The aorta (aorta) is the largest vessel in the human body. It gives rise to all the arteries of the systemic circulation.

It has the following parts:

The ascending aorta (pars ascendens aortae)

The arch of the aorta (arcus aortae)

The descending aorta (pars descendens aortae)

Three major arteries arise from the arch:

The brachiocephalic trunk (truncus brachiocephalicus)

The left common carotid artery (arteria carotis communis sinistra)

The left subclavian artery (arteria subclavia sinistra)

The right common carotid artery (arteria carotis communis dextra) arises from the brachiocephalic trunk.

At the level of the superior border of the thyroid cartilage, the common carotid artery divides into the external carotid artery (arteria carotis externa) and the internal carotid artery (arteria carotis interna).

In this video, we will walk through the anatomy of the external carotid artery and its branches, as well as the areas of blood supply and anastomoses.

The external carotid artery (a. carotis externa) arises from the common carotid artery in the area of the so-called carotid triangle.

In the initial part, it is located on the medial side of the internal carotid artery and then passes to the lateral side. The initial part of the external carotid artery lies in front of the sternocleidomastoid muscle, and in the area of the carotid triangle is located under the superficial layer of the cervical fascia and the platysma.

In the thickness of the parotid gland at the level of the mandible, it divides into its final branches – the superficial temporal (a. temporalis superficialis) and maxillary arteries (a. maxillaris).

Along its course, the external carotid artery gives off a number of branches that arise from it in several directions.

1. Anterior branches

2. Posterior branches

3. Medial branches

4. Terminal branches

The anterior branches include the following arteries:

1. The superior thyroid artery (a. thyroidea superior)

2. The lingual artery (a. lingualis)

3. The facial artery (a. facialis)

The superior thyroid artery (a. thyroidea superior) arises most proximally and goes to the thyroid gland. At the superior pole of the gland, the artery divides into two glandular branches: the anterior and posterior. On its posterior surface and in the tissues of the gland, they anastomose with the branches of the inferior thyroid artery. It supplies the thyroid gland with blood.

A number of branches arise from the superior thyroid artery:

• The superior laryngeal artery (a. laryngea superior), which pierces the thyrohyoid membrane and supplies muscles and mucous membrane of the larynx with blood;



• The sternocleidomastoid artery (a. sternocleidomastoidea) supplies the muscle of the same name with blood;



• The infrahyoid branch (r. infrahyoideus) supplies the hyoid bone with blood;



• The cricothyroid branch (r. cricothyroideus) supplies the cricothyroid muscle with blood.

The lingual artery (a. lingualis) arises at the level of the greater horn of the hyoid bone. It passes in the lingual (Pirogov) triangle and goes in the superior direction to the tongue.

It has a number of branches along its length:

• The sublingual artery (a. sublingualis) supplies the sublingual salivary gland and nearby muscles with blood;



• The suprahyoid branch (r. suprahyoideus) is located along the superior border of the hyoid bone and supplies the muscles attached to it with blood. It anastomoses with a similar branch of the artery of the same name from the opposite side;



• Dorsal branches of the tongue (rr. dorsales linguae), usually in the amount of 2-3 small vessels, arise from the lingual artery medial to the hyoglossus muscle and pass into the posterior part of the tongue. They supply the base of the tongue and its mucous membrane, the palatoglossal arch, tonsils, soft palate and epiglottis with blood. They form anastomoses with their contralateral counterparts.



• The deep artery of the tongue (a. profunda linguae) is located on the inferior side of the tongue, next to the frenulum of the tongue and follows to the tip of the tongue. It supplies the body of the tongue with blood.

The facial artery (a. facialis) arises from the trunk of the external carotid artery at the level of the angle of the mandible passes over the edge of the mandible to the face. It goes to the medial corner of the eye. It adheres to the submandibular salivary gland, sometimes passes through its thickness, where it gives off glandular branches.

It gives off a number of branches along its course:

• The ascending palatine artery (a. palatina ascendens) goes to the soft palate and supplies it with blood;



• The tonsillar branch (r. tonsillaris) goes to the palatine tonsil and supplies it with blood;
• The submental artery (a. submentalis) passes to the chin and suprahyoid muscles along the external surface of the mylohyoid muscle and supplies them with blood;



• The superior and inferior labial arteries (aa. labiales inferior et superior) supply the lips with blood and anastomose with the arteries of the same name on the opposite side;





• The angular artery (a. angularis) is a part of the main trunk of the facial artery that goes to the medial corner of the eye. It anastomoses with the dorsal artery of the nose.

Posterior branches includes two arteries:

1. The occipital artery (a. occipitalis)

2. The posterior auricular artery (a. auricularis posterior)

Let’s consider the listed branches in greater detail.

