This document discusses the vascular structure of the head and neck. It begins by explaining the components of the circulatory system, including the cardiovascular and lymphatic systems. It then describes the three main circuits of circulation: coronary, pulmonary, and systemic. The document focuses on the head and neck vasculature, detailing arteries like the aorta, carotid, vertebral and various branches. It also discusses venous drainage and the circle of Willis. Common clinical indications involving the head and neck vessels are presented. In conclusion, the circulatory system of the head and neck is reviewed to aid in angiography identification and understanding normal and abnormal vascular distributions.

1. Vascular structure of head and
neck
Almas khan
Radiographer
Khorfakkhan Hospital

2. Vascular structure of head and neck
Talk plan:-
 Explain Vascular system and Circulations
 Co relation with Anatomical landmark
 Common Indications.

3. Components of circulatory system
Circulatory system
Cardiovascular Lymphatic system
Cardio Vascular Lymph
(heart) (vessels) Lymph vessels
Lymphatic nodules
Pulmonary Systemic
( lung) ( body)
The circulatory system consists of cardiovascular and lymphatic components
.
The cardiovascular portion includes heart, blood , and vessels that
Transport the blood.

4. Blood vessels
• Arteries: carry blood away
from the heart
Arterioles – smallest
arteries , carrying blood
to tissue.
• Veins: carry blood back to
the heart
• Venules – smallest vein ,
returning blood from tissue.
• Capillaries: microscopic
blood vessels .

5. Blood vessels
• Carry blood to and from the
heart
• Blood moving away from the
heart: full of oxygen and
nutrients
• Blood moving back to the
heart: full of carbon dioxide
and wastes
• blood only moves in one
direction

6. 3 sections of circulatory system
• Coronary circulation
• Pulmonary circulation
• Systemic circulation

7. Coronary Circulation
• Flow of blood to and from tissues of the heart
Coronary artery – blood supply to heart muscles.
• The right coronary artery branches into:
• Right marginal artery
• Posterior descending artery
• The left main coronary artery branches into:
• Circumflex artery
• Left Anterior Descending artery
Venous drainage :-
• Coronary sinus – venous drainage from heart

8. Pulmonary Circulation
• Flow of blood through the heart, to the lungs, and back to the
heart
• Venous Blood returning to the heart enters the right atrium.
– Enters through 2 major veins: superior and interior vena
cava
• Superior vena cava: returns blood from head and neck
• Inferior vena cava: returns blood from lower body
– Blood is high in carbon dioxide and low in oxygen

10. Systemic Circulation
• Oxygen-rich blood flows to organs and
body tissues, and oxygen-poor blood
returns to the heart
• Largest of the three parts of the
circulatory system
• Oxygen-rich blood exits left ventricle,
enters aorta, and is taken throughout
body by arteries and capillaries
• Oxygen-poor blood is taken back to
heart by veins, then superior and
inferior vena cava take this blood to
heart’s right atrium

11. Vascular structure

12. Aorta
Four segments of Aorta
1) Aortic bulb ( root )
2) Ascending aorta
3) Ascending arch
4) Descending aorta.
Branches of Arch of Aorta :-
1) Brachiocephalic artery
2 ) Left common carotid artery
3) Left subclavian artery

13. Arch of aorta
Variants of Arch :-
A) Left circumflex – Arch to left
B) Inverse aorta – Arch to right
C) Pseudocoarctation - Arched descending aorta
Normal

14. Head and neck arteries
• Blood Supply of the Brain : -
The four major arteries supplying
the brain
• 1 ) Right common carotid artery
• 2) Left common carotid artery
• 3) Right vertebral artery
• 4) Left vertebral artery

15. Head and neck arteries
• 1) The brachiocephalic trunk
bifurcates in to
• a) Right subclavien artery
• b) Right common carotid
2) Right and Left vertebral artery
arise from subclavien artery on
each side
Bifurcation posterior to right
sterno clavicular joint.

16. Head and neck arteries

17. Subclavian Artery
Right Subclavian Artery
• Arises from the brachiocephalic artery,
behind the right sternoclavicular joint
• Arches upward and laterally over the
pleura and between the scalens anterior
and medium muscles.
• At the outer border of the first rib, it
becomes the axillary artery.
Left Subclavian Artery
• Arises from the arch of the aorta in the
thorax.
• Ascends to the root of the neck and then
arches laterally in a manner similar to
that of the right subclavian artery

18. Head and neck arteries
Each common carotid divides in to internal and external carotid arteries
at the levels of C3 - C4 ( upper border of thyroid cartilage )
Left common carotid is slightly longer than the right, because it directly
arise from the arch.
External carotid artery branches :-
a) facial artery
b) Maxillary artery
c) Superficial temporal artery
d) Occipital artery
supply – neck , face , scalp and meninges

19. Head and neck
arteries
External carotid artery
branches :-
facial artery
Maxillary artery
Superficial temporal
artery .
Superior thyroid artery
Occipital artery
supply – neck , face
, scalp and meninges

20. Head and neck arteries
Internal carotid arteries :- ICA
• Passes through carotid canal in the
petrous part of temporal bone.
• The ICA passes through a collection of
venous channel around of sella turcica .
• ICA passes through dura matter medial
to each anterior clinod process to
supply the cerebral hemispheres.
• The anterior circulation of brain
supplied by ICA
• The S – Shaped portion of each internal
carotid artery is termed the carotid
siphon.

