Segments of the internal carotid artery. Anatomy

External carotid artery,a. carotis externa, is one of the two terminal branches of the common carotid artery. It is separated from the common carotid artery within the carotid triangle at the level of the upper edge of the thyroid cartilage. Initially, it is located medial to the internal carotid artery, and then lateral to it. The initial part of the external carotid artery is externally covered by the sternocleidomastoid muscle, and in the area of the carotid triangle - by the superficial plate of the cervical fascia and the subcutaneous muscle of the neck. Located medially from the stylohyoid muscle and the posterior belly of the digastric muscle, the external carotid artery at the level of the neck of the lower jaw (in the thickness of the parotid gland) is divided into its final branches - the superficial temporal and maxillary arteries. On its way, the external carotid artery gives off a number of branches that extend from it in several directions. The anterior group of branches consists of the superior thyroid, lingual and facial arteries. The posterior group includes the sternocleidomastoid, occipital and posterior auricular arteries. The ascending pharyngeal artery is directed medially.

Anterior branches of the external carotid artery:

1 superior thyroid artery,A.thyreoidea superior, departs from the external carotid artery at its beginning, goes forward and downward, and at the upper pole of the thyroid lobe divides into front And rear [ glandular] branches, rr. anterior et posterior. The anterior and posterior branches are distributed in the thyroid gland, anastomosing on the posterior surface of each of its lobes, as well as in the thickness of the organ with the branches of the inferior thyroid artery. On the way to the thyroid gland, the following lateral branches depart from the superior thyroid artery:

1superior laryngeal artery,a. laryngea superior, which, together with the nerve of the same name, pierces the thyrohyoid membrane and supplies blood to the muscles and mucous membrane of the larynx;

2sublingual branch, d.infrahyoldeus, - to the hyoid bone; 3) sternocleidomastoid branch, d.sternocleidomasto- ideus, and 4) cricothyroid branch, d.cricothyroideus, blood supplying muscles of the same name.

2 lingual artery,a. lingualis, branches from the external carotid artery at the level of the greater horn of the hyoid bone. The artery goes below the hyoglossus muscle into the region of the submandibular triangle, then goes into the thickness of the muscles of the tongue and gives off dorsal branches,rr. dorsdles linguae. Its final branch, penetrating to the apex of the tongue, is deep artery of the tongue,a. profunda linguae. Before entering the tongue, two branches depart from the lingual artery: 1) thin suprahyoid branch, d.suprahyoldeus, anastomosing along the upper edge of the hyoid bone with a similar branch of the opposite side, and 2) relatively large hypoglossal artery,a. sublingudlis, going to the sublingual gland and adjacent muscles.

3 . Facial artery,a. facidlis, departs from the external carotid artery at the level of the angle of the lower jaw, 3-5 mm above the lingual artery. The lingual and facial arteries can begin in common lingual-facial trunk,truncus linguofacidlis. In the region of the submandibular triangle, the facial artery is adjacent to the submandibular gland (or passes through it), giving it glandular branches,rr. gldnduldres, then it bends over the edge of the lower jaw onto the face (in front of the masticatory muscle) and goes up and forward, towards the corner of the mouth.

Branches in the neck depart from the facial artery: 1) ascending palatine artery,a. palatina ascendens, to the soft palate;

2almond branch, g.tonsilldris, to the palatine tonsil;

3submental artery,a. submentdlis, next along the outer surface of the mylohyoid muscle to the chin and neck muscles located above the hyoid bone; on the face: in the area of the corner of the mouth 4) inferior labial artery,a. labidlis inferior, and 5) superior labial artery,a. labidlis superior. Both labial arteries anastomose with similar arteries of the opposite side; 6) angular artery, a. ap-guldris, - the area of the facial artery to the medial corner of the eye. Here the angular artery anastomoses with the dorsal nasal artery, a branch of the ophthalmic artery (from the internal carotid artery system).

Posterior branches of the external carotid artery: 1. Occipital artery,a. occipitdlis (Fig. 45), departs from the external carotid artery almost at the same level as the facial artery. Heading backward, it passes under the posterior belly of the digastric muscle, and then lies in the groove of the same name in the temporal bone. After this, the occipital artery between the sternocleidomastoid and trapezius muscles exits to the back surface of the head, where it branches in the skin of the back of the head to occipital branches,rr. occipitdles, which anastomose with similar arteries of the opposite side, as well as with the muscular branches of the vertebral and deep cervical arteries (from the subclavian artery system). The lateral branches depart from the occipital artery: 1) sternocleidomastoid branches,rr. sternocleidomastoidei, to the muscle of the same name; 2) auricular branch,rr. auriculdris, anastomosing with the branches of the posterior auricular artery, to the auricle; 3) mastoid branch, d.mas- toideus, penetrating through the hole of the same name to the hard

lining of the brain; 4) descending branch, g.descendens, to the muscles of the back of the neck.

2. Posterior auricular artery,a. auriculdris posterior, arises from the external carotid artery above the upper edge of the posterior belly of the digastric muscle and follows obliquely backwards. Her auricular branch, gg.auriculdris, And occipital branch, g.occipitdlis, They supply blood to the skin of the mastoid region, the auricle and the back of the head. One of the branches of the posterior auricular artery - stylomastoid artery,a. stylomastoidea, penetrates through the hole of the same name into the canal of the facial nerve of the temporal bone, where it gives off posterior tympanic arterya. tympdnica posterior, to the mucous membrane of the tympanic cavity and the cells of the mastoid process. The terminal branches of the stylomastoid artery reach the dura mater of the brain.

