Artery meningeal middle. External carotid artery, its topography, branches and areas supplied by them with blood Accessory branch of the middle meningeal artery

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ARTERY

ARTERY Rabbi Moshe Ephraim, the grandson of the Baal Shem, was an opponent of the Polish Hasidim, because he heard that they mortify their flesh too harshly and destroy the image of God in themselves instead of making all parts of their body perfect and uniting them with the soul into one

The external carotid artery and its branches differ from the internal carotid artery, which penetrates into the main cavity of the skull, in that it supplies blood and oxygen to the parts of the head, as well as to the neck, which are outside. It is one of the 2 main branches of the carotid artery, it is separated from the common vessel in the triangle area near the upper edge of the thyroid cartilage.

This artery goes straight up in the form of a gyrus and is located closer to the middle of the passage of the internal vessel, then goes a little to the side. The external artery at its base is covered by the mastoid muscle, in the area of \u200b\u200bthe carotid triangle it is covered by the subcutaneous muscle and the cervical plate. Having reached the level of the lower jaw, it is completely divided into terminal small branches. The main external carotid artery has multiple branches in its path, extending in all directions.

Front branches

Several fairly large vessels belong to this impressive group. The anterior group of branches of the external carotid artery provides blood flow and promotes the development of organs that are derivatives of the so-called branchial arches, that is, the larynx, thyroid gland, face, tongue. There are three main arteries that branch off from the external common vessel. This scheme makes it possible for the blood supply to the whole organism and the supply of oxygen to its tissues.

Upper thyroid artery. It diverges from the main external vessel at its beginning in the region of the hyoid bone at the level of the horns and supplies blood to the parathyroid and thyroid glands, as well as the larynx through the superior artery and mastoid muscle.

On its way, it divides into the following side branches:

• The subhyoid branch follows to the nearest muscles, as well as towards the hyoid bone;
• The cricothyroid branch supplies blood to the same muscle of the same name, connects on the other side with a similar vessel;
• The superior laryngeal artery oxygenates and supplies blood to the lining of the larynx, epiglottis, and muscles.
• Lingual artery. This vessel branches off from the external carotid artery slightly above the superior thyroid vessel, approximately at the level of the hyoid bone, and passes further into the region of Pirogov's triangle. Then the artery reaches the thickness of the tongue from below. The lingual artery, although small, on its way also branches into the following small branches:
• The deep artery of the tongue is a large terminal branch of the lingual vessel. It rises up to the tongue and goes to its very tip, surrounded by the lower longitudinal muscle and the lingual muscle;
• The suprahyoid branch extends along the upper edge of the hyoid bone, supplying it with blood;
• The sublingual artery is located above the sublingual muscle, enriches the gums, mucous membrane, salivary gland with oxygen;
• The dorsal branches run upward from the hyoid vessel and pass under the hyoid muscle.
• Facial. It departs from the main vessel in the area of \u200b\u200bthe lower jaw angle, passes through the submandibular gland. Further, the facial artery passes through one of the edges of the lower jaw to the face, moves forward and upward, to the corner of the mouth and to the eye area. The following branches branch off from this artery:
• The amygdala branch stretches up to the palatine tonsil, as well as to the root of the tongue along the wall of the oral cavity;
• The ascending palatine artery runs along one of the lateral walls upward from the initial part of the facial vessel. Its terminal branches are directed to the mucous membrane of the pharynx, palatine tonsil and auditory tubes;
• The submental artery is directed towards the muscles of the neck and chin through the outer surface of the hyoid muscle.

Back branches

The posterior group of branches of the external carotid artery includes two large vessels. These are the occipital as well as the ear arteries. They deliver blood to the area of \u200b\u200bthe auricles, the posterior muscles of the neck, the canals of the facial nerve, and also penetrate into the dura mater of the brain.

Occipital artery. This vessel rejects the external carotid artery almost at the same level as the facial one. The occipital artery passes under the digastric muscle and is placed in the groove of the same name in the temple area. Then it goes to the back of the scalp and branches into the epidermis of the occiput. The occipital branches are connected to similar arteries on the opposite side. There is also a connection with the muscle branches of the deep cervical artery and the branches of the spine.

The occipital artery is divided into the following lateral branches:

• The auricular branch follows the direction of the auricle and connects with the other branches of the posterior auricular artery;
• The descending branch extends to the back distant region of the neck;
• The mastoid branch penetrates into the lining of the brain through the holes of the same name.
• Posterior ear. This artery is directed obliquely back from the upper edge of the posterior abdomen of the digastric muscle. The posterior ear artery diverges into the following branches:
• The occipital branch runs along the very base of the mastoid process, supplies blood and fills with oxygen the skin in the occiput;
• The auricular branch supplies blood to the auricles, runs along their back side;
• The styloid artery supplies blood to the canal of the facial nerve, which is located at the temporal bone.