21. Head and neck arteries
• Vertebral artery : -
• Right and Left vertebral artery
arise from subclavien artery on
each side
• They pass through transverse
foramina of vertebra C6 to C 1
• Then pass through foramen
magnum posterior and enter in to
cranium.
• The two vertebral arteries
supplied posterior circulation of
the brain.

22. Head and neck arteries
Anterior cerebral artery :-
Each internal carotid branches in to anterior cerebral
artery and middle cerebral artery.
Anterior cerebral artery supplies the forbrain on the
midline and also mid portion of cerebral hemispheres .
Each anterior cerebral artery connects to the opposite one,
and posterior circulation.

23. Anterior cerebral artery

24. Head and neck arteries
Middle cerebral artery :-
Largest portion of the ICA
Its supplies lateral aspects of anterior circulation and central
lobe of brain.

25. Head and neck arteries
Vertebro basilar artery :-
Both vertebral arteries enter the cranium through
foramen magnum and unite to form basilar artery.
Its supplies spinal code and hindbrain
Basilar artery rests on clivus
Basilar artery gives several branches to hindbrain and
posterior cerebrum

26. Head and neck arteries
COW……. ?

27. Head and neck arteries
Circle of Willis :-
Blood to brain supplied by ICA and VA
Posterior circulation communicates with anterior
circulation at the base of brain as the Circle of Willis.
Five arteries form the COW.
1) Anterior communicating artery
2) Anterior cerebral artery
3) Internal carotid artery
4) Posterior communicating artery.
5) Posterior cerebral artery

28. Head and neck arteries
Circle of Willis

29. Common Indications
 Aneurysm :- The blood filled bulge of blood vessels , wall become waek.
 Infracts :- An area of dead tissue caused by a loss of blood supply.
 AVM :- AV malformation is an abnormal connection between the arteries and
veins
 Hemorrhage :-To lose blood rapidly and uncontrollably
 CVA :- It is interruption of the blood supply to the brain, usually because a
blood vessel bursts or is blocked .
 Stroke :- The loss of brain functions when blood supply suddenly
interrupted.
 Thrombosis :- It’s the formation of blood clot inside the blood vessels
 TIA :-(TIA) is a transient episode of neurologic dysfunction caused by ischemia
 Stenosis :- Narrowing of an artery inside the brain , Caused by buildup plaque
inside the artery.

30. Aneurysm
An aneurysm is an
abnormal, weak spot on a
blood vessel that causes an
outward bulging or
ballooning of the arterial
wall
A hemorrhagic stroke
when they rupture, which
can lead to brain damage
and death.

32. Indications
ACA Infract Left MCA and ACA infract

33. Indication of head and neck vessels
MCA Infract

34. left MCA and PCA

35. AV Malformation

36. Hemorrhage TIA

37. Stenosis

38. Venous drainage
Dural sinus ( Sinuses of dura mater):-
Venous channels which drain blood from brain.
It consist of
1) superior sagittal
2) inferior sagittal
3) straight sinus
4) Two transverse sinus
5) Occipital sinus
Confluence of sinus : Connecting point of superior sag , straight
and occipital .

39. Venous drainage
Sup sag sinus : Received blood from cerebral cortex
Inferior sag sinus :- It received blood from mid cerebral
hemispheres.
Straight sinuses :- Received blood from inferior sag , vein of
galan , sup cerebellar vein.
Vein of Galan :- it receive blood from a collection of small
vein.
Transverse sinus :- from posterior aspect.
Sigmoid sinus :- posteriorly and inferiorly

40. Head and neck vein
Great vein of the neck :-
The three pairs of major veins that
drain the head , face and neck.
1) Right and Left Internal jugular
vein
2) Right and left external jugular vein
3) Right and left vertebral veins.

41. Head and neck vein
• Each Internal jugular vein drain to
meninges and brain.
• Pair of external jugular veins are more
superficial trunks that drain scalp face
and neck
• Each external jugular vein join
Subclavian vein
• Right and left vertebral vein outside of
cranium and drain the upper neck and
occipital region. Enters transverse
foramin C1 – C6 joint to subclavien
vein

42. Head and neck vein
Right and left Branchiocephalic vein :-
Join to from the superior vena cava , which returns blood
to the right atrium

44. Venous trombosis

45. Bolus tracking time in MDCT :-
CTA Neck = 15 sec , F/R 3.5cc/sec
CTA Circle of Willis = 16 to 18 sec ,F/R 3.5sec
CT Brain routine = 5minuts after the injection
Routine Neck = 20 to 30 sec , F/R 3.5 sec

48. CONCLUSION
 We are able to understand how the circulation of blood
is organized in the head and neck.
 Helps to identify vessels after injection of contrast.
 A good understanding of anatomy is essential while
performing angiography.
Normal and abnormal distribution of circulatory system
 Co relation with Anatomical landmark helps to identify
vascular structures of head and neck precisely .

49. Thanks