Medial branch of the external carotid artery - ascending pharyngeal artery,a. pharyngea ascendens. This is a relatively thin vessel, departs from the inner semicircle of the external carotid artery at its beginning, and rises up to the lateral wall of the pharynx. From the ascending pharyngeal artery depart: 1) pharyngeal branches,rr. pharyngedles, to the muscles of the pharynx and to the deep muscles of the neck; 2) posterior meningeal artery,a. meningea poste rior, follows into the cranial cavity through the jugular foramen; 3) inferior tympanic artery,a. tympdnica inferior, through the lower opening of the tympanic canaliculus penetrates into the tympanic cavity.

Terminal branches of the external carotid artery:

1. Superficial temporal artery,a. tempordlis superficid- lis, is a continuation of the trunk of the external carotid artery, passes upward in front of the auricle (partially covered at the level her tragus with the posterior part of the parotid gland) to the temporal region, where its pulsation is palpable above the zygomatic arch in a living person. At the level of the supraorbital margin of the frontal bone, the superficial temporal artery divides into frontal branch, g.frontdtis, And parietal branch, g.parietdlis, feeding the epicranial muscle, the skin of the forehead and crown and anastomosing with the branches of the occipital artery. A number of branches depart from the superficial temporal artery: 1) under the zygomatic arch - branches of the parotid gland,rr. parotidei, to the salivary gland of the same name; 2) located between the zygomatic arch and the parotid duct transverse artery of the face,a. transversa faciei, to facial muscles and skin of the buccal and infraorbital areas; 3) anterior auricular branches, gg.auriculares anteriores, to the auricle and external auditory canal, where they anastomose with the branches of the posterior auricular artery; 4) above the zygomatic arch - zygomaticoorbital artery,a. zygo- maticoorbitdlis, to the lateral corner of the orbit, supplies blood to the orbicularis oculi muscle; 5) middle temporal artery,a. tempo rdlis media, to the temporalis muscle.

2. maxillary artery,a. maxilldris, - also the terminal branch of the external carotid artery, but larger than the superficial temporal artery. The initial part of the artery is covered on the lateral side by the branch of the mandible. The artery reaches (at the level of the lateral pterygoid muscle) to the infratemporal muscle and further to the pterygopalatine fossa, where it splits into its terminal branches. According to the topography of the maxillary artery, three sections are distinguished in it: maxillary, pterygoid and pterygopalatine. From the maxillary artery within its maxillary region depart: 1) deep auricular artery,a. auriculdris profunda, to the temporomandibular joint, external auditory canal and eardrum; 2) anterior tympanic artery,a. tympdnica anterior, which through the petrotympanic fissure of the temporal bone follows to the mucous membrane of the tympanic cavity; 3) relatively large inferior alveolar artery,a. alveoldris inferior, entering the canal of the lower jaw and giving off on its way dental branches,rr. dentdles. This artery leaves the canal through the mental foramen as mental artery,a. mentdlis, which branches in the facial muscles and in the skin of the chin. Before entering the canal, a thin branch branches off from the inferior alveolar artery maxillohyoid branch, d.mylohyoideus, to the muscle of the same name and the anterior belly of the digastric muscle; 4) middle meningeal artery,a. meningea media, - the most significant of all the arteries that supply the dura mater of the brain. Penetrates into the cranial cavity through the foramen spinosum of the greater wing of the sphenoid bone and gives off there superior tympanic arterya. tympdnica superior, to the mucous membrane of the tympanic cavity, frontal And parietal branches,rr. front- tdlis et parietdlis, to the dura mater of the brain. Before entering the foramen spinosum, it departs from the middle meningeal artery meningeal accessory branch, d.meningeus accessorius[G.ac cessorius], which first, before entering the cranial cavity, supplies blood to the pterygoid muscles and the auditory tube, and then, passing through the oval opening into the skull, sends branches to the dura mater of the brain and to the trigeminal ganglion.

Within the pterygoid region, branches that supply the masticatory muscles depart from the maxillary artery: 1) masticatory artery,a. masseterica, to the muscle of the same name; 2) temporal deep [anterior] And [temporal posterior/ arteries,a. tempordlis profunda [ anterior] And [ a. tempordlis posterior], extending into the thickness of the temporal muscle; 3) wing-shaped branches,rr. pterygoidei, to the muscles of the same name; 4) buccal artery,a. buccdlis, to the buccal muscle and to the buccal mucosa; 5) posterior superior alveolar artery,a. alveoldris superior posterior, which, through the openings of the same name in the tubercle of the upper jaw, penetrates into the maxillary sinus and supplies its mucous membrane with blood, and its dental branches,rr. dentdles, - teeth and gums of the upper jaw.

