The common carotid bifurcates at the superior border of the thyroid cartilage into external and internal branches. The dilated carotid bulb lies at the bifurcation (see carotid anatomy). The external branch supplies the face and superficial head and its terminal branch is the superficial temporal artery. The internal carotid ascends branchless to the base of the skull.
The vertebral arteries arise as the first branch of the subclavian on each side and ascend posteromedially to enter the foramen in the transverse process of the 6th cervical vertebra. They ascend through the succeeding transverse processes, wind around the superior articular facets of the atlas and penetrate the atlantooccipital membrane and dura to enter the posterior fossa via the foramen magnum.
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The main venous drainage of the head is via the internal jugular veins. Extensive intracranial venous collateral communication via the dural venous sinuses allow sacrifice of one internal jugular as in a radical neck dissection, (see subclavian catheterization ) without serious consequences. The internal jugulars drain with the subclavian veins into the brachiocephalic veins.
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