It descends close to the larynx to reach the superior pole of the thyroid gland, where it is distributed.
• This superior thyroid artery ensures nutrition to the organs in its path, gives off its collateral branches, and supplies several muscles.
• These include a subhyoid branch to the infrahyoid muscles, a sternomastoid branch, a superior laryngeal branch, and an inferior laryngeal branch.

Lingual Artery

• The lingual artery originates above the facial artery, or sometimes via the common trunk.
• It pierces the lateral region of the pharynx near the hyoid and supplies the tongue.
• In this path it is covered by diagastric muscles, and also the hyoglossus and mylohyoid muscle.
• Relevant relationships exist near its origin and in the suprahyoid region with Berclard's angle and Pirogoff's triangle.
• In the floor of the mount it is located between the genioglossus and inferior lingual.
• Its cervical branches are the hyoid branch for the suprahyoid muscles and the dorsal lingual artery.
• The dorsal lingual ascends to the base of the tongue and distributes into pillar of the paladar.
• The sublingual artery enters the gland and divides into del frenillo and the incisive branches.
• The terminal branch is called ranina that reached to the tongue vertex.

Facial Artery

• The facial artery is an important vessel with a long path.
• It branches off the carotid's cervical portion, advances to the inner part of the orbit, then crosses the face diagonally.
• It gives many branches to the anatomical elements, both cervical and facial.
• First, it is located in the neck above the lingual, next to the side of the pharynx, it is housed in a channel offered by the submaxillary gland.
• From here it gives the submental branch that runs superficial, then it runs on the outside of the labial commissure.
• The distribution branches are divided into cervical and facial collaterals.
• The cervicals branches are the ascending palatine is a branch that rises along the amygdala.
• The facial artery issues the inferior masseteric branch, the inferior coronary, covers the orbicular.
• The coronary superior some times is connected with the front the facial.
• These superior forms the arterial circle whose characteristic is to be sinuous for the great mobility of the lips.
• The superior coronary artery emits a collateral ramite called from the subtabique, destined for this nose formation.

Occipital Artery

• The occipital artery follows the path of posterior diagastric to the nape region runs between the esplenio and perforates to the muscles.
• Afterwards it rises through the posterior part of the hair to the hair root and is divided.

Posterior Auricular Artery

• The posterior auricular artery advances vertically with common trunk for the surface, finishes in one front and posterior.

Inferior Pharyngeal Artery

• The inferior pharyngeal artery is close to the lateral side and ascends straight and transforms into the posterior meningeal artery
• The superficial temporal branch arises at the parotid gland and runs upwards.

Internal Maxillary Artery

• The internal maxillary artery has a deep path on the face and follows the inside to connect the elements on the 2 big facial cavities.

Branches of Internal Maxillary Artery

• From the terminal of the maxillary the branches that are divided among ascending, descending, front and and back are detailed.
• The ascending that they are tympanic destined to irrigate to the drum, middle membrane and temporal with destination endocraneal.
• The descendents are inferior dental, the smaller part of the inferior maxillary; masseteric, pterygoid and the for the muscles respective, bucal for the cheek, palatine superior that descends to the paladar vault.
• The front are alveolar as the uppers teeth are e infraorbitaria for the superficial the alveolar.
• The back are name for the where is destined.

Internal Carotid Artery

• It ascends upwards and inwards, then vertical following the area.
• It passes through the retroestileo area and penetrates the encefalo.
• arteria carótida interna forms with the jugular one carotico jugular trígono.
• The the carotida form two portions vertica e horizontal where with a venous set.
• There are differences in absence of collateral on his cervical and retropestileo trajeto that some authors the the primitiva is only the the the cráneo.

Opthalmic Artery

• It Goes to the orbit that passes along with the retina and crosses the optic and goes to to the inner part to go form a front branch.
• There are 11 Ramites that depend on of this course.

Circle of Willis

• It is detailed the is detail the conformation the circle.
• As well is detailed the arteries in form of polygon, passes to the lateral and is shorte with a transverse.