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1. Arteries, veins and lymphatic drainage of the head and neck. The epithelial
tissue. The development of blood vessels.
Posted in Head & Neck by Sahaja on December 1, 2008

1. Arteries, veins and lymphatic drainage of the head and neck. The epithelial tissue. The development of blood
vessels.

Anatomy: Arteries, veins and lymphatic drainage of the head and neck.

Arteries of Head & "eck

For this topic, you will need to discuss the branches of common carotid a, subclavian a, the veins that follow them, and
superficial and deep lymph nodes of the head and neck.

In this topic, if you have time, you may want to review infratemporal fossa, carotid triangle, scalenotracheal fossa,
scalenus hiatus & tent

Common Carotid a:

General Info:

Emerges from brachiocephalic a on R side, and aortic arch on L side

ascends in carotid sheath, w/ CN X, Int Jugular v and number of other structures (will discuss soon)
divides into int/ext carotid at superior border of thyroic cartilage
Has two receptors:
Carotid Body
located at the bifurcation of common carotid (Body = Bifurcation)
chemoreceptor = sensory receptor to detect levels of O2 & CO2
Or, remember that since it is located lower to the sinus, and closer to the lungs than the sinus – lungs =
O2,CO2
Carotid Sinus
located at the beginning of the int carotid a (Sinus = Internal carotid)
baroreceptor = detects blood pressure
Remember that it is the one closest to the head, so need to keep track of blood pressure in the head.

Int carotid a:

no branches in the neck,

ascends in carotid sheath w/ CN X and IJV
enters skull via carotid canal
only major branch to head and neck region is ophthalmic a – exits skull via optic canal

Ext Carotid a

emerges @ upper border of thyroid cartilage

runs in carotid sheath, then to neck of mandible
pierces the parotid glang, where it gives its 2 terminal branches = maxillary, and superficial temporal
8 main branches = Superior Thyroid, Lingual, Facial, Asc Pharyngeal, Greater Auricular, Occipital, Maxillary,
Superficial Temporal.

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NOTE: How to remember all the branches?

St. Louis FATSIS Apt to GO to Max Stein —- like fat people from St. Louis need to go to this famous weight
loss instructor, Max Stein. Sounds stupid, but hang on - it works.

Superior Thyroid a – St.

emerges at level of greater horn of hyoid bone
also in carotid sheath
branches = br. to infrahyoid m, br to SCM, sup laryngeal (which peirces the thyrohyoid membrane), br to
cricthyroid m, glands
Lingual a – Louis
emerges @ level of greater horn of hyoid bone
passes deep to hyoglossus m.
located w/in Pyrogov’s Triangle – Clinical note – by pushing at the location of triangle, can stop bleeding from
branches of lingual a
Borders:
ant = mylohyoid m
post = post digastric m
sup = hypoglossal n (CN XII)
floor = hyoglossus m
part of the Submandibular triangle (see salivary gland topic)
branches = suprahyoid a, dorsal lingual a, sublingual a, deep lingual a
supplies most of blood supply of tongue
Facial a – Fatsis
emerges just above lingual a, goes forward, deep to post digastric m & stylohyoid m
hooks around lower border of angle of mandible @ ant border of masseter (jsut deep to platysma)
run diagonally to the medial corner of the eye, running deep to zygomatic major & levator labii superiorus
major blood supply to face, terminates with angular a.
branches = FATSIS - is an abbreviation for facial and all its branches
F = facial
A = asc palatine
T = tonsillar
SI = Sup/Inf labial
S = submental
Asc Pharyngeal a - Apt
in carotid triangle
asc b/w int carotid & wall of pharynx
branches = pharyngeal, palatine, inf tympanic, meningeal branches
Greater (Posterior) Auricular a – G
arises just above post digastric –> deep to parotid –> runs superficial to styloid process
branches = stylomastoid, auricular, and occipital branches
Occipital a – O
emerges just above the hyoid bone –> passes deep to post digastric –> occipital groove –> on mastoid process
branches =
a to SCM – over CN XII, anatomosis w. SCM branch of sup thyroid a
decending br – has 2 branches
superficial – anatomosis w/ superficial br of transverse cervical a
deep – anatomosis w/ deep br of deep cervical a (from costocervical trunk of subclavian a
Maxillary a – Max
lies in infratemporal fossa
many many branches = How to remember them? DAAM I Bite SPAIDS.
divided into 3 parts by lat pterygoid m
Part 1 = Mandibular = DAAM I - 5 branches
Deep auricular a
Ant tympanic a
Acc meningeal a
Middle meningeal a – can be shown in practical exam
Inf alveolar a – can be shown in practical exam