Three terminal branches depart from the third - pterygopalatine - section of the maxillary artery: 1) infraorbital artery,a. infraorbitdlis, which passes into the orbit through the inferior palpebral fissure, where it gives branches to the inferior rectus and oblique muscles of the eye. Then, through the infraorbital foramen, this artery exits through the canal of the same name onto the face and supplies blood to the facial muscles located in the thickness of the upper lip, in the area of the nose and lower eyelid, and the skin covering them. Here the infraorbital artery anastomoses with the branches of the facial and superficial temporal arteries. In the infraorbital canal, the infraorbital artery gives off anterior superior alveolar arteries, aa.alveoldres superiores anteriores, giving dental branches,rr. dentdles, to the teeth of the upper jaw; 2) descending palatine artery,a. palatina descendens, - a thin vessel, which, having given first artery of the pterygoid canal,a. candlis pterygo ideas, to the upper part of the pharynx and auditory tube and passing through the greater palatine canal, supplies the hard and soft palates (ah.palatinae major et minores), anastomoses with the branches of the ascending palatine artery; 3) sphenopalatine artery,a. sphe- nopalatina. passes through the hole of the same name into the nasal cavity and gives off lateral posterior nasal arteries, aa.nasdles posteriores laterdles, And posterior septal branches,rr. septdles posteriores, to the nasal mucosa.

The most difficult test on the head and neck awaits all medical students who managed to get to the first half of the second year. I remember that after the first lecture I was horrified by the huge number of branches of arteries and veins, and the cranial nerves (12 of them) generally seemed unimaginably scary.

But is it really that bad? Not at all! You just need to put everything on the shelves in accordance with the classification.

Advice: start teaching the vessels of the head and neck from the internal carotid artery. When you start external sleep, you will already have part of the topic that you know well, your strong point, so to speak.

Yes, when we come to the internal carotid, it is assumed that you already know the heart, aorta, brachiocephalic trunk and common carotid artery. So, very briefly:

The first thing you need to remember about the internal carotid artery is that it supplies the head with blood to the brain and the organ of vision.
The second important thing is that topography will help us very, very much in studying this artery.

Topography of the internal carotid artery

Everything is very simple - topographically, the internal carotid artery is divided into 4 parts.

The cervical part (pars cervicales). It is shown from the bifurcation of the carotid artery to the entrance to the carotid canal of the temporal bone (to the entrance to the skull, in other words). The carotid artery must carry a large volume of blood to the brain, so the cervical spine has no branches - all the blood must flow into the cranial cavity.
Stony section (pars petrosa). So, the carotid artery entered the skull. Several thin ones carotid-tympanic arteries(arteriae caroticotympanicae) will go here into the tympanic cavity. Again, the carotid artery saves blood, slightly supplied the tympanic cavity with blood and carried the bulk of the blood directly to the brain. We show the petrous part inside the carotid canal of the temporal bone.
Cavernous department (pars cavernosa). A very simple association. The cavernous sinuses surround the sella turcica, on which the pituitary gland sits. This is where it will go to the pituitary gland inferior pituitary artery(arteria hypophyseos inferior).
Brain section (pars cerebralis). Here we see the end of the internal carotid artery and its terminal branches - the middle cerebral, anterior cerebral, ophthalmic arteries (more about them below), and the posterior communicating ones. Let's move the ophthalmic arteries a little, which clearly supply blood, and look at the anterior and posterior connecting arteries, which take part in the formation of the Circle of Willis.

Brain section of the internal carotid artery.

It would seem that all of the above is difficult to remember. But when we talk about the cerebral part of the internal carotid artery, we always mention the circle of Willis. A wonderful thing, very simple and memorable. The circle of Willis is the most important arterial anastomosis of our body, which is responsible for the blood supply to the brain. The arteries of the circle of Willis, connecting with each other, form a recognizable ring.

Now let’s color only the Circle of Willis:

Functionally, the Circle of Willis is capable of one very interesting thing - in addition to the fact that it supplies blood to the entire brain normally, it is also adapted to various pathological situations. If any of the cerebral arteries becomes unable to deliver the required amount of blood to the brain (for example, due to compression by a tumor), the remaining arteries of the circle of Willis take over part of the blood supply and deliver blood to the “starving” area in a roundabout way.

We defined the Circle of Willis, learned how to display it on a tablet, and examined its function. Now let's find out what it consists of. So, the Circle of Willis is formed:

Anterior cerebral arteries (right and left);
Anterior communicating artery;
Posterior communicating arteries (right and left);
The basilar artery closes the circle, which diverges into the posterior arteries - right and left. We will talk about them in the topic “subclavian artery and its branches.”

Also in the zone of the Circle of Willis there is a segment of the internal carotid artery, from which the median cerebral arteries depart, but they do not directly participate in the Circle of Willis. Now let's look at everything we listed on the tablet.

Look - this is anterior cerebral artery(arteria cerebri anterior), I indicated it with blue lines.

The anterior cerebral artery is a steam room. As you can see, in the Circle of Willis there are two anterior cerebral arteries - the right and left. And connects them anterior communicating artery(arteria communicans anterior).

Let's take a closer look at the front connection:

Posterior communicating artery(arteria communicans posterior) is another very important component of the Circle of Willis. Not to be confused with the posterior medullary, it is partly included in the circle of Willis, but the posterior connective is included entirely. Look how noticeable it is:

We are not considering the posterior arteries now. It is important to understand and remember the connecting arteries - anterior and posterior. Then the Circle of Willis will immediately appear before your eyes.

