c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Carotid Artery Anatomy: 1

A D V E R T I S E M E N T

   
 

The carotid artery traverses the neck in the angle between the deep spinous muscles (longus colli/longus capitis, scalenes) and the central visceral structures (larynx, pharynx, trachea, esophagus). It passes from the superior thoracic aperture up to the base of the skull (internal branch) and to the extracranial head structures (external branch). The internal carotid passes deep to the styloid process.      

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Carotid Artery Anatomy: 2

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The common carotid artery normally bifurcates into internal and external at the superior border of the thyroid cartilage. It usually has no branches except for the occasional low takeoff of the superior thyroid artery. The internal carotid is slightly dilated at its origin (carotid bulb) and is larger than the external. Within the medial wall of the bulb is the pressure sensituve carotid sinus. Bound to the adventitia of the medial side of the bulb is the carotid body, a chemoreceptor. The internal carotid passes medial to the styloid process and enters the carotid foramen medial to the styloid (see skull base figures below). The external carotid sends the illustrated branches to the external cranial structures. The continuation of the external carotid passes between the two deeper styloid muscles and the stylohyoid shown as a cut stump here.    

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Carotid Artery Anatomy: 3

A D V E R T I S E M E N T

   
 

Several important nerves lie close to the carotid. The glossopharyngeal nerve passes from the jugular foramen around the styloid and stylopharyngeus muscle to reach the tongue and pharynx. It is in jeopardy during high internal carotid manipulation. The hypoglossal nerve swings down lateral to the two carotid branches above the bifurcation. It is routinely visualized and mobilized upward during carotid endarterectomy. The vagus nerve descends from the jugular foramen lying between the carotid and internal jugular vein. The fine carotid sinus branch of the vagus lies deep between the internal and external carotids. The superior laryngeal branch of the vagus descends deep to the internal carotid (see thyroid folio). The facial nerve passes across the base of the styloid between the stylomastoid foramen and the parotid.    

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This page was last modified on 5/1/1999.