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: 13

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

   
 

The internal carotid artery enters the carotid canal of the temporal bone. The internal jugular vein emerges from the jugular foramen formed between the temporal and occipotal bones. The jugular formane lies just medial to the base of the styloid process. The anterior inclination of the styloid places it lateral to the terminal part of the internal carotid artery and it may be necessary to resect it for high exposure. There is a passage for the hypoglossal nerve through the base of the occipotal condyles.     

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Carotid Artery Anatomy: 14

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

   
 

The majority of closely related nerves emerge with the internal jugular vein. The cranial portion of the accessory nerve and the vagus nerve emerge at the posterior margin of the jugular foramen and pass laterally and directly downward respectively. The smaller glossopharyngeal nerve exits just anterior to the other two and passes lateral to the internal jugular vein toward the tip of the styloid process. The internal jugular vein starts anterolateral to the carotid at the base of the neck and crosses it diagonally to reach a posterolateral position at the base of the skull. The hypoglossal nerve passes through the canal of the same name. The facial nerve emerges from the stylomastoid foramen and runs forward lateral to the base of the styloid.    

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Carotid Artery Anatomy: 15

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

   
 

The nerves at risk for injury during carotid endarterectomy are intimately related to the styloid muscles. The more cephalad of the two deep styloid muscles is the styolglossus and the caudal one is the stylopharyngeus. The glossopharyngeal nerve passes between the stylopharyngeus and stylohyoid (most superficial of the three) and spirals around the lower border of the stylopharyngeus to reach the tongue and pharynx.      

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