The occipital artery (a. occipitalis) arises from the external carotid artery at the level of the posterior belly of the digastric muscle, passes superiorly and posteriorly medial to the mastoid process in the same-named groove of the temporal bone. Then the artery follows to the sternocleidomastoid and trapezius muscles, to the occipital region, where it branches into many occipital branches (rr. occipitales), which anastomose with the branches of the artery of the same name on the opposite side.

It gives off a number of branches along its course:

• Sternocleidomastoidei branches (rr. sternocleidomastoidei) supply the muscle of the same name with blood;
• The auricular branch (r. auricularis) supplies the skin of the posterior surface of the auricle with blood and anastomoses with the branches of the posterior auricular artery;



• The mastoid branch (r. mastoideus) – passes through the mastoid foramen and supplies the dura mater with blood;



• The descending branch (r. descendens) supplies the muscles of the back of the neck with blood.

The posterior auricular artery (a. auricularis posterior) arises from the trunk of the external carotid artery above the posterior belly of the digastric muscle, passes superiorly and posteriorly to the auricle.

It gives off a number of branches along its course:

• The stylomastoid artery (a. stylomastoidea) passes through the foramen of the same name into the facial canal, where the posterior tympanic artery (a. tympanica posterior) arises from it and supplies the mucous membrane of the tympanic cavity and cells of the mastoid process, as well as the dura mater of the brain with blood;



• The auricular branch (r. auricularis) and occipital branches (rr. occipitales) supply the skin of the occiput, auricle and mastoid process with blood.

Medial branches

Only one branch belongs to this group.

The ascending pharyngeal artery (a. pharyngea ascendens) arises from the external carotid artery. It passes superiorly along the lateral wall of the pharynx.

It gives off a number of branches along its course:

• The posterior meningeal artery (a. meningea posterior) passes into the cranial cavity through the jugular foramen and supplies the dura mater of the brain with blood;



• The pharyngeal branches (rr. pharyngeales) supply the pharyngeal muscles and deep neck muscles of the neck with blood;

The inferior tympanic artery (a. tympanica inferior) passes into the tympanic cavity through the inferior foramen of the tympanic canaliculus and supplies the mucous membrane of the tympanic cavity with blood.

And lastly, we will consider a group consisting of two terminal branches:

1. The superficial temporal artery (a. temporalis superficialis)

2. The maxillary artery (a. maxillaris)

Let’s consider the vessels listed above in greater detail and start with a less complex from an anatomical point of view.

The superficial temporal artery (a. temporalis superficialis) arises at the level of the neck of the mandible and is a continuation of the trunk of the external carotid artery. It is located in the temporal region anterior to the external acoustic meatus. At the level of the supra-orbital margin of the frontal bone, the superficial artery divides into the frontal (r. frontalis) and parietal branches (r. parietalis). They are its final parts and supply the skin of the frontal and parietal regions, as well as the epicranius muscle with blood.

It has a number of branches along its length:

• The transverse facial artery (a. transversa faciei) supplies the skin of the buccal and suborbital areas, as well as facial muscles with blood;



• Parotid branches (rr. parotidei) supply the salivary gland of the same name with blood;



• The zygomatico-orbital artery (a. zygomaticoorbitalis) supplies the circular muscle of the eye with blood;



• The middle temporal artery (a. temporalis media) supplies the temporal muscle with blood.

The maxillary artery (a. maxillaris) lies in front of the neck of the mandible and passes to the submandibular and pterygopalatine fossa, where it divides into its terminal branches.

The artery is usually divided into 3 segments:

1. The mandibular (proximal)

2. The pterygoid

3. The pterygopalatine (distal)

At the level of the mandibular part, it has the following branches:

• The deep auricular artery (a. auricularis profunda), which supplies the temporomandibular joint, external acoustic meatus and tympanic membrane with blood;
• The anterior tympanic artery (a. tympanica anterior) – penetrates into the tympanic cavity through the petrotympanic fissure of the temporal bone and supplies its mucous membrane with blood;
• The inferior alveolar artery (a. alveolaris inferior) passes through the mandibular canal, where it gives off the dental branches (rr. dentales) that supply the teeth of the mandible with blood. Then it exits the mandibular canal through the mental foramen, after which it is called the mental artery (a. mentalis).

It supplies the skin of the chin and the muscles of facial expression with blood. Also, the mylohyoid branch (a. mylohyoidea) arises from the inferior alveolar artery, supplying the muscle of the same name and the anterior belly of the digastric muscle with blood.

• The middle meningeal artery (a. meningea media) passes into the cranial cavity through the foramen spinosum.

It gives the frontal and parietal branches to the cranial dura mater, as well as the superior tympanic artery (a. tympanica superior), which penetrates into the tympanic cavity through the canal for the tensor tympani muscle.

