Neck Blood Vessels: Arteries

• The presentation is about blood vessels of the neck by Dr. Ramya Rathan, Asst Professor of Antatomy on March 1, 2025

Learning Objectives

• Describe the beginning, end, course, and branches of arteries and veins of the neck

Major Arteries of the Neck

• The major arteries are the common carotid artery (CCA) & subclavian artery
• The CCA branches are the internal carotid artery (ICA) and the external carotid artery (ECA)
• The ICA supplies the brain
• The ECA supplies the neck face and scalp
• Both ECA and the Subclavian give branches in the neck

Carotid System

• Branch of the brachiocephalic trunk, begins in the neck behind the right sternoclavicular joint
• The left CCA branches from the arch of the aorta and begins in the thorax behind the manubrium sterni
• The left CCA ascends to the back of the left sternoclavicular joint and enters the neck
• In the neck, both CCAs extend upward and laterally within the carotid sheath from the back of the sternoclavicular joint
• At the upper border of the lamina of the thyroid cartilage, the CCA divides into the external and internal carotid arteries in the carotid triangle between the C3 and C4 vertebrae

External Carotid Artery

• One of the terminal branches of the CCA
• Main artery of supply to the neck and the face
• It begins in the carotid triangle at the upper border of the thyroid cartilage between C3 and C4 vertebrae
• Runs upwards, slightly backwards, and laterally and terminates behind the neck of the mandible, within the substance of the parotid gland into the maxillary and superficial temporal arteries
• In the carotid triangle, it is overlapped by the sternomastoid muscle
• The ECA is anteromedial to the ICA in its lower part and anterolateral to the ICA in its upper part
• The ECA has 8 branches: superior thyroid, lingual, facial, occipital, posterior auricular, ascending pharyngeal, maxillary, and superficial temporal arteries

Subclavian Artery

• Right side origin is the brachiocephalic trunk
• Left side origin is the arch of the aorta
• Its course travels from the sternoclavicular joint to the outer border of the first rib
• It is divided into 3 parts by the scalenus anterior muscle
  • 1st medial border of the muscle
  • 2nd behind the muscle
  • 3rd lateral to the muscle, extends till the outer border of the first rib
• It terminates at the outer border of the first rib, continuing as the axillary artery
• The subclavian artery branches into the thyrocervical, costocervical, vertebral, and dorsal scapular arteries
  • internal thoracic arteries located in the thorax

Vertebral Artery

• Branches off the subclavian artery and arises from the upper surface of the first part of the subclavian artery
• Artery passes upward through the foramina transversaria of the upper six cervical vertebrae and enters the cranial cavity through the foramen magnum
• It terminates at the lower border of the pons where it unites with the artery from the opposite side to form the basilar artery
  • 1st Part: From origin to foramen transversarium of C6 vertebra
  • 2nd Part: in foramen transversaria of C6 to C1 vertebrae
  • 3rd Part: in sub occipital triangle
  • 4th Part: pierces the dura mater and arachnoid matters and passes through foramen magnum

External Jugular Vein

• Formed below the angle of the mandible, within the parotid gland, from the posterior division of the retromandibular vein and the posterior auricular vein
• Descends across the sternocleidomastoid muscle and lies beneath the platysma muscle
• Drains the exterior cranium and the deep parts of the face
• Drains into the subclavian vein
• Tributaries include posterior auricular and retromandibular (formative tributaries), posterior external jugular, anterior jugular, suprascapular vein, and transverse cervical vein

Anterior Jugular Vein

• Begins inferior to the chin by the union of superficial veins from the submandibular region
• Descends anterior in the neck, closing to the midline
• Superior to the sternum where it combines with the contralateral vessel through the Jugular arch and drains to the external jugular vein
• Occasionally drains directly to the Subclavian vein

Internal Jugular Vein (IJV)

• Formed as a continuation of the sigmoid sinus in the jugular foramen (posterior cranial fossa)
• Passes downward through the neck within the carotid sheath
• Terminates behind the medial end of the clavicle by uniting with the subclavian vein to then form the brachiocephalic vein
• It has superior and inferior bulbs which are dilations near the origin and termination of the vein, respectively
• Drains the brain, superficial part of the face and neck
• Tributaries include the inferior petrosal sinus, pharyngeal veins, and common facial vein
  • The inferior petrosal sinus leaves the skull through the anterior part of the jugular foramen, and joins the superior bulb of the internal jugular vein
  • The pharyngeal veins originate from the pharyngeal plexus
    • The common facial vein is formed by the union of the facial vein and the anterior division of the retromandibular vein
• Other tributaries are lingual, superior thyroid, middle thyroid, and occipital veins

Subclavian Vein

• Continuation of the axillary vein
• Begins at the outer border of the first rib and ends at the medial border of the scalenus anterior
• Joins the internal jugular vein to form the junction of the brachiocephalic vein
• Tributaries include the external jugular vein, dorsal scapular vein, and thoracic duct on the left side
• Right lymphatic duct on the right side with an occasional anterior jugular vein