So, once again, the anterior communicating artery connects the two anterior cerebral arteries (branches of the internal carotid), the posterior communicating arteries connect the internal carotid with the posterior ones. Just behind, the circle is closed by the basilar artery, which we also haven’t touched yet.

Middle cerebral artery

Also, do not forget about the middle cerebral artery (arteria cerebri media) - it is located approximately in the middle of the brain from the same angle as ours, so you will immediately remember it. I decided to highlight it in length - its dimensions allow this.

The middle cerebral artery gives terminal branches to the temporal lobe, basal ganglia and thalamus. The middle artery is a continuation of the internal carotid artery.

Ophthalmic artery

So, we are done with the Circle of Willis. We still have one more very important point - the organ of vision. It is of enormous importance for the perception of the outside world, therefore, it requires a significant blood supply.

The ophthalmic artery (arteria ophthalmica) departs from the internal carotid artery, or more precisely, from its cerebral section. It goes straight to the optic canal, and there it gives off a series of branches:
1. The mucous membranes of the openings of the ethmoid bone supply blood anterior and posterior ethmoidal arteries(arteriae ethmoidales anterior et pasterior). By the way, when you disassemble the trigeminal nerve, you will also encounter the anterior and posterior ethmoidal branches;
2. Lacrimal artery(arteria lacrimalis) provides blood to the lacrimal gland;
3. Muscular arteries(arteriae musculares) will direct blood to the upper muscles of the eye - oblique and straight;
4. Central retinal artery(arteria centralis retinae), naturally supplies the retina;
5. Medial arteries of the eyelids(arteriae palpebrales mediales) - they will carry blood to the medial part of the eyelids. By the way, they close with the lateral arteries of the eyelids into the arterial arches of the upper and lower eyelids;
6. Dorsal nasal artery(arteria dorsales nasi). This artery will go to the medial corner of the eye, where it will close an anastomosis with the angular artery - the same one that is a branch of the facial artery (this is the external carotid).
These are not all the branches of the ophthalmic artery, however, by remembering these main ones, you can easily “get” the necessary information. The main thing is to remember the top and bottom lattice arteries, lachrymal And muscular, the rest will already be added to those you know in your memory.

My text is not 100% accurate and should not be used as the only source of preparation. I wrote it to help structure the knowledge that already exists, but is in a chaotic order. But for starters, your lectures, Sapin’s textbook, Sinelnikov’s atlas, and, of course, the video of the magnificent anatomist Vladimir Izranov will help you.

Lexical minimum

If you think you have mastered the topic “The Internal Carotid Artery and the Circle of Willis,” I suggest you test your knowledge. If you really know this material well, then naming all these terms in Russian and showing them on tablets will not be difficult. Ideally, you should have no hitches at all. If there are more than two hitches, you need to go through the topic again. So, let's go check it out:

Arteria carotis communis;
Arteria carotis interna;
Pars cervicales;
Pars petrosa;
Pars cavernosa;
Pars cerebralis;
Arteriae caroticotympanicae;
Arteria hypophyseos inferior;
Arteria cerebri anterior;
Arteria communicans anterior;
Arteria communicans posterior;
Arteria cerebri media;
Arteria ophthalmica;
Arteriae ethmoidales anterior et pasterior;
Arteria lacrimalis;
Arteriae musculares;
Arteria centralis retinae;
Arteriae palpebrales mediales

The carotid aorta is a large vessel that is of the muscular-elastic type. With its help, nutrition is provided to such important parts of the body as the head and neck. The performance of the brain, as well as organs such as the eyes, thyroid gland, tongue, and parathyroid gland, depends on the blood flow of the carotid artery.

Arteries and veins play a fairly important role in the human body. They help transport blood, which contains a large amount of oxygen. Carotid arteries ensure full functionality of all organs located on the head.

Arteries are vessels that, when compressed, cause oxygen starvation. The anatomy of the artery is quite complex. There are internal and external aortas. They are also characterized by the presence of the vagus and hypoglossal nerves. Experts tell us how many carotid arteries a person has. There is a common aorta that performs all major functions. The internal and external aorta depart from this aorta. There are three common carotid arteries in the human neck.

Functions of the carotid artery

The functions of the human carotid artery are to provide reverse flow of blood. If the vertebral branch narrows, then the veins and arteries begin to pump blood much more intensely. Thanks to the carotid artery, the possibility of oxygen starvation is eliminated.

Artery and vein are different. The carotid artery in humans is characterized by a regular cylindrical shape and a round cross-section. The veins are characterized by flattening and also a tortuous shape, which is explained by the pressure of other organs. A distinctive feature is not only the structure, but also the quantity. There are many more veins in the human body than arteries.

The aorta differs according to its location. They lie deep in the tissues, and the veins lie under the skin. The aorta supplies organs with blood more efficiently than a vein. Arterial blood is characterized by the presence of a large amount of oxygen in its composition, which is why it has a scarlet color. Venous blood includes decay products and is therefore characterized by a darker shade. Arteries transport blood from the heart to the organs. Veins transport blood to the heart.

The walls of arteries are characterized by a higher level of elasticity than the walls of veins. The movement of blood in the aortas is carried out under pressure, as it is pushed out by the blood. Veins are used to collect blood for tests or administer medications. Aortas are not used for these purposes.