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Part 2 – Pterygoid = Bite (Bite = muscle of mastication) – 5 branches

lat & med pterygoid a
massteric a
buccal a
deep temporal
Part 3 – Pterygopalatine = SPAIDS – 7 branches
Sup (post/mid) alveolar a
Pharyngeal a
A. of pterygoid canal
Infraorbital a
Desc Palatine a
Sphenopalatine a
Superficial Temporal a
terminal branch
emerges on face b/w TMJ and ear
runs w/ auriculotemporal n, sup temporal v
branches = transverse facial a (b/w zyg arch & parotid duct), frontal/parietal br
transv. facial a gives blood supply to parotid gland, duct, masseter and skin of face

Subclavian a

br of Brachiocephalic trunk on R, arises from arch of aorta on L

Pathway: enters neck behind the sternoclavicular joint –> runs towards the apex of pleura along the mediastinal
surface –> over the apex –> turns forward and down along sternocostal surface of apex –> exits neck to enter thorax
@ scalenus hiatus w/ brachial plexus
has 3 divisions, separated by ant scalene m.
"OTE = to remember the # of branches – its opposite of part # – i.e. Part 1 has 3 branches, Part 2 has 2 branches, and
Part 3 has 1 branch (sometimes)
123=321

Thoracic part = medial to ant scalene m - 3 branches, b/w trachea and ant scalene m

Vertebral a – has a med/sup path –> goes thru transverse foramen of C6-C1 –> thru post occipital membrane –>
foramen magnum
Int Thoracic a - runs along the inside of thoracic wall
1st 6 ant intercostal a
sup epigastric – medistinal, thymic, sternal br
musculophrenic – gives the ant intercostal arteries 7-10
Thyrocervical trunk – 3 branches again
Transverse cervical a – under SCM –> occipital triangle –> runs below trapezius m
Suprascapular a - runs parallel to clavicle w/ a/v/n — anatomosis w/ circumflex scapular a
Inf thyroid a – asc along thyroid gland and anatomosis w/ asc cervical a

Muscular part = behind ant scalene m. – 2 branches, = Costocervical trunk

Supreme IC a – gives 1st 2 post IC a

Deep cervical a – blood supply to deep m of back, asc along levator scapulae m.

Cervial part = lat to ant scalene m – 1 branch, sometimes

dorsal scapular a - only present if suprascapular a is missing

usually no branches here

Veins of Head & "eck

Veins mostly follow the arteries, so there is no need to go into each branch. Also, veins have an extremely variable branching
pattern, so your body may be different from what is laid out here. We’ve seen a body with 2 Ext Jugular v!

To learn veins of any area – just draw the picture a bunch of times. Hell, draw it on the exam.

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Here’s an “in general” flow pattern of the veins:

Supraorbital v + Supratrochlear v = angular v at the corner of the eye

angular v + deep facial v = facial v
Maxillary v + Superficial temporal v = Retromandibular v
ant branches of Retromandibular v + Facial v —> flows into IJV, w/ a bunch of other v
post branches of Retromandibular v + Post Auricular v = EJV
Ant Jugular —> flows into EJV
Subclavian v collect veins that follow the arteries that branch off subclavian a
Subclavian v + IJV = Brachiocephalic v —- called angulus venosus, also where major lymph ducts of the the body
drain into
EJV can flow into Subclavian v OR IJV OR angulus venosus itself (the intersection of the 2 veins)

Other vein info, specifics: Doubt you have to know this, but rather give u extra info, than not at all.

