{"id":1158,"date":"2020-07-23T08:23:37","date_gmt":"2020-07-23T08:23:37","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/test\/head-and-neck\/blood-vessels\/"},"modified":"2022-01-05T19:15:53","modified_gmt":"2022-01-05T17:15:53","slug":"blood-vessels-hn","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/skull-head-and-neck\/neurovasculature\/blood-vessels-hn\/","title":{"rendered":"Blood Supply"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><div class=\"intro\">The blood supply of the head and neck arises from two main contributors: the carotid system supplying the head and the upper parts of the neck, and the branches of the subclavian artery supplying the lower parts of the neck.<\/div><\/p>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h2 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">The carotid system<\/h2>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">Generally, the carotid system supplies the upper neck and head (including most of the brain). It consists of the <strong>internal <\/strong>and<strong>&nbsp;external&nbsp;<\/strong>carotid arteries:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The carotid system of each side begins with the <strong>common carotid artery (CCA)<\/strong> <ul><li>The left CCA branches out of the <strong>arch of the aorta<\/strong><\/li><li>The right CCA branches out of the&nbsp;<strong>brachiocephalic trunk<\/strong><\/li><li>Thus, the two CCAs are of different length &#8212; the right one is 1cm shorter <\/li><\/ul><\/li><li>Both sides have a similar course from the neck upwards<\/li><li>The CCA branches out to the <strong>internal<\/strong> (ICA) and <strong>external carotid artery <\/strong>(ECA) approximately at the level of the 4th cervical vertebra (C4) or at the superior edge of the thyroid cartilage<\/li><li><strong>The external carotid artery <\/strong>is the&nbsp;main contributor to the blood supply of the head and upper neck, while the internal carotid artery supplies only small parts of it (its main blood supply is the brain)<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><a href=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/arch-aorta.png\" target=\"_blank\" title=\"Blood Supply\"><img loading=\"lazy\" decoding=\"async\" width=\"961\" height=\"1024\" src=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/arch-aorta-961x1024.png\" alt=\"\" class=\"wp-image-1176\" srcset=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/arch-aorta-961x1024.png 961w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/arch-aorta-282x300.png 282w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/arch-aorta-768x818.png 768w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/arch-aorta.png 1264w\" sizes=\"auto, (max-width: 961px) 100vw, 961px\" \/><\/a><figcaption><strong>Figure 1. Aortic arch and related structures <\/strong>(Credit: OpenStax, CC BY-SA 4.0)<\/figcaption><\/figure><\/div>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h2 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Branches of the subclavian artery<\/h2>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">The subclavian artery supplies the upper limbs, neck, spinal cord, and the posterior cranium.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Origin and path<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<ul class=\"wp-block-list\"><li>The right subclavian artery arises from the brachiocephalic trunk<\/li><li>The left subclavian artery arises from the arch of the aorta directly<\/li><li>As the subclavian arteries progress towards the limbs and pass the first rib, they become the&nbsp;<strong>axillary artery<\/strong><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Parts<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<p class=\"wp-block-paragraph\">The<strong> anterior scalene muscle<\/strong> divides the subclavian artery into three parts &#8212; medial, posterior, and lateral parts (shown in the illustration below).<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title3\">Medial part<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<ol class=\"wp-block-list\"><li><strong>Vertebral artery<\/strong>\n<ul>\n<li>Enters the transverse foramen of the cervical vertebrae of C6, leaving on a groove on C1 vertebra<\/li>\n<li>Supplies the spinal cord and the brain<\/li>\n<\/ul>\n<\/li><li><strong>Thyrocervical trunk<\/strong>\n<ul>\n<li>Called&nbsp;<strong>trunk<\/strong> because the vessel is very short since it splits into several branches right away<\/li>\n<li>Gives off 4 branches:\n<ul>\n<li>Suprascapular artery<\/li>\n<li>Transverse cervical artery<\/li>\n<li>Inferior thyroid artery\n<ul>\n<li>Will give off the inferior laryngeal artery<\/li>\n<li>Inferior thyroid and inferior laryngeal arteries supply the lower larynx, trachea and thyroid gland<\/li>\n<\/ul>\n<\/li>\n<li>Ascending cervical artery<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li><li><strong>Internal thoracic artery<\/strong>\n<ul>\n<li>Descends to supply the thoracic wall and chest<\/li>\n<\/ul>\n<\/li><\/ol>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title3\">Posterior part<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n\n<p class=\"wp-block-paragraph\">Contains the costocervical trunk which branches out to:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Superior<\/strong> or <strong>supreme intercostal artery<\/strong><\/li><li><strong>Deep cervical artery<\/strong><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_7\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title3\">Lateral part<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_7\">\n\n\n<p class=\"wp-block-paragraph\">In some cases, the&nbsp;<strong>dorsal scapular artery<\/strong> will arise directly from the subclavian artery at this part, opposed to the transverse cervical artery of the thyrocervical trunk.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><a href=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/bc-trunk-blood-supply.png\" target=\"_blank\" title=\"Blood Supply\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"889\" src=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/bc-trunk-blood-supply-1024x889.png\" alt=\"\" class=\"wp-image-1175\" srcset=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/bc-trunk-blood-supply-1024x889.png 1024w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/bc-trunk-blood-supply-300x260.png 300w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/bc-trunk-blood-supply-768x667.png 768w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/bc-trunk-blood-supply-1536x1333.png 1536w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/bc-trunk-blood-supply.png 1600w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/a><figcaption><strong>Figure 2. The subclavian artery and its branches<\/strong><\/figcaption><\/figure><\/div>\n\n\n<\/span><span class=\"block-heading\" id=\"header_8\">\n<h2 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Clinical information<\/h2>\n<\/span><span