Middle branches

The middle group of branches of the external carotid artery includes one large artery and several of its branches. These vessels deliver blood and oxygen to the frontal areas: parietal, to the muscles of the lips, cheeks, and nose.

Ascending pharyngeal artery. The external carotid artery branches off this vessel and directs it along the pharyngeal wall.

The ascending pharyngeal vessel branches as follows:

1. The posterior meningeal artery passes into the tympanic part through the lower cavity of the tympanic tubule.

End branches

The terminal branches of the external carotid artery form a small group. It consists of the superficial temporal, maxillary arteries. These vessels are the terminal branches of the main external carotid artery. They all have different sizes and secondary branches of varying lengths.

Superficial temporal. This vessel is the continuing external carotid artery. It runs along the anterior wall of the auricle under the skin and moves upward to the temporal region. Here its pulsation is well felt. At the level of the edge of the eye, this artery is divided into the parietal and frontal, nourishing the skin of the crown, forehead, and supracranial muscle.

The superficial artery diverges into the following branches:

1. The transverse facial artery passes near the duct of the parotid gland, goes to the skin of the cheeks, to the infraorbital region, to the mimic muscle tissue;
2. The ophthalmic artery ensures proper blood flow and blood supply to the circular ocular muscles, passing over the lesser zygomatic arch;
3. The branches in the parotid gland are directed to the salivary gland, pass under the cheekbones in an arc;
4. The anterior auricular branches are directed towards the auricle, where they are connected to the vessels of the posterior auricular artery;
5. The middle temporal artery passes the muscle fascia in this area and supplies it with blood.

Maxillary artery. This vessel is also the terminal branch of the main external carotid artery. Its initial part is covered on the front side of one of several branches of the vessels of the lower jaw. The maxillary artery also passes through the infratemporal, pterygoid-palatine fossa. Further, it splits into some final branches. There are three divisions in it: pterygo-palatine, pterygoid and jaw.

Within the jaw region from this artery, such vessels depart in all directions:

• The anterior tympanic artery passes through the petrotympanic temporal fissure;
• The deep ear artery is directed towards the external auditory ear canal, the temporomandibular joint and the tympanic membrane;
• The inferior alveolar artery is large enough. On the way to the canal, directed to the lower jaw, it gives off dental branches;
• The middle meningeal vessel is the most dense of all arteries directed to the meningeal membrane.

The terminal branches of the arteries, as they decrease to the edges of the skin or mucous membranes, form a huge network of capillaries that extend into the eyeballs and the oral cavity. Everyone can make sure they are available. When the face becomes covered with a blush, at the moment of embarrassment or in a stressful situation, this is a consequence of the work of the vessels with which the external carotid artery is so enriched.

The human body is riddled with blood vessels from head to toe. They allow the body to function normally and carry nutrients and oxygen throughout the body. Among them there are such vessels that play a vital role for humans.

Carotid artery

Each of us at least once in our life damaged some part of the body, for example, when a finger was cut, blood began to flow from it. It is not difficult to stop such bleeding, since the diameter of the vessel is rather small and the pressure in it is small. In addition, there are platelets in human blood, which clog the cut, and after a couple of minutes, the blood itself stops flowing.

But this does not always happen: in the human body there are vessels that differ in both their large diameter and the pressure of the blood that moves through them. They are usually the most important in the human body, and their damage and lack of medical attention can lead to serious blood loss. One of these is the carotid artery.

This blood vessel is a paired artery that begins at chest and forks, heading towards the head. Because of this, its main functions can be considered the blood supply to the brain, eyes and other parts of the human head.

More about the structure and its functions

The carotid artery has two branches: right and left. The first originates in the region of the shoulder trunk. The left artery, in turn, begins in the region of the aortic arch. Due to these anatomical features, the left artery is a couple of centimeters longer than the right one. Then it moves vertically upward, located in the neck, then branches and is located in different parts of the head.

The main function of this artery is to supply blood to the brain. This can happen only when this vessel has no pathologies and various diseasesinterfering with normal blood circulation. When the arteries become blocked, the person is more likely to need surgery.

External carotid artery

This type of artery is considered one of the main components of one common trunk of the carotid artery. It starts from a single artery, is at the level of the carotid triangle, one of its parts. First, it passes closer to the middle of the artery located inside, and then much more lateral to it.