Supratrochlear v = begins as a collection of veins connected to the frontal branches of superficial temporal v
Supraorbital v = begins also in the forehead, where it connects w/ branches from supratrochlear, superfical temporal
v, and middle temporal v, a branch of it passes through supraorbital notch to anatomose w/ superior ophthalmic v
Together, these 2 v. drain ant part of scalp and forehead
Facial v = runs from medial angle of eye and inf border of orbit, starting from angular v, is much straighter than than
facial a
receives pterygoid venous plexus (via deep facial v), sup/inf labial v
branch of it anatomose w/ superior ophthalmic v
drains ant scalp, forehead, eyelids, ext nose, ant cheek, lips, chin, submandibular gland
Superficial temporal v = receives a number of v of scalp/zygomatic arch, runs thru parotid gland
drains side of scalp, superficial aspect of temporalis m, ext ear
Retromandibular v = formed by union of superficial temporal & maxillary v
is post to ramus of mandible, goes thru parotid gland, has ext carotid a behind and facial n in front of it
drains masseter m, and parotid gland

Lymph Drainage of Head & "eck

The head and the neck, each have a set of superficial & deep lymph nodes and vessels. The superficial lymph nodes and
vessels run with veins, deep lymph nodes and vessels run with arteries. All lymph from head and neck drains into deep
cervical lymph nodes, that run w/ IJV.

Superficial lymph nodes of Head:

In general, the face, scalp, and ear –> drains into occipital, retroauricular, parotid, buccal, submandibular,
submental, superficial cervical l.n.
lat face, including eyelids –> parotid l.n. –> deep cervical l.n
upper lip, lat lower lip –> submandibular l.n.
chin, central lower lip –> submental l.n.

Deep lymph nodes of Head:

middle ear –> retropharyngeal & upper deep cervical l.n.

nasal cavity/ pasanasal sinuses –> submandibular, retropharyngeal, upper deep cervical l.n.
tongue –> submental, submandibular, upper/lower deep cervical l.n.
larynx –> upper/lower deep cervical l.n.
pharynx –> retropharyngeal, upper/lower deep cervical l.n.
thyroid –> lower deep cervical, prelaryngeal l.n., pretracheal l.n., paratracheal l.n.

Superficial cervical lymph nodes:

lie along the ext jugular v in posterior triangle & along ant jugular v in anterior triangle
drain into deep cervical nodes

Deep cervical lymph nodes:

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Superior
lie along int jugular v, in carotid triangle of neck
receive: lymph from back of head and neck, tongue, palate, nasal cavity, larynx, pharynx, trachea, thryroid
gland, & esophagus
efferent vessels that join those of the inf deep cervical nodes to from jugular trunk –> thoracic duct on L, and
angulus venosus on R
Inferior
lie on the IJV, near subclavian v
receive lymph from ant jugular, transverse cervical, axillary nodes

Histology: The epithelial tissue.

Epithelium = sheets of cells that cover external surfaces of the body, line internal cavities, form various organs,glands and
ducts. Remember that it is avascular - no blood vessels!

Epithelium can be classified in 3 ways: functionally, # of cell layers, & structure of surface cells

Functional groups:

Lining epith – formation of barrier on surface of body, ex/ skin, inner stomach
Glandular epith – production/secretion of substances to extra cellular territory in high amt
Sensory epith – for special sensations, ex/ taste buds, olfactory

Epithelium has what is called functional polarity = basically, this means that different sides of the cells have different
functions.