Why is the carotid artery called this?

A large number of people ask why the carotid artery is called the carotid artery. When you press on the carotid artery, its receptors actively reduce pressure. This is explained by the fact that pressure is perceived by the receptors as . Cardiac disturbances are observed in the form of a slow heartbeat. When the blood vessels are compressed, oxygen starvation develops, which leads to drowsiness. Specialists who determined what the aorta is and what functions it performs gave it this name.

If the venous wall is compressed, then the person is not drawn to sleep. If the aorta is exposed to mechanical means for a long time, then consciousness may turn off. In some cases, death is diagnosed. That is why it is strictly forbidden to check the functions of the aorta out of curiosity. Everyone should know about the location of the aorta, since this information is necessary to provide first aid.

What happens if the carotid artery is clamped?

All experts talk about what will happen if the carotid artery is clamped. It is characterized by a fairly delicate structure. That's why if compress the carotid artery, the person will lose consciousness. When wearing a tie or scarf, people experience a feeling of discomfort due to compression.

If a critical situation occurs, then it is necessary to find the cervical artery where the pulse passes. You need to press in the hollow under the cheekbone. It is necessary to feel the pulse as carefully as possible. If you put pressure on this area, the situation will worsen.

Where is the carotid artery located?

Every person should know where the carotid artery is located. In this case, it is necessary to remember that veins and arteries are completely different things. The location of the common aorta is the neck. It is characterized by the presence of two identical vessels. On the right side, the vein begins from the brachiocephalic trunk, and on the left, from the aorta.

Both arterial veins are characterized by an identical anatomical structure. They are characterized by a vertical upward direction through the chest. Above the sternocleidomastoid muscle are the internal and external carotid aortas.

After the internal artery branches off, an expansion is formed, which is characterized by the presence of multiple nerve endings. This is a fairly important reflex zone. If a patient is diagnosed with hypertension, it is recommended that he massage this area. It will help you lower your blood pressure on your own.

How to find the carotid artery?

The location of the carotid arteries in the neck is on the left and right sides. In order to know how to find the carotid artery, you need to know its location. The main aorta passes under the sternocleidomastoid muscle. Above the thyroid cartilage it divides into two branches. This place is called bifurcation. In this place, there are receptor-analyzers that signal the level of pressure inside the vessel.

Right coronary artery

Veins and arteries, which are located on the right side, provide blood supply to organs such as:

Teeth;
Eyes;
Nasal cavities;
Oral cavity;

The branches of the carotid artery pass through the skin of the face and entwine the brain from above. If a person is embarrassed or his body temperature rises, this leads to redness of the epithelial surfaces on the face.

With the help of this aorta, blood flow is directed in the reverse order in order to assist the branches of the internal aorta and the vertebral aorta, provided they are narrowed.

Left coronary artery

The left branch of the carotid artery enters the brain through the temporal bone, which is characterized by the presence of a special opening. This is an intracranial location. The vein diagram is quite complex. The vertebral vessels and cerebral aortas form the circle of Willis through anastomosis. The arteries supply blood with oxygen, which provides adequate nutrition to the brain. From it there is a branch of arteries into the convolutions, as well as gray and white matter. The aortas also extend into the cortical centers and nuclei of the medulla oblongata.

Possible diseases of the carotid artery

There are various diseases of the carotid artery, which develop under the influence of various provoking factors. In most cases, patients are diagnosed with coronary artery syndromes.

In the general and internal trunk, the development of pathologies that arise against the background of various chronic diseases is diagnosed:

Syphilis;
Tuberculosis; atherosclerosis;
Fibromuscular dysplasia.

Pathologies in the trunk can develop against the background of an inflammatory process. If there is a plaque in the aorta, this can lead to the development of pathologies. They can also be observed against the background of proliferation of the internal membranes or dissection. In the area of the branch of the internal aorta, the inner lining may rupture. Against this background, the formation of an intramural hematoma is observed, against the background of which full blood flow is impossible.

Violation of the full functioning of the aorta is observed against the background of various pathological processes:

Arteriovenous fistulas;
Facial and cervical hemangiomas;
Angiodysplasia.

These diseases often occur against the background of facial injuries. If a person has undergone otolaryngeal or rhinoplastic surgery on the face, this may cause a pathological process. The cause of the disease is often hypertension. If the patient has had unsuccessful medical procedures, which include punctures, tooth extraction, rinsing of the nasal sinuses, injections into the eye socket, then this can lead to the development of pathologies.

Against the background of the influence of these factors, the occurrence of an arteriovenous shunt is diagnosed. Along its drainage paths, arterial blood flows to the head under high pressure. With such anomalies, cerebral venous congestion is most often diagnosed. Quite often, patients are diagnosed with the development of angioplasia. They manifest themselves as throbbing pain in the head, cosmetic defects, and profuse hemorrhages, which are not sufficiently amenable to standard therapeutic methods.

When the aorta narrows, patients are diagnosed with the development of an aneurysm, trifurcation, abnormal tortuosity of the internal aorta, and thrombosis. Quite often, people are diagnosed with trifurcation, in which the main trunk is divided into three branches.

