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

vascular surgery
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  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 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

  2. 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.

  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 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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