Basal side:
attached to basement membrane = basement lamina + reticular fibers
has hemidesmosomes
protein, polysaccharides rich layer
Lateral side:
intracellular junctions = tight, adherent, desmosomes
Apical side:
microvilli – inc surface absorption
kinocilia – move substances across apical surface
stereocilia – sensory function, absorption

Cell-Cell Junctions

Occluding/Tight Jxns: impermeable and allow epithelia cells to functions as a barrier

form primary intercellular diffusion barriers b/w adjacent cells
located @ most apical part
Proteins:
occludins - maintain barrier b/w cells, @ apical/lateral domains, not in all tight jxns
claudins - form backbone of each strand, form extracellular H2O channels for ions and small molecules
JAM (Junctional adhesions molecule) – immunoglobulin, w/ claudins, interactions b/w endothelium &
monocytes
Anchoring Junctions: mechanical stability to epithelium, by linking cytoskeleton of 1 cell to adjacent cell.
interact w/ both actin & intermediate filaments
lateral cell surface, basal domain
signal transductions capability, cell-cell recognition, cell differentiation, morphogenesis
Zonula adherens – interact w/ network of actin filaments inside cell, lateral adhesion
Macula adherens (desmosomes) - interact w/ network of intermediate flaments
Communication Junctions (Gap): direct communications b/w adjacent cells by diffusion of small molecules
epithelia, smooth m, cardiac m, and nerves
open communication – quicker exchange of ions, regulatory molecules, small metabolites
easier to coordinate activity
Proteins = connexons, in 6 subunits of 2 = connexin

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Apical Modifications:

Microvilli
small, non motile projections that cover all absorptive cells in SI and prox convoluted tubules in kidney
proteins = villin, actin filaments, fimbrin, fascin, myosin I in core, and spectrin & myosin II in base
sit on intermed filaments
Kino cilia
motile structures that are found in uterin tubes, uterus, repiratory system
move substances across a surface
dark line @ apical surface

2 microtubules in center, surrounded by 9 doublets of microtubles, w/ dynein, & nexin

Sterocilia
long, non motile branched microvilli of sorts that cover cells in epididymis & vas deferens
absprption!
Proteins: actin filaments, erzin, fimbrin in core, and alpha -actinin in base

Classification by layers

Simple – one layer of cells only, attached directly to basement membrane

Stratified – multiple layers of cells
Pseudostratified – one layer of cells, all attached to basement membrane, but have varying heights, so appear
stratified

Classification by morphology

squamous - flat cells

Simple squamous -
called mesothelium on the outside surfaces of lungs, heart, digestive organ == i.e. where-ever there is
pleura, pericardium, or peritoneum, there is mesothelium anatomically – Histo wise, this is called a serosa
covering.
called endothelium on the internal surface of arteries, lymph vessels, and internal surface of heart
Stratified squamous –
keratinized – top cells are dead & have no nuclei, are instead filled w/ keratin protein – located in
external areas of body ex/ skin
non-keratinized – live surfaces, all cells of epithelium alive – located in areas exposed to outside
elements, but not on external areas of body ex/ oral mucosa, pharynx, vagina, anal canal, esophagus.
Cuboidal – height = width
Simple cuboidal – excretory ducts, like prox convoluted tubules of kidney, very common in glands
Stratified cuboidal – not as common, ducts of salivary glands and pancreas
Columnar – height > width
Simple columnar – characteristic of digestive organs, like in stomach and gallbladder, SI, LI – tend to have
microvilli
Stratified columnar – limited in body, ducts again
Transitional Epithelium = Urothelium
located in urinary system, like bladder and ureter, and minor/major calices – NOT IN URETHRA
Cell Types:
Umbrella cells – binucleated, is dome shaped when urinary structures are empty, flat when full
Piriform cells – in the middle
Basal cells - single layer on bottom , right above BM

Embryology: The development of blood vessels

Blood vessels develop in two ways:

vasculo genesis – vessels arise from the combination of blood islands aka angioblasts – mainly dorsal aorta, &
cardinal veins
angiogenesis – vessels arise from existing vessels