Carotid artery aneurysm

During the period of an aneurysm, a person’s aortic wall becomes locally thinner. This section of the human aorta expands. The disease can develop against the background of a genetic predisposition. The reasons for the formation of the acquired form of the disease are the occurrence of inflammatory processes. Also the cause of the pathology is atrophy of the muscle layer.

The location of the pathological process is the intracranial segments of the internal aorta. Most often, a saccular shape is characteristic of a cerebral aneurysm. Diagnosis of this pathological condition is carried out only by pathologists. No manifestations of this disease are observed during a person’s life. The thinned wall ruptures if the patient's head and neck are injured. The cause of the development of pathology is high blood pressure. The wall breaks if a person experiences physical or emotional stress.

If blood accumulates in the area of the subarachnoid space, this leads to swelling and compression of the brain. The consequences are directly affected by the size of the hematoma, as well as the speed of provision of medical care. If an aneurysm is suspected, differential diagnosis is performed. This is explained by the fact that this disease is similar to chemodectoma. This is a benign neoplasm that turns into cancer in 5 percent of cases. The location of the tumor is the bifurcation zone. If the pathological process is not treated in a timely manner, tumor spread into the submandibular zone is observed.

Carotid artery thrombosis

Thrombosis is a fairly serious pathological process in which a blood clot forms in the aorta. Thrombus formation in most cases is observed at the branching site of the main aorta. Thrombosis is observed against the background of:

Heart defects;
Increased blood clotting;
Atrial fibrillation;
Antiphospholipid syndrome.

Patients who lead a sedentary lifestyle are at risk. The disease can develop with traumatic brain injuries, Takayasu arteritis. Thrombosis appears if the tortuosity of the aorta increases. If a spasm occurs due to smoking, this becomes the cause of pathology. With congenital hypoplasia of the vessel walls, pathology is observed.

The disease can be characterized by an asymptomatic course. In the acute form of the pathology, the blood supply to the brain is suddenly disrupted, which can lead to death. In some patients, a subacute course of the disease is diagnosed. In this case, the carotid aorta is completely blocked. In this form, recanalization of the thrombus is observed, which leads to the appearance and disappearance of symptoms.

The pathological process is accompanied by fainting and frequent loss of consciousness when a person is in a sitting position. Patients complain of paroxysmal pain in the neck and head. Patients may experience specific tinnitus. A person does not feel sufficient strength in the chewing muscles. In case of thrombosis, the patient is diagnosed with visual impairment.

Carotid artery stenosis

There are a large number of veins and arteries on the patient’s body that can be affected by stenosis. The veins can be removed through surgery, but the aorta is treated using other unique techniques. With stenosis, the lumen of the carotid aorta narrows, which leads to deterioration in nutrition of the head and neck.

In most cases, the pathological process occurs without symptoms. In some people, the disease is accompanied by transient ischemic attacks, which leads to a decrease in nutrition of certain areas of the brain. This leads to dizziness, weakness in the limbs, blurred vision, etc. Treatment of pathology is carried out surgically. In the first case, an open endarterectomy is performed, which is performed by vascular surgeons. Today, the second type of surgical intervention is most often used - stenting. A special stent is placed in the artery, which widens the artery.

Diagnostics

The symptoms and treatment of carotid aortic diseases are completely consistent. That is why, when the first signs of pathology appear, the patient needs to seek help from a doctor. The specialist will examine the patient and collect anamnesis. But in order to make a diagnosis, it is necessary to use instrumental methods:

Electroencephalography;
Rheoencephalography;
Computed tomography.

Quite often, patients are recommended to undergo magnetic resonance imaging. An informative research method is angiography, for which contrast is introduced. Patients are recommended to use Doppler ultrasound examination of the neck and head.

Treatment options

The choice of treatment method directly depends on the severity of the pathological process. If the aneurysm is small in size or thrombosis is observed in the initial stages, then this requires the use of medications. After the onset of thrombosis, thrombolytics must be used with a high level of effectiveness for 4-6 hours. Patients are prescribed:

Fibrinolysin;
Streptodecases;
Urokinase;
Plasmina.

Anticoagulants are quite effective in treating the initial stages of diseases. The most common treatment is Heparin, Syncumar, Neodicoumarin, Phenilin, Dicoumarin. While taking medications, it is necessary to regularly monitor the level of blood clotting.

In order to relieve spasm and expand the vascular bed, it is recommended to install a novocaine blockade. If the location of the pathology is the external carotid aorta, then the arteriovenous shunt is excised. Most experts consider this method to be insufficiently effective. Surgery on the carotid aorta is carried out in specialized medical institutions. If the patient has a narrowing of the aorta, then the pathology is eliminated by stenting. In this case, a thin metal mesh is used, when deployed, the patency of the vessel is restored.

If there is a crimped or thrombosed area, it is removed and replaced with a plastic material. Surgery should only be performed by a highly qualified specialist due to the risk of bleeding. Surgery may also be used to create a bypass for blood flow. The intervention requires the use of an artificial shunt.

The carotid aorta plays a fairly important role in the human body. That is why, when pathological processes occur, it is necessary to carry out treatment using conservative or surgical methods. The choice of treatment regimen is made by the doctor according to the individual characteristics of the patient and the severity of the disease.