class=\"block-content\" id=\"contents_8\">\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-8f761849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\"><\/span><span class=\"block-heading\" id=\"header_9\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Pulse palpation<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_9\">\n\n\n<p class=\"wp-block-paragraph\">In the head and neck, we can palpate the pulse and measure the heart rate in several locations:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Temporal pulse<\/strong>. Can be palpated at two places: <ol><li>Directly from the superficial temporal artery, can be felt on the surface between the external acoustic meatus and the zygomatic bone<\/li><li>Anterior branch of the superficial temporal artery can be felt on the surface around the pterion <\/li><\/ol><\/li><li><strong>Facial pulse<\/strong> <ul><li>Can be palpated at the angle of the mandible <\/li><\/ul><\/li><li><strong>Carotid pulse<\/strong> <ul><li>Can be palpated at the medial border of the sternocleidomastoid muscle, lateral to the thyroid cartilage (at the level of C4-C5 vertebra)<\/li><\/ul><ul><li><strong>Do not palpate both carotids at the same time<\/strong>. This can lead to the loss of conciousness.<\/li><li><strong>Do not press too hard<\/strong>, as it may stimulate the vagus nerve (once again, leading to the loss of conciousness), or dislodge an atherosclerotic plaque, leading to obstruction (older patients).<\/li><\/ul><\/li><li><strong>Subclavian pulse<\/strong><ul><li>Can be palpated at the supraclavicular fossa, in the mid-clavicular line.<\/li><\/ul><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The pulse should be palpated by applying light pressure using 2-3 fingers or the thumb.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_10\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Compression<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_10\">\n\n\n<p class=\"wp-block-paragraph\">In the case of severe, arterial bleeding, compressing a central artery may save a patient&#8217;s life.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Arterial bleeding is seen as bright red, high-pressure, pulsating spurs of blood.<\/li><li>An arterial bleeding from the head and upper neck can be stopped by the compression of the <strong>common carotid artery<\/strong> of the affected side. (never both!)<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The CCA should be firmly pressed with the thumb or fingers just below the carotid pulse palpation point (at the level of C6 vertebra), using one of two techniques (see Figure 4):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>When standing in front of the patient, using the <strong>thumb<\/strong>, with the palm and fingers holding the back of the neck.<\/li><li>When standing behind the patient, using the <strong>fingers <\/strong>(without the thumb), while the thumb wraps around the back of the neck.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">In some cases, individual arteries may be compressed, such as the <strong>facial artery<\/strong> (by pressing against the angle of the mandible). Due to the extensive anastomosis between the two sides, both facial arteries must be compressed to reduce blood loss (compared to the CCA, where this is forbidden).<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-medium\"><a href=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/pulse-measurement.png\" target=\"_blank\" title=\"Blood Supply\"><img loading=\"lazy\" decoding=\"async\" width=\"195\" height=\"300\" src=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/pulse-measurement-195x300.png\" alt=\"\" class=\"wp-image-1174\" srcset=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/pulse-measurement-195x300.png 195w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/pulse-measurement-667x1024.png 667w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/pulse-measurement-768x1179.png 768w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/pulse-measurement-1000x1536.png 1000w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2020\/07\/pulse-measurement.png 1042w\" sizes=\"auto, (max-width: 195px) 100vw, 195px\" \/><\/a><figcaption><strong>Figure 3. Pulse palpation sites<\/strong> (Credit: OpenStax, CC BY-SA 4.0)<\/figcaption><\/figure><\/div>\n\n\n\n<figure class=\"wp-block-image size-medium\"><a href=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/12\/compression_cca.png\" target=\"_blank\" title=\"Blood Supply\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"165\" src=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/12\/compression_cca-300x165.png\" alt=\"\" class=\"wp-image-9141\" srcset=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/12\/compression_cca-300x165.png 300w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/12\/compression_cca-1024x562.png 1024w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/12\/compression_cca-768x421.png 768w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/12\/compression_cca.png 1099w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption><strong>Figure 4. Compression of the CCA<\/strong><\/figcaption><\/figure>\n<\/div>\n<\/div>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h2 class=\"wp-block-heading\" class=\"wp-block-heading\">The carotid system<\/h2><h2 class=\"wp-block-heading\" class=\"wp-block-heading\">Branches of the subclavian artery<\/h2><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Origin and path<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Parts<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Medial part<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Posterior part<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Lateral part<\/h4><h2 class=\"wp-block-heading\" class=\"wp-block-heading\">Clinical information<\/h2><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Pulse palpation<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Compression<\/h3><\/div>","protected":false},"excerpt":{"rendered":"<p>The carotid system Generally, the carotid system supplies the upper neck and head (including most of the brain). It consists of the internal and&nbsp;external&nbsp;carotid arteries: The carotid system of each side begins with the common carotid artery (CCA) The left CCA branches out of the arch of the aorta The right CCA branches out of [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1194,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1158","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Blood Supply &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/skull-head-and-neck\/neurovasculature\/blood-vessels-hn\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/skull-head-and-neck\\\/neurovasculature\\\/blood-vessels-hn\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/skull-head-and-neck\\\/neurovasculature\\\/blood-vessels-hn\\\/\",\"name\":\"Blood Supply &#8211; 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