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Development of arteries

Aortic sac develops from distal part of truncus arteriosus

sac gives a set of aortic arches, one to each pharyngeal arch
arches terminate in two (R&L) dorsal aortas
aorticopulmonary septum divides outflow part of truncus arterious into ventral aorta & pulmonary trunk
dorsal aorta b/w 3rd and 4th arch disappears (carotid duct)
R dorsal aorta disappears b/w 7th segmental aorta and L dorsal aorta
heart is pushed into thoracic cavity by folding of embryo
because of the heart movement – this is why recurrent laryngeal a is in diff location in R & L side

Aortic Arches:

Arch I = part of maxillary a, by day 27

Arch II = part of stapedial a & hyoid a
Arch III = part of R &L common carotid a, R&L int carotid a
Arch IV = part of R subclavian a, and part of aortic arch on L
Arch V = disappears
Arch VI = part of R &L pulmonary a, ductus arteriosus – connection b/w pul a & arch of aorta, is
ligamentum arteriosum in non fetal life

Dorsal Aorta

R & L dorsal aortae combines into dorsal aorta.

from dorsal aorta, originates posterolateral a, lateral a, and ventral a
Posterolateral a = a to upper and lower limb, IC, lumbar and lateral sacral arteries
Lateral a = renal, suprarenal, and gonadal arteries *NOTE = paired visceral arteries of abdominal aorta
Ventral a
Vitelline a = celiac, superior mesenteric, inf mesenteric a *NOTE = unpaired visceral arteries of abdominal
aorta
Umbilical a = part of Int Iliac, superior vescical arteries, run in medial umbilical ligaments. = PELVIS

Coronary a – from 2 sources

angioblasts formed elsewhere and sent over the heart surface

from epicardium – some of its epithelial cells will become mesenchymal cells due to some reaction from underlying
mesenchyme
new mesenchyme and neural crest cells create smooth m cells in these arteries
endothelial cells from these arteries push into aorta

Development of Veins

develop mainly from three pairs of veins = vitelline v, umbilical v, and cardinal v —> empty blood into sinus
venosus
vitelline v = carry blood from yolk sac
become hepatocardiac part of IVC, hepatic v &sinusoids, ductus venosus, portal v, inf mesenteric v, sup
mesenteric v, splenic v
form plexus around duodenum and pass thru septum transversum, pushing into liver to form sinusoids
the duodenal plexus becomes the portal v
umbilical v = from chorionic villi and carries O2 blood to embryo
pass on each side of liver, some connect to sinusoids
only L umbilical v remains to carry blood from placenta to liver — becomes ligamentum teres of liver, and
ductus venosus, to become ligamentum venosum in life.
cardinal v = drains embryo itself
Ant =drain cephalic part of embryo intially–> SVC, int jugular v, L brachiocephalic v
Post = drain rest of embryo initially –> part of IVC, R common iliac v
Subcardinal v = drain kidneys –> renal v, part of IVC, gonadal v
Sacrocardinal = drain lower limb –> sacrocardinal part of IVC, L common iliac v
Supracardinal v = drain body wall via IC v (takes over fxn of post cardinal v) –>part of IVC, IC v, azygos

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system

Anim = Development of Aorta, Pulmonary Trunk, and Interventricular Septum

Anim = Aortic Arch Vessels

Possibly related posts: (automatically generated)

First-Ever Recording of Blood Vessel Development During the Formation of an…

Tagged with: carotid body, carotid sinus, columnar eptihelium, cuboidal epithelium, development of arteries, development of
veins, dorsal aorta, endothelium, epithelium, external carotid, gap junctions, keratinized v. nonkeratinized, kinocilia, lymph
drainage of head and neck, macula adherens, mesothelium, microvilli, pseudostratified epithelium, pyragov's triangle,
squamous, sterocilia, subclavian a, urothelium, veins of head and neck, zonula occludens

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2. The somatosensory and somatomotor innervation of the head and neck. The cells of the connective tissue. The
development of the neurocranium. »

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1. Abigail said, on February 2, 2009 at 1:17 AM

just a little correction, the stomach is the foregut and is supplie by the ciliac artery