ARTERIES OF THE FACE
Dr.Anitha MA
BHMS,MD(Hom)
Tutor,Dr.Padiyar Homoeopathic Medical College.Kerala
The two principal arteries that supply the
face are the facial artery and superficial temporal artery. In
addition many branches of the ophthalmic and maxillary arteries that
accompany Cutaneous branches of the trigeminal nerve add to the rich
vascular supply to the face
1. FACIAL ARTERY
The facial artery supplies the muscles and tissues of the face, the
sublingual gland, the tonsil and the soft palate.
Facial artery arises from the front of the external carotid artery in
the carotid triangle above the lingual artery, and immediately above
the greater cornu of the hyoid bone. Medial to the ramus of the
mandible it arches upwards and grooves the posterior border of the sub
mandibular gland. It next turns downwards and forwards between the
gland and the medial Pterygoid and reaching the lower border of the
mandible hooks round it at the anterior edge of the masseter and enter
the face.
On the face it passes
forwards and upwards across the mandible and buccinator almost to the
angle of the mouth where the pulsations can be felt if the cheek be
grasped lightly between finger and thumb. It then ascends the side of
the nose and ends at the medial palpebral commissure to supply the
lachrymal sac and anastamoses with the dorsal nasal branch of the
ophthalmic artery.
The facial artery is remarkably tortuous in the neck to accommodate
itself perhaps to the movement of the Pharynx during deglutition and
on the face to the movement of the mandible, lips and cheeks.
Its branches can be divided into cervical and facial groups
Cervical branches
1. The ascending palatine artery
2. The tonsillary artery
3. The glandular branches
4. The submental artery: It branches off as it quite the sub
mandibular gland; it runs forwards upon the mylohyoid below the body
of the mandible. It supplies the surrounding muscle and anastamoses
with sublingual branches of the sublingual artery and the mylohyoid
branch of the inferior alveolar artery.
At the chin it turns upwards over the base of the mandible and divides
into superficial and deep branches which anastamoses with interior
labial and mental arteries, supplying the chin and lower lip.
Facial branches
1. The interior labial artery : Arises near the angle of the
mouth; it passes upwards and forwards under cover of the depressor
anguli oris and penetrating the orbicularis oris, runs in a tortuous
course near the edge of the lower lip between this muscle and the
mucous membrane.
It supplies the glands, mucous membrane, and muscle of the lower lip
and anastamoses with artery of the opposite side and with the mental
branch of the inferior alveolar artery.
2. The superior labial artery: It follows a similar course near
the edge of the upper lip, lying between the mucous membrane and the
orbicularis oris, and anastamoses with artery of the opposite side.
It supplies the upper lip, and gives off a septal branch, which
ramifies on the lower and front part of the nasal septum and an alar
branch, to the ala of the nose.
3. The lateral nasal branch. Is derived from the facial artery
as the vessel ascends along the side of the nose.
It supplies the ala and dorsum of the nose, anastamosing with its
fellow with the septal and alar branches of the superior labial
artery; with the dorsal nasal ramus of the ophthalmic artery; and with
the infra orbital branch of the maxillary artery.
The lateral nasal artery may be represented by several small ramii it
may alternatively arise from the superior labial artery, diverging
from its septal branch.
The Anastamoses of the facial artery are very numerous, not
only within the branches of the vessel of the opposite side, but in
the neck.
With sublingual branch of lingual
With the ascending pharyngeal and
With palatine branch of maxillary
On the face
With the mental branch of the inferior alveolar
The transverse facial branch of the superficial temporal
The infra orbital branch of the maxillary and
The dorsal nasal branch of the ophthalmic artery.
The anastamoses across the midline between the superior and inferior
labial arteries are by their main trunk, an important fact in the
treatment of split lip.
Variations
The facial artery not infrequently arises in common with the lingual
artery, constituting the linguo – facial trunk. It varies in size and
in the extend to which it supplies the face:
It occasionally ends by forming the submental artery and not
infrequently extends only as high as the angle of the mouth or nose.
The deficiency is then compensated for by enlargement of one of the
neighboring arteries.
In a series of 110 human fetuses a common linguo-facial – trunk
occurred in 43 percent. In 42 percent it did not reach the medial
orbital angle, terminating as the superior (20 percent) or inferior
(22 percent) labial artery.
Applied anatomy.
The superior and interior labial branches supply the lips and lie in
the submucous tissue. During operations on the lips these vessel may
be controlled by an assistant who grasps the lip between his finger
and thumb, or they may readily be occluded by spring clamps which take
the whole thickness or the lip.
The superior labial gives a small artery to the nasal septum and
troublesome epistaxis may occur from the vessel as a result of small
septic ulcer of the anterior portion of the septum. The epistaxis may
occur from the vessel as a result of small septic ulcer of the
anterior portion of the septum. The epistaxis may be temporarily
arrested by compressing the labial trunk in the upper lip of the
affected side.
2. THE SUPERFICIAL TEMPORAL ARTERY
Arises in the parotid gland as one of the two terminal
branches of the external carotid artery. It emerges from the superior
aspect of the parotid gland in front of the ear. It is accompanies in
its course by the auriculo temporal branch of V3. The artery divides
into a frontal and parietal branch above the zygoma and is distributed
to the scalp overlying the frontal and parietal bones, respectively.
A transverse facial artery may arise from the superficial temporal
artery within the parotid. The transverse facial artery course between
the parotid duct and the zygomatic arch to supply the facial tissue
over the body of zygoma.
A temporal pulse is frequently taken by compressing the superficial
temporal artery against the Squamous part of the temporal bone above
the ears.
3. THE POSTERIOR AURICULAR ARTERY ( Branch of ext.
carotid artery)
Arises posteriorly from the external carotid artery it ascends between
the superior surface of the posterior belly of the digastric muscle
and the parotid gland. It grooves the base of the skull between the
mastoid process and auricle.
4. THE MAXILLARY (internal maxillary) ARTERY
It runs anteriorly out of the retromandibular position of
the parotid gland to supply the deep face as well as portion of the
nasal and oral cavities.
(a) The first (Mandibular) portion of the maxillary artery lies on the
deep surface of mandibular ramus. Most of its branches pass through
the foramina. Its branches are
i) Middle meningeal artery
ii) Interior alveolar artery and tiny tympanic branches and an
accessory meningeal artery.
(b)The second (Pterygoid) portion of maxillary artery passes deep to
the inferior head of the lateral Pterygoid. its branches
Muscular branches : Include the masseteric, buccal, temporal and
pterygoid arteries.
(c) The third (Pterygopalatine or terminal) portion of the maxillary
dives into pterygo maxillary fissure to enter the pterygopalatine
fossa. Branches are pharyngeal branch, posterior superior alveolar
arteries, Sphenopalatine artery supplying the medial wall of the nasal
cavity by way of the naso palatine artery and the lateral walls by way
of the lateral nasal arteries, the descending palatine artery, and
infra orbital artery (supplying facial structures, and anastamosing
with branches of the facial artery.
The Internal Carotid
Artery
Gives rise to the ophthalmic artery. Its supra trochlear and supra
orbital branches supply the forehead and anterior scalp. It
anastomoses with superficial temporal, facial and posterior auricular
branches of the external carotid artery.
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