I.

Arterial Origins
1) Brachiocephalic trunk a.
2) Right common carotid a. → head
3) Right subclavian a. → right upper limb
4) Left common carotid a.
5) Left subclavian a.
6) External carotid a. → face, scalp
7) Internal carotid a. → brain
8) Vertebral a. → brain

II. Blood Supply of Face and Neck

Starts from external carotid a.
 Superior thyroid a.
- Thyroid, larynx, neck
 Lingual a.
- Tongue
 Facial a.
- Muscles of facial expression, skin of face
- Crosses anterior to angle of mandible
 Occipital a.
- Posterior scalp and neck
 Posterior auricular a.
- Skin around ear
 Terminal branches of external carotid a.
- Superficial temporal a. → anterior portion of scalp
- Maxillary a. → supply to teeth, oral cavity, mm of mastication
 Middle meningeal a: supplies meninges → rupture = epidural bleed
 Inferior alveolar a. → supplies lower arcade of teeth, passes through
mandibular foramen
Venous Drainage of Face
- Internal jugular v.
III. Blood Supply – Brain
A) Overview
1) Carotid sinus:
 contains baroreceptors
 can detect changes in blood pressure
2) Carotid body
 contains chemoreceptors
 can detect changes in O2 content
Both have innervation from CN IX and CN X
2 main branches going to cerebral arterial circle
 Internal carotid a.
 Vertebral a.
D) Clinical
Cerebral vascular accident
 Stroke
- Ischemic → results from occlusion (blockage)
- Hemorrhagic → burst blood vessel
 Berry aneurism: weakening of vessel wall
 Trauma
 Intracranial hemorrhage

Venous Return from Head and Face

I. General
2 pathways
- Arterial blood → nervous tissue → venous return → dural venous sinuses → internal
jugular v.
- Arterial blood → choroid plexus – CSF → ventricles → subarachnoid space → dural
venous sinuses → internal jugular v.

II. Venous Return

A) Cranial Meninges
- dura has two distinct layers
 Periosteal layer
 Meningeal layer
  Dural venous sinuses

1) Separation of periosteal and meningeal layers

2) Formed from in-folding of dura
- epidural space NOT a real space
B. Dural In-foldings
- made of meningeal layer
- helps to compartmentalize hemispheres, provides stability
- can form dural venous sinuses
- specific infoldings
 Falx cerebri – sits between L and R hemispheres
 Falx cerebelli – between cerebellar hemispheres (superior ↔ inferior)
 Tentorium cerebelli – separates cerebellum from occipital lobes
 Tentorial notch – for brainstem to pass through

III. Venous Return from Face

- drains into internal jugular v
- all veins in face are valveless
- zit danger zone