The internal carotid artery (a. carotis interna) has a diameter of 8-10 mm and is a branch of the common carotid artery. Initially, it is located behind and lateral to the external carotid artery, separated from it by two muscles: m. styloglossus and m. stylopharyngeus. It goes up the deep muscles of the neck, being in the peripharyngeal tissue next to the pharynx, to the external opening of the carotid canal. There are options when the internal carotid artery in the neck twists. Its length in the carotid canal is 10-15 mm. Having passed through the carotid canal, it exits into the sinus cavernosus, in which it makes two turns at right angles, first forward, then upward and somewhat posteriorly, perforating the dura mater behind the canalis opticus. Lateral to the artery is the sphenoid process. In the neck area, the internal carotid artery does not give branches to organs. In the carotid canal, the carotid-tympanic branches (rr. caroticotympanici) depart from it to the mucous membrane of the tympanic cavity and the artery for the pterygoid canal. The superior and inferior pituitary branches depart from the cavernous part of the internal carotid artery.

In the cranial cavity, the internal carotid artery is divided into 5 large branches (Fig. 395).

395. Arteries of the brain.
1 - a. communicans anterior; 2 - a. cerebri anterior; 3 - a. carotis interna; 4 - a. cerebri media; 5 - a. communications posterior; 6 - a. choroidea; 7 - a. cerebri posterior; 8 - a. basilaris; 9 - a. cerebri inferior anterior; 10 - aa. vertebrales; 11 - a. spinalis anterior.

The ophthalmic artery (a. ophthalmica) arises immediately after passing through the dura mater, located under the optic nerve. Together with it it penetrates into the orbit, goes between the superior rectus muscle of the eye and the optic nerve. In the superomedial part of the orbit, the ophthalmic artery divides into branches that supply blood to all formations of the orbit, the ethmoid bone, the frontal region and the dura mater of the anterior fossa of the skull. The ophthalmic artery is divided into 8 branches: 1) the lacrimal artery (a. lacrimalis) supplies blood to the lacrimal gland and anastomoses with the middle meningeal artery; 2) central retinal artery (a. centralis retinae) - retina of the eye; 3) lateral and medial arteries of the eyelids (aa. palpebrales lateralis et medialis) - the corresponding corners of the orbit (there are upper and lower anastomoses between them); 4) posterior ciliary arteries, short and long (aa. ciliares posteriores breves et longi), - the white and choroid of the eyeball; 5) anterior ciliary arteries (aa. ciliares anteriores) - the tunica albuginea and the ciliary body of the eye; 6) supraorbital artery (a. supraorbitalis) - forehead area; anastomoses with branches of a. temporalis superficialis; 7) ethmoid arteries, posterior and anterior (aa. ethmoidales posteriores et anteriores) - ethmoid bone and dura mater of the anterior cranial fossa; 8) dorsal artery of the nose (a. dorsalis nasi) - the back of the nose; connects with a. angularis in the area of the medial corner of the orbit.

The posterior communicating artery (a. communicans posterior) goes back and connects with the posterior cerebral artery (branch of a. vertebralis). Supplies blood to the optic chiasm, oculomotor nerve, gray tubercle, cerebral peduncles, hypothalamus, optic tubercle and caudate nucleus.

The anterior artery of the choroid plexus (a. choroidea anterior) runs back along the lateral side of the cerebral peduncles between the optic tract and the gyrus parahippocampal, penetrates the lower horn of the lateral ventricle, where it participates together with aa. choroideae posteriores in the formation of the choroid plexus (). Supplies blood to the optic tract, internal capsule, lenticular nucleus, hypothalamus and optic thalamus.

The anterior cerebral artery (a. cerebri anterior) is located above the optic nerve in the area of the trigonum olfactorium and substantia perforata anterior, located at the base of the cerebral hemisphere. At the beginning of the anterior longitudinal cerebral sulcus, the right and left anterior cerebral arteries are connected using the anterior communicating artery (a. communicans anterior), which has a length of 1-3 mm. Then the terminal part of the anterior cerebral artery lies on the medial surface of the cerebral hemisphere, bending around the corpus callosum. Supplies Blood to the olfactory brain, corpus callosum, cortex of the frontal and parietal lobes of the cerebral hemisphere. Anastomoses with the middle and posterior cerebral arteries.

The middle cerebral artery (a. cerebri media) has a diameter of 3-5 mm and represents the terminal branch of the internal carotid artery. Along the lateral sulcus of the brain it is directed to the lateral part of the hemisphere. Supplies blood to the frontal, temporal, parietal lobes and insula of the brain, forming anastomoses with the anterior and posterior cerebral arteries.

internal carotid artery,a. carotis interna, supplies blood to the brain and organ of vision. The initial section of the artery is its cervical part, pars cervicdlis, located laterally and posteriorly, and then medially from the external carotid artery. Between the pharynx and the internal jugular vein, the artery rises vertically (without giving off branches) to the external opening of the carotid canal. Behind and medially from it are the sympathetic trunk and the vagus nerve, in front and laterally - the hypoglossal nerve, above - the glossopharyngeal nerve. In the carotid canal there is a stony part, pars petrosa, internal carotid artery, which forms a bend and gives thin carotid-tympanic arteries, aa.caroticotympdnicae.