Initially, this artery is covered with muscle, and if we consider its location in the area of \u200b\u200bthe carotid triangle, then it can be observed under the subcutaneous muscle located in the neck. The artery does not end there, it divides. In the area of \u200b\u200bthe lower jaw, approximately at the level of the neck, the first branches of the external carotid artery appear. They are represented by the maxillary and superficial temporal artery. Further, other branches of the external carotid artery appear, they diverge in different directions in the corresponding directions. Therefore, the anterior, middle and posterior branch of the external carotid artery is defined here. Each of them is responsible for the normal functioning of certain parts of the human body, supplying them with nutrients and oxygen.

Front group

It is these areas related to the external branch of the carotid artery trunk that include quite impressive vessels. The peculiarity of this group is that it allows blood to flow to the organs located in the face and throat. Therefore, the functioning of the larynx, face, tongue, thyroid gland depends on their normal work. From the common vessel, which is the branches of the external carotid artery, there are three main vessels, rather large in size. Then there is another division into smaller vessels, this differentiation allows blood to be supplied to all the necessary parts of the body.

The anterior group of branches of the external carotid artery includes three main vessels, each of which has a specific function and location.

Superior thyroid artery

Its branch occurs at the level of the horns at the very beginning of the hyoid bone. This arrangement allows this particular artery to supply blood to the thyroid gland and, of course, the parathyroid gland. Also, thanks to this artery, blood flows to the larynx, passing through the superior artery in the area of \u200b\u200bthe mastoid muscle.

After that, she, like most of the vessels in the human body, separates again. And the sublingual and cricothyroid branches appear in the superior thyroid artery. One of them, namely the sublingual, becomes the main vessel that feeds the nearby muscles, and

As for the cricothyroid branch, it allows blood to flow to the corresponding muscle. After that, it is connected to a vessel similar to it on the other side.

The superior laryngeal artery allows blood to flow to the epiglottis and larynx. With its help, it seems possible to enrich the membranes of these organs with oxygen, as well as those located around the muscles.

Lingual artery

This vessel, like the previous ones, is a component of the branch of the external carotid artery; a branch occurs just above one of the vessels, in particular the thyroid. This happens in the area of \u200b\u200bthe hyoid bone, then it moves and gradually reaches the area of \u200b\u200bthe Pirogov triangle. Then the lingual artery is directed to the point from which it got its name, that is, to the tongue itself, it is located below. Although. in comparison with other arteries, the lingual is considered not so big, it also has its own smaller vessels.

For example, the deep artery of the tongue looks like a large branch of the lingual artery. Its location is quite interesting: first, it rises up and reaches the so-called base of the tongue. Then he continues to move along it and reaches the very tip. This vessel is surrounded by several muscles, in particular, the lingual and the lower longitudinal.

In addition, there is a suprahyoid branch, its main function is the blood supply to the hyoid bone. Accordingly, it is located along the upper edge of this bone. The sublingual artery is located in the area of \u200b\u200bthe hyoid muscle, just above it. Its functional features are in the blood supply to a part of the oral cavity, thanks to which oxygen is supplied to all components of the human oral cavity. This number includes the oral mucosa, salivary glands and even the gums. The dorsal branches have a peculiar arrangement, so they can be observed in the area of \u200b\u200bone of the muscles, in this case the sublingual.

Facial artery

This type of vessel forks in the area of \u200b\u200bthe corner of the lower jaw, and then goes through the gland located nearby, that is, the submandibular. It is not for nothing that this vessel is called the facial artery, since, starting from the neck, it goes through the area of \u200b\u200bthe lower jaw, gradually moving to the area of \u200b\u200bthe face. Then he goes forward and moves to the top. The tips of the vessels end in the area of \u200b\u200bthe corners of the mouth, and another branch reaches the eyes. In addition, the artery itself includes additional vessels, respectively, other branches appear.

Despite the fact that there are mainly branches of the external carotid artery in the neck, the smaller arteries included in the group are located in the face and part of the human mouth. The amygdala branch goes to the palatine tonsil, and from the ramification goes across the palate. It also goes to the base of the tongue, reaching there along the wall of the human oral cavity.

As for the palatine artery, its location is directly from the very base of the facial artery, which is part of a group called the anterior branches of the external carotid artery. The ascending palatine artery ends in the pharynx region, in particular, its mucous membrane and, in addition, the palatine tonsil. The latter branches also extend to the tubes responsible for normal hearing.

The sublingual artery runs through the hyoid muscle, more specifically, through the outer surface of this muscle. The ends of the vessel move to the chin and certain cervical muscles.

