EndS: ln the middle cranial fossa. lt divides into anterior & posterior divisions: * Anterior Division . Directed upwards & forwards towards the pterion, grooving the greater wing of sphenoid. . Then passes upwards & backwards crossing to motor & sensory areas of the brain, towards a point 1cm behind corona[ suture, grooving the parietal bone.

 

- They are usually embedded in the back of the false capsule (rarely in the

substance of the gland).

- Superior parathyroid is more constant in position (posterior to thyroid &

above inferior thyroid artery).

- lnferior parathyroid may rarely be located in superior mediastinum.

The pituitary gland, or hypophysis, is an endocrine gland about the size of a pea and

weighing 0.5 g. lt is a protrusion of the bottom of the hypothalamus at the base of the

brain, and rests in a small, bony cavity (sella turcica) covered by a dural fold

(diaphragma sellae). The pituitary fossa, in which the pituitary gland sits, is situated in the

sphenoid bone in the middle cranial fossa at the base of the brain.

I HEAD & NECK

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- The Rt. is a branch of the

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- The Lt. is a branch of the

aortic arch.

Course & relations:

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Each common carotid artery

enters the neck behind the

sterno-clavicu Iar joi nt.

It ascends inside the carotid

sheath, medial to the internal

jugular vein & between them

is the vagus nerve.

is crossed antero-laterally by

omohyoid & sternomastoid

muscle.

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End$l at the level of the upper

border of thyroid cartilage (between

Co & C+) by dividing into external & internal carotid arteries.

Brachiocephalic bunk

Expogu re

o Median sternotomy incision is continued along the anterior border of sternomastoid to the tip of the mastoid process or it is commenced in the neck.

o The incision is carried down through SC tissue & platysma. After division of

external jugular vein, the cervical fascia is opened along the anterior border of

sternomastoid which is retracted laterally to expose the carotid artery.

HrAD & NrCK I

Co u rse

- From the common carotid artery, passes in the neck inside carotid sheath

without giving any branches.

- lt then enters carotid canal in the skull, emerges in the upper part of foramen

lacerum, passes in cavernous sinus & ends in the circle of Willis.

- lt is separated from the external carotid by styloid process & structures attached

to it. A Ar*erlor aolemnhetlno

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B ra n Ch es : lt is the principal artery of the brain

1) Ophthalmic artery(it gives lacrimal & supraorbital As & ends by

supratrochlear A & dorsal nasal A which anastomoses with facial A).

2) Anterior & middle cerebral arteries.

3) Posterior communicating & anterior choroid arteries.

Surqical ImportanCe: A-V fistula between ICA & the cavernous sinus leading

to throbbing pain and pulsating proptosis.

fnrAo a NECK

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EndSl At the level of neck of mandible inside parotid gland by dividing into superficial

temporal & maxillary arteries.

Branches

1) From its medial aspect:. ascendlng pharyngeal artery.

2) From its anterior aspect:

. Superior thyroid artery.

. Lingual artery.

. Facial artery.

3) From its posterior aspect:

. Occipital artery.

. Posterior Auricular artery (at the level of the upper border of posterior

belly of digastric muscle).

4) 2 terminal branches:

. Superficial temporal artery @alled anesthetist's artery, as if ts

used o count pulse by anesthefisfs).

. Maxillary artery.

Su rqica I Irn po!:tamee;

ln malignant goiter, obstruction of the carotid can occur. This causes loss or

weakening of pulsation of the s rperficial temporal artery (Sign of Berry).

Goelocordcal

1-{rAr}& NreKI

BeqinS: from the front of thp external carotid artery, at the level of the fip of greater

norn or nwid bone.

Pa rts: {F

1) First Part

- Makes a loop above tip of hyoid bone & is crossed by hypoglossal n.

- Branch ) Supra-hyoid artery.

2) Second Part

- Passes above hyoid bone & deep to hyoglossus & hypoglossal n.

- Branches> 2- 3 dorsal lingual arteries.

3) Third Part

Passes deep to anterior border of hyoglossus & is crossed by hypoglossal

& lingual nerves.

Branches ) Artery to sublingual gland.

Ends by forming profunda artery of tongue which is separated from

mucosa of lower surface of tongue by its vein.

Esernal

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- -xGenirglo+sus

Hyogloo*ur Subllngualadery

Lebrrlvlrw Dorsal lhgual arlo{iss $ubm€{rlalarlery

Surqical Importance:

- During tongue bleeding, we should pull tongue outwards as this causes

compression on the lingual a. against the greater horn of hyoid bone.

- lf it is mandatory to tigite the lingual a, ltls better to ligate the 2nd part after cutting

hyoglossus m. because the 1't part is related to hypoglossal nerve.

BeginS: from the front of ECA above the lingual artery.

Cou rse:

*. lt ascends deep to the posterior belly of digastric & stylohyoid m. to reach the

tF digastric triangle & runs deep to the submandibular gland.

. lt enters the face at the antero-inferior angle of the masseter and then it

ascends in the face to reach the angle of the eye.

Surqical imoortance

. Should be double ligated during operation for submandibular salivary gland.

1. Angular A. (ECA) with branches of ophthalmic A (lCA).

2. Superficial temporal A. (ECA) with supraorbital & supratrochlear As (lCA).

Beqins: *

Aranch of the maxillary artery deep to lateral pterygoid.#

Co u rse;

o Passes between the two roots of auriculo-temporal nerve, and then enters the

middle cranial fossa by passing in foramen spinosum with nervus spinosus.

. ln the cranial cavity the artery & its branches lie extra-dural.

EndS: ln the middle cranial fossa. lt divides into anterior & posterior divisions:

* Anterior Division

. Directed upwards & forwards towards the pterion, grooving the greater

wing of sphenoid.

. Then passes upwards & backwards crossing to motor & sensory areas of

the brain, towards a point 1cm behind corona[ suture, grooving the parietal

bone.

. It is the artery of extra-dural hemorrhage.

NlTl p\rrion is H-shaped suture between frontal, parietal, temporal & sphenoid bone. tt is

4 cm above mid-zygomatic arch.

* Posterior Division

. Passes upwards & backwards towards the lambda grooving the temporal

& parietal bones. Mll l|passes at the point of meeting of a horizontal tine drawn from upper border of orbit

& a vertical line drawn from post. border of mastoid process.

HHAD & NTCK I