Upon leaving the canal, the internal carotid artery bends upward and lies in the short groove of the same name of the sphenoid bone, and then the cavernous part, pars caverno- sa, The artery passes through the cavernous sinus of the dura mater of the brain. At the level of the optic canal, the brain part, pars cerebrdlis, The artery makes another bend, convexly facing forward, gives off the ophthalmic artery and, at the inner edge of the anterior inclined process, divides into its terminal branches - the anterior and middle cerebral arteries.

1. Ophthalmic artery,a, ophthalmica (Fig. 46), departs in the area of the last bend of the internal carotid artery and, together with the optic nerve, enters the orbit through the optic canal. Next, the ophthalmic artery follows along the medial wall of the orbit to the medial corner of the eye, where it splits into its terminal branches - the medial arteries of the eyelids and the dorsal artery of the nose.

The following branches depart from the ophthalmic artery: 1) lacrimal arterya. lacrimdlis, follows between the superior and lateral rectus muscles of the eye, giving them branches, to the lacrimal gland; thin ones are also separated from it lateral arteries of the eyelids, aa.palpebrdles laterdles; 2) long and short posterior ciliary arteries, aa.ciliares posteriores longae et breves, pierce the sclera and penetrate the choroid of the eye; 3) central retinal artery,a. centrdlis retinae, enters the optic nerve and reaches the retina; 4) muscular arteries, aa.muscles, to the superior rectus and oblique muscles of the eyeball; 5) posterior ethmoidal artery,a. ethmoidalis posterior, follows to the mucous membrane of the posterior cells of the ethmoid bone through the posterior ethmoidal opening; 6) anterior ethmoidal artery,a. ethmoidalis anterior, passes through the anterior ethmoidal opening, where it divides into its terminal branches. One of them - anterior meningeal artery [branch], a. [G.]meningeus anterior, enters the cranial cavity And supplies blood to the dura mater of the brain, while others penetrate under the cribriform plate of the ethmoid bone and nourish the mucous membrane of the ethmoid cells, as well as the nasal cavity and the anterior parts of its septum; 7) anterior ciliary arteries, aa.ciliares anteriores, in the form of several branches accompany the muscles of the eye: above the scleral arteries, aa.episcterdles, enter the sclera and anterior conjunctival arteries, aa.conjunctivdles anteriores, supply blood to the conjunctiva of the eye; 8) supratrochlear artery,a. supratrochlearis, leaves the orbit through the frontal foramen (together with the nerve of the same name) and branches in the muscles and skin of the forehead; 9) medial arteries of the eyelids, aa.palpebrdles mediates, They go to the medial corner of the eye, anastomose with the lateral arteries of the eyelids (from the lacrimal artery), forming two arches: arch of the upper eyelid, ag-cus palpebrdlis superior, And arch of the lower eyelid,crcus palpebrdlis inferior; 10) dorsal nasal artery,a. dorsalis nasi, passes through the orbicularis oculi muscle to the corner of the eye, where it anastomoses with the angular artery (the terminal branch of the facial artery). The medial arteries of the eyelids and the dorsal nasal artery are the terminal branches of the ophthalmic artery.

2. Anterior cerebral artery,a. cerebri anterior (Fig. 47), departs from the internal carotid artery slightly above the ophthalmic artery, approaches the artery of the same name on the opposite side and connects with it by a short unpaired communicating artery,a. communications anterior. Then the anterior cerebral artery lies in the groove of the corpus callosum, goes around the corpus callosum (Fig. 48) and goes towards the occipital lobe of the cerebral hemisphere, supplying blood to the medial surfaces of the frontal, parietal and partly occipital lobes, as well as the olfactory bulbs, tracts and striatum. The artery gives off two groups of branches to the substance of the brain - cortical and central.

3middle cerebral artery,a. cerebri media, is the largest branch of the internal carotid artery. It has a wedge-shaped part, pars sphenoidalis, adjacent to the large wing of the sphenoid bone, and the insular part, pars insularis. The latter rises upward, enters the lateral sulcus of the cerebrum, adjacent to the insula. Then it continues into its third, final (cortical) part, pars terminalis (pars corticalis), which branches on the superolateral surface of the cerebral hemisphere. The middle cerebral artery also gives off cortical and central branches.

4Posterior communicating artery, a. communications posterior, extends from the end of the internal carotid artery until the latter divides into the anterior and middle cerebral arteries. The posterior communicating artery is directed towards the bridge and at its anterior edge flows into the posterior cerebral artery (a branch of the basilar artery).

5. Anterior villous artery,a. choroidea anterior, - a thin vessel that arises from the internal carotid artery behind the posterior communicating artery, penetrates the lower horn of the lateral ventricle, and then into III ventricle With its branches it participates in the formation of choroid plexuses. It also gives off numerous thin branches to the gray and white matter of the brain: to the optic tract, lateral geniculate body, internal capsule, basal ganglia, hypothalamic nuclei and red nucleus.

The following arteries participate in the formation of anastomoses between the branches of the internal and external carotid arteries: a. dor- salts ndsi (from the ophthalmic artery) and a. anguldris (from the facial artery), a. supratrochledris (from the ophthalmic artery) and G.frontlis (from the superficial temporal artery), a. carotis interna And a. cerebri posterior (via the posterior communicating artery).