Back group

The posterior branch of the external carotid artery, like the previous ones, has its own branches of the vessels. The ear extends from it, and it is in this place that the occipital artery originates. With their help, blood is supplied to the visible inner part of the ear. In addition, thanks to these arteries, blood flows to the muscles of the neck located in the back, in the back of the head, as well as the canal of the facial nerve. A distinctive feature of this branch is that it tends to penetrate

Occipital artery

It departs separately, is almost as high as the front. Its location is in the area of \u200b\u200bthe digastric muscle, located under it, after which it moves into the groove near the temple. Further, her path goes under skin covering, where it is located, the back of the head is involved, and the branching occurs in the epidermis of the occipital region.

Having gone all this way, they are connected with the same branches that go from the opposite side. Connection is carried out with other branches, some vessels of the spinal column.

The occipital artery is divided into several smaller vessels, respectively, the ear, descending, mastoid branches appear. The first goes straight to the visible inner part of the human ear, and after passing it, it becomes one with the other branches of the posterior ear artery. Descending reaches the most secret corners, as it goes to the neck area that is farther than the rest. As for the mastoid, it lies in the lining of the human brain, in the corresponding channels available there.

Posterior ear artery

The branches of the external and internal carotid arteries play an important role in the human body, as well as their smallest branches. For example, this vessel is directed obliquely backward, it goes from the digastric muscle, then it spreads in this way: it passes from the edge of the posterior abdomen. It also splits into three smaller branches. One of these vessels will be the occipital branch.

Its location matches the base allows blood to enter the skin in the occipital region. The ear ramus has made its way along the back of the ear and allows blood to be supplied to the visible areas of the inner ear of a person. The styloid artery plays an equally important role: the facial nerve largely depends on its normal functioning, because it is to it that blood flows, the location partially corresponds to the temporal bone.

Middle group

The middle group of branches of the external carotid artery has fewer branches in comparison with the previous ones. In fact, this group includes one artery, which then branches into a number of smaller vessels, but this does not diminish its importance.

The medial branches of the external carotid artery include the pharyngeal ascending artery and other vessels, which make it possible to supply nutrients, and most importantly, oxygen, to those muscles that are located on the face, that is, nourish the lips, cheeks, etc.

Ascending pharyngeal artery

After its branch, this artery takes a direction towards the pharynx and passes along its wall. The branching of this vessel occurs so that the posterior meningeal artery goes towards the tympanic part and spreads further through the tympanic tubule, located in one of its cavities, in this case the lower one.

End branches

The terminal branches of the external carotid artery are a small number of blood vessels that are part of the carotid artery. This branch has two arteries, namely the maxillary and the superficial-temporal. They vary in size, and other vessels extending from them allow blood to be transported to distant parts of the body.

Superficial temporal artery

This vessel is considered a continuation of the external carotid artery. Its passage corresponds to the visible surface of the inner part of the ear, namely its front wall, the artery is located under the skin. The movement goes up and towards the temple area. If it is necessary to feel the pulsation, point the branches of the external carotid artery in this place. It is quite simple to determine the beating of the blood flow here.

Then another division occurs: the parietal, as well as the frontal artery appears. This happens at the level of the corner of the eye, located near the temporal region. These arteries carry blood to the forehead, crown, and supracranial muscle.

The terminal branches of the external carotid artery include a superficial vessel, which is divided into five smaller ones. One of them is the transverse facial artery. This blood vessel is located in the parotid gland, its duct. Then it moves towards the cheeks and is located in the skin. The vessels spread in the infraorbital region and reach another type of muscle tissue - mimic.

The ophthalmic eye allows blood to flow to some muscles of the eye, passing through the small zygomatic arch. The anterior ear go to the ear, namely its visible surface of the inner part, there is also a middle temporal artery and branches located in the region of the gland located here.

The maxillary artery does not go by one trunk and is also divided into other vessels, in this case several sections are distinguished, one of which is the jaw. It is he who includes the smaller vessels extending from him, for example, this is the deep ear artery. There is also a fairly large artery called the inferior alveolar artery. The most dense among the vessels of this group is the middle meningal one, located in the direction of the cerebral membrane.

Conclusion

The above information shows what the external carotid artery is. The branch topography divides it into 4 groups. All of them are important for a person, and a malfunction of one of them can affect not only problems in the area of \u200b\u200ba certain part of the body, but also the work of the whole organism. An important role is played by small vessels that extend from each branch, since they allow supplying blood to the area of \u200b\u200bthe eyes, cheeks, chin, and various parts of the head, pass both in the muscles and are located closer to the epithelium.

Within the pterygoid region, branches supplying the chewing muscles branch off from the maxillary artery: 1) the chewing artery, a. masseterica, to the muscle of the same name; 2) deep temporal (anterior! And ^ temporal posterior arteries, a. Tempordlis profunda anterior and fa. tempordlis posterior /, going into the thickness of the temporal muscle; 3) pterygoid branches, rr. pterygoldei, to the muscles of the same name; 4) buccal artery, a. buccalis, to the buccal muscle and to the buccal mucosa; 5) the posterior superior alveolar artery, a. alueolaris superior posterior, which, through the holes of the same name in the tubercle of the upper jaw, penetrates into the maxillary sinus and supplies blood to its mucous membrane, and its dental branches, rr. dentdles, - teeth and gums of the upper jaw.

Three terminal branches extend from the third-pterygo-palatine-section of the maxillary artery: 1) the infraorbital artery, a. infraorbitdlis, which passes into the orbit through the lower palpebral fissure, where it gives off branches to the lower rectus and oblique muscles of the eye. Then, through the infraorbital foramen, this artery exits through the channel of the same name to the face and supplies the mimic muscles located in the thickness of the upper lip, in the region of the nose and lower eyelid, and the skin covering them. Here, the infraorbital artery anastomoses with the branches of the facial and superficial temporal arteries. In the infraorbital canal, the anterior superior alveolar arteries branch off from the infraorbital artery, aa. alueoldres superiores anteriores, giving off dental branches, rr. dentdles, to the teeth of the upper jaw; 2) the descending palatine artery, a. palatlna descendens, - a thin vessel, which, having first given the artery of the pterygoid canal, a. candlis pterygoidei, to the upper part of the pharynx and the auditory tube and passing through the large palatine canal, supplies the hard and soft palate (aa. palatinae major et minores), anastomoses with the branches of the ascending palatine artery; 3) wedge-palatine artery, a. sphenopalatina. passes through the hole of the same name into the nasal cavity and gives off the lateral posterior nasal arteries, aa. nasales posteri6res laterales, and back septal branches, rr. septales posteri6res, to the nasal mucosa.

Review questions 1. Name the branches of the aortic arch. 2. Which parietal branches extend from the thoracic aorta? 3. Name the visceral branches of the thoracic aorta. 4. In what sequence do branches of the carotid artery branch off in the carotid triangle? 5. What are the terminal branches of the external carotid artery and the area of \u200b\u200btheir lesion? outdoor distribution

Internal carotid artery, a. carotis interna, supplies the brain and the organ of vision. The initial part of the artery - its cervical part, pars cervicalis, is located laterally and behind, and then medially from the external carotid artery. Between the pharynx and the internal jugular vein, the artery rises vertically upward (without giving up branches) to the external opening of the carotid canal. Behind and medially from it are the sympathetic trunk and the vagus nerve, in front and laterally - the hypoglossal nerve, above - the glossopharyngeal nerve. In the carotid canal there is a stony part, pars petrosa, of the internal carotid artery, which forms a bend and gives off thin carotid arteries to the tympanic cavity, aa. caroticotympanicae.

Upon exiting the canal, the internal carotid artery makes a bend upward and lies in the short groove of the same name of the sphenoid bone, and then the cavernous part, pars cavernosa, of the artery passes through the cavernous sinus of the hard shell of the brain. At the level of the visual canal, the cerebral part, pars cerebrdlis, of the artery makes another bend, facing the bulge forward, gives off the ophthalmic artery, and at the inner edge of the anterior inclined process it divides into its terminal branches - the anterior and middle cerebral arteries.

1. Ocular artery, a. ophthalmica (Fig. 46), departs in the region of the last bend of the internal carotid artery and, together with the optic nerve, enters the orbit through the optic canal. Further, the ophthalmic artery follows the medial wall of the orbit to the medial corner of the eye, where it splits into its terminal branches - the medial arteries of the eyelids and the dorsal artery of the nose. The following branches branch off from the ocular artery: 1) the lacrimal artery, a. lacrimalis, follows between the superior and lateral rectus muscles of the eye, giving them branches, to the lacrimal gland; thin lateral arteries of the eyelids are also separated from it, aa. palpeb rates laterales; 2) long and short posterior ciliary arteries, aa. ciliares posteriores longae et breves, pierce the sclera and penetrate the choroid; 3) the central retinal artery, a. centrdlis retinae, enters the optic nerve and reaches the retina; 4) muscle arteries, aa. musculdres, to the upper straight and oblique muscles of the eyeball; 5) posterior ethmoid artery, a. ethmoidalis posterior, follows to the mucous membrane of the posterior ethmoid cells through the posterior ethmoid opening; 6) anterior ethmoid artery, a. ethmoidalis anterior, passes through the anterior lattice opening, where it divides into its terminal branches. One of them is the anterior meningeal artery branch), and. g. meningeus anterior, enters the cranial cavity and supplies blood to the hard shell of the brain, while others penetrate under the ethmoid plate of the ethmoid bone and nourish the mucous membrane of the ethmoid cells, as well as the NOSE cavity and the anterior parts of its septum; 7) anterior ciliary arteries, aa. ciliares anteriores, in the form of several branches accompany the muscles of the eye: suprascleral arteries, aa. episclerdles, enter the sclera, and the anterior conjunctival arteries, aa. conjunctiudles anteriores, supply blood to the conjunctiva of the eye; 8) supra-block artery, a. supratrochlearis, leaves the orbit through the frontal opening (together with the nerve of the same name) and branches into the muscles and skin of the forehead; 9) medial arteries of the eyelids, aa. palpebrdles mediates, go to the medial corner of the eye, anastomose with the lateral arteries of the eyelids (from the lacrimal artery), forming two arcs: the arch of the upper eyelid, drcus palpebrdlis superior, and the arch of the lower eyelid, drcus palpebrdlis inferior; 10) the dorsal artery of the nose, a. dorsalis ndsi, passes through the circular muscle of the eye to the corner of the eye, where it anastomoses with the angular artery (the terminal branch of the facial artery). The medial arteries of the eyelids and the dorsal artery of the nose are the terminal branches of the ophthalmic artery.

2. Anterior cerebral artery, a. cerebri anterior (Fig. 47), departs from the internal carotid artery slightly above the ophthalmic artery, approaches the opposite side of the artery of the same name and is connected to it by a short unpaired connective artery, a. communicans anterior. Then the anterior cerebral artery lies in the groove of the corpus callosum, bends around the corpus callosum (Fig. 48) and is directed towards the occipital lobe of the cerebral hemisphere, supplying blood to the medial surfaces of the frontal, parietal and partly occipital lobes, as well as the olfactory bulbs, tracts and striatum. The artery gives off two groups of branches to the substance of the brain - cortical and central.

3. Middle cerebral artery, a. cerebri media, is the largest branch of the internal carotid artery. It distinguishes between the wedge-shaped part, pars sphenoidalis, adjacent to the large wing of the sphenoid bone, and the insular part, pars insuldris. The latter rises upward, enters the lateral groove of the large brain, adjacent to the islet. Then it continues into its third, final (cortical) part, pars termindlis (pars corticalis), which branches out on the superior lateral surface of the cerebral hemisphere. The middle cerebral artery also gives off cortical and central branches.

4. Posterior communicating artery, a. communicans posterior, departs from the end of the internal carotid artery before dividing the latter into the anterior and middle cerebral arteries. The posterior connecting artery is directed towards the bridge and, at its anterior edge, flows into the posterior cerebral artery (a branch of the basilar artery).

5. Anterior villous artery, a. choroidea anterior, a thin vessel, departs from the internal carotid artery behind the posterior communicating artery, penetrates into the lower horn of the lateral ventricle, and then into the third ventricle. With its branches, it participates in the formation of vascular plexuses. It also gives off numerous thin branches to the gray and white matter of the brain: to the optic tract, lateral geniculate body, internal capsule, basal nuclei, hypothalamic nuclei and to the red nucleus.

The following arteries are involved in the formation of anastomoses between the branches of the internal and external carotid arteries: dorsails nasi (from the ocular artery) and a. angularis (from the facial artery), a. supratrochlearis (from the ocular artery) and g. frontalis (from the superficial temporal artery), a. carotis interna and a. cerebri posterior (through the posterior connecting artery).

Review questions 1. Name the parts of the internal carotid artery. 2. What curves does the internal carotid artery have? Where they are? 3. Name the branches of the internal carotid artery. 4. What anastomoses exist between the branches of the internal and external carotid arteries? Where are they located?

Subclavian artery, a. subclavia, starts from the aorta (left) and brachiocephalic trunk (right). The left subclavian artery is about 4 cm longer than the right one. The subclavian artery leaves the thoracic cavity through its upper aperture, bends around the dome of the pleura, enters (together with the brachial plexus) into the interscalene space, then passes under the clavicle, bends over 1 rib (lies in its eponymous groove) and below the lateral edge of this rib it penetrates into the axillary cavity, where it continues as the axillary artery.

Conventionally, the subclavian artery is divided into three sections: 1) from the origin to the inner edge of the anterior scalene muscle, 2) in the interscalene space, and 3) at the exit from the interscalene space. In the first section, three branches extend from the artery: the vertebral and internal thoracic arteries, the thyroid trunk, in the second section - the costal-cervical trunk, and in the third - sometimes the transverse artery of the neck.

1. Vertebral artery, a. vertebralis, - the most significant of the branches of the subclavian artery, departs from its upper semicircle at the level of the VII cervical vertebra. In the vertebral artery, 4 parts are distinguished: between the anterior scalene muscle and the long neck muscle, its prevertebral part, pars prevertebrdlis, is located. Further, the vertebral artery goes to the VI cervical vertebra - this is its transverse (cervical) part, pars transversdria (cervicalis), then passes up through the transverse holes of the VI-II cervical vertebrae. Coming out of the transverse foramen II of the cervical vertebra, the vertebral artery turns laterally and the next section is the atlantic part, pars atldntica. Having passed through the hole in the transverse process of the atlas, it goes around its superior glenoid fossa behind surface, pierces the posterior atlanto-occipital membrane, and then the hard shell of the spinal cord (in the spinal canal) and through the foramen magnum enters the cranial cavity - here its intracranial part, pars intracranidlis, begins. Behind the pons of the brain, this artery connects to a similar artery on the opposite side, forming the basilar artery. From the second, transverse, part of the vertebral artery, the spinal (radicular) branches depart, rr. spindles (radiculdres), penetrating through the intervertebral foramen to the spinal cord, and muscle branches, rr. musculares, to the deep muscles of the neck. All other branches are separated from the last - the intracranial part: 1) the anterior meningeal branch, r. Meningeus anterior, and the posterior meningeal branch, r. Meningeus posterior / meningeal branches, rr. meningei, 2) posterior spinal artery, a. spinalis posterior, bends around the medulla oblongata outside, and then goes down along the posterior surface of the spinal cord, anastomosing with the artery of the same name on the opposite side; 3) anterior spinal artery, a. spinalis anterior, connects to the opposite side of the artery of the same name into an unpaired vessel heading down into the depths of the anterior fissure of the spinal cord; 4) the posterior inferior cerebellar artery (right and left), a. inferior posterior cerebelli, having rounded the medulla oblongata, branches out in the posterior inferior parts of the cerebellum.

Basilar artery, a. basildris (see Fig. 47, 48), is an unpaired vessel, located in the basilar groove of the bridge. At the level of the anterior edge of the bridge, it is divided into two terminal branches - the posterior right and left cerebral arteries. From the trunk of the basilar artery depart: 1) the anterior lower cerebellar artery (right and left), a. Inferior anterior cerebelli, forks on the lower surface of the cerebellum; 2) labyrinth artery (right and left), a. labyrinthi, pass next to the vestibular cochlear nerve (VIII pair of cranial nerves) through the internal auditory canal to the inner ear; 3) arteries of the bridge, aa. pontis (branches to the bridge); 4) the middle cerebral arteries, aa. mesencephdiicae (branches to the midbrain); 5) superior cerebellar artery (right and left), a. superior cerebelli, forks in the upper cerebellum.

Posterior cerebral artery, a. cerebri posterior, bends around the leg of the brain, branches on the lower surface of the temporal and occipital lobes of the cerebral hemisphere, gives off the cortical and central branches. A flows into the posterior cerebral artery. sotmunicans posterior (from the internal carotid artery), resulting in the formation of an arterial (Willis) circle of the large brain, circulus arteriosus cerebri. Its formation involves the right and left posterior cerebral arteries, which close the arterial circle behind. The posterior cerebral artery is connected to the internal carotid artery on each side by the posterior communicating artery. The anterior part of the cerebral arterial circle is closed by the anterior communicating artery, located between the right and left anterior cerebral arteries, extending from the right and left internal carotid arteries, respectively. The cerebral arterial circle is located at its base in the subnautical space. It covers the front and sides of the optic chiasm; the posterior connecting arteries lie on the sides of the hypothalamus, the posterior cerebral arteries are in front of the pons.

2. Internal thoracic artery, a. thoracica interna (Fig. 49), departs from the lower semicircle of the subclavian artery opposite and somewhat lateral to the vertebral artery. The artery descends down the posterior surface of the anterior chest wall, adjacent to the back of the cartilage of the I-VIII ribs. Under the lower edge of the VII rib, it splits into two terminal branches - the musculophrenic and superior epigastric arteries. A number of branches depart from the internal thoracic artery: 1) mediastinal branches, rr. mediastinales, to the mediastinal pleura and tissue of the upper and anterior mediastinum;

2) thymic branches, rr. thymici; 3) bronchial and tracheal branches, rr. bronchidles et tracheales, to the lower trachea and the main bronchus of the corresponding side; 4) pericardial diaphragmatic artery, a. pericardiacophrenica, starts from the trunk of the artery at the level of the I rib and, together with the phrenic nerve, descends along the lateral surface of the pericardium (between it and the mediastinal pleura), gives branches to it and to the diaphragm, where it anastomoses with other arteries that supply the diaphragm; 5) sternal branches, rr. sterndles, which supply blood to the sternum and anastomose with the branches of the same name on the opposite side; 6) piercing branches, rr. perfordntes, pass in the upper 5-6 intercostal spaces to the pectoralis major muscle, skin, and the 3rd, 4th and 5th perforating arteries give medial branches of the mammary gland, rr. mammdrii fmediates (in women); 7) anterior intercostal branches, rr. intercostdles anteriores (I-V), depart in the upper five intercostal spaces in the lateral direction to the intercostal muscles; 8) muscular-phrenic artery, a. musculophrenica, goes down and laterally to the diaphragm. Along the way, gives the intercostal branches to the muscles of the five lower intercostal spaces; 9) the superior epigastric artery, a. epigastrica superior, enters the vagina of the rectus abdominis muscle, through its back wall, supplies this muscle with blood, located on its back surface. At the level of the navel, it anastomoses with the lower epigastric artery (a branch of the external iliac artery). The musculophrenic and superior epigastric arteries are the terminal branches of the internal thoracic artery.

3. The thyroid trunk, truncus thyrocervicalis, departs from the subclavian artery at the medial edge of the anterior scalene muscle. The trunk is about 1.5 cm long and in most cases is divided into 3 branches: the lower thyroid, suprascapular and transverse arteries of the neck. 1) Inferior thyroid artery, a. thyroidea inferior, goes up the front surface of the long neck muscle to the thyroid gland and gives off the glandular branches, rr. gtanduldres. The pharyngeal and esophageal branches depart from the lower thyroid artery, rr. pharyngedles et oesophagedles; tracheal branches, rr. tracheales, and the lower laryngeal artery, a. laryngedlis inferior, which anastomoses with the superior laryngeal artery (a branch of the superior thyroid artery) under the plate of the thyroid cartilage.

2) Suprascapular artery, a. suprascapuldris, behind the clavicle goes back to the notch of the scapula, through which it penetrates * into the supraspinatus, and then into the infraspinatus fossa, to the muscles lying there. Anastomoses with the artery that bends around the scapula (a branch of the subscapularis artery), and gives off the acromial branch, g. Acromidlis, which anastomoses with the branch of the same name from the thoracic acromial artery.

3) Transverse neck artery, a. transverse, cervicis, most often passes between the trunks of the brachial plexus posteriorly and at the level of the medial end of the spine of the scapula is divided into a superficial branch, g. superficidlis, following to the muscles of the back, and a deep branch, g. profundus, which runs along the medial edge of the scapula down to the muscles and back skin. Both branches of the transverse artery of the neck are anastomosed with the branches of the occipital artery (from the external carotid artery), the posterior intercostal arteries (from the thoracic aorta), with the subscapularis artery and the artery surrounding the scapula (from the axillary artery) (Table 2).

4. Costal-cervical trunk, truncus costoceruicalis, departs from the subclavian artery in the interscalene space, where it is immediately divided into the deep cervical and the highest intercostal arteries. 1) Deep cervical artery, a. cervicalis profunda, follows posteriorly between the I rib and the transverse process of the VII cervical vertebra, to the semispinal muscles of the head and neck. 2) The highest intercostal artery, a. intercostdlis suprema, goes down in front of the neck of the I rib and branches in the first two intercostal spaces, giving the first and second posterior intercostal arteries, aa. intercostdles posteriores (I-II).

Axillary artery, a. axilldris (Fig. 50), is a continuation of the subclavian artery (from the level of the I rib), located deep in the axillary fossa and surrounded by the trunks of the brachial plexus. At the lower edge of the latissimus dorsi tendon, the axillary artery merges into the brachial artery. Accordingly, the topography of the anterior wall of the axillary fossa, the axillary artery is conventionally divided into three sections. In the first section, at the level of the clavicothoracic triangle, the following arteries branch off from the axillary artery:

1) subscapular branches, rr. subscapuldres, branch in the muscle of the same name; 2) the superior thoracic artery, a. thoracica superior, splits into branches that go to the first and second intercostal spaces, where they supply blood to the intercostal muscles, and also gives off thin branches to the pectoral muscles; 3) the grod oacrom and the aln artery, thoracoacromialis, departs from the axillary artery above the upper edge of the pectoralis minor and splits into 4 branches: the acromial branch, r, acromidlis, takes part in the formation of the acromial network, from which the acromioclavicular is supplied with blood joint, and also partially the capsule of the shoulder joint; clavicular branch, Mr. clauiculdris, unstable, nourishes the clavicle and subclavian muscle; the deltoid branch, g. deltoideus, supplies blood to the deltoid and pectoralis major muscles and the corresponding areas of the breast skin; thoracic branches, rr. pectorales are directed to the pectoralis major and minor muscles.