At the level of the pterygoid part, the following branches arise:

• The masseteric artery (a. masseterica), which supplies the muscle of the same name with blood;



• The anterior and posterior deep temporal arteries (aa. temporales profundae anterior et posterior), which supply the temporal muscle with blood;





• Pterygoid branches (rr. pterygoidei) supply the muscles of the same name with blood;



• The buccal artery (a. buccalis) supplies the muscle of the same name and the mucous membrane of the cheek with blood;
• The superior posterior alveolar artery (a. alveolaris superior posterior), which passes into the maxillary sinus through the superior alveolar foramen and supplies the mucous membrane of the maxillary sinus with blood. It gives off dental branches (rr. dentales), which supply the gums and teeth of the maxilla with blood.

Next, let’s consider the branches of the pterygopalatine part.

• The infraorbital artery (a. infraorbitalis) penetrates into the orbit through the inferior orbital fissure and gives off branches that supply the lower rectus and oblique muscles of the eye with blood.

Then it passes through the infra-orbital canal, in which the superior anterior alveolar arteries (aa. alveolares superiores anteriores) arise from it, giving off dental branches that supply to the teeth of the maxilla with. The artery exits through the infra-orbital foramen to the face and supplies to the facial muscles lying in the thickness of the upper lip, nose, and lower eyelid, as well as the skin of these areas with blood.

The branches of the infra-orbital artery widely anastomose with the branches of the facial and superficial temporal arteries.

• The descending palatine artery (a. palatina descendens) gives off the artery of the pterygoid canal (a. canalis ptrerygoidei), which supplies the superior part of the pharynx and the auditory tube with blood, after which it passes through the greater palatine canal and supplies the hard and soft palate with blood.

The branches of the descending palatine artery widely anastomose with the branches of the ascending palatine artery.

• The sphenopalatine artery (a. sphenopalatina) passes into the nasal cavity through the foramen of the same name, where the posterior lateral nasal arteries (aa. nasales posteriores laterales) and the posterior septal branches (rr. septales posteriores) arise from this artery, which supply the nasal mucosa with blood.

Dictionary

The external carotid arteryand its branches

External carotid artery

a. carotis externa

Superior thyroid artery

a. thyroidea superior

Superior laryngeal artery

a. laryngea superior

Sternocleidomastoid artery

a. sternocleidomastoidea

Infrahyoid branch

r. infrahyoideus

Cricothyroid branch

r. cricothyroideus

Lingual artery

a. lingualis

Sublingual artery

a. sublingualis

Suprahyoid branch

r. suprahyoideus

Dorsal lingual branches

rr. dorsales linguae

Deep lingual artery

a. profunda linguae

Facial artery

a. facialis

Ascending palatine artery

a. palatina ascendens

Tonsillar branch

r. tonsillaris

Submental artery

a. submentalis

Superior and inferior labial arteries

aa. labiales inferior et superior

Angular artery

a. angularis

Occipital artery

a. occipitalis

Sternocleidomastoid branches

rr. sternocleidomastoidei

Auricular branch

r. auricularis

Mastoid branch

r. mastoideus

Descending branch

r. descendens

Posterior auricular artery

a. auricularis posterior

Stylomastoid artery

a. stylomastoidea

Posterior tympanic artery

a. tympanica posterior

Occipital branches

rr. occipitales

Ascending pharyngeal artery

a. pharyngea ascendens

Posterior meningeal artery

a. meningea posterior

Pharyngeal branches

rr. pharyngeales

Inferior tympanic artery

a. tympanica inferior

Superficial temporal artery

a. temporalis superficialis

Frontal branch

r. frontalis

Parietal branch

r. parietalis

Transverse facial artery

a. transversa faciei

Parotid branches

rr. parotidei

Zygomatico-orbital artery

a. zygomaticoorbitalis

Middle temporal artery

a. temporalis media

Maxillary artery

a. maxillaris

Deep auricular artery

a. auricularis profunda

Anterior tympanic artery

a. tympanica anterior

Inferior alveolar artery

a. alveolaris inferior

Dental branches

rr. dentales

Mental artery

a. mentalis

Mylohyoid branch

a. mylohyoidea

Middle meningeal artery

a. meningea media

Tympanic artery

a. tympanica

Masseteric artery

a. masseterica

Anterior and posterior deep temporal artery

aa. temporales profundae anterior et posterior

Pterygoid branches

rr. pterygoidei

Buccal artery

a. buccalis

Superior posterior alveolar artery

a. alveolaris superior posterior

Infra-orbital artery

a. infraorbitalis

Superior anterior alveolar arteries

aa. alveolares superiores anteriores

Descending palatine artery

a. palatina descendens

Artery of the pterygoidcanal

a. canalispterygoidei

Sphenopalatine artery

a. sphenopalatina

Posterior lateral nasalarteries

aa. nasales posteriores laterales

Posterior septal branches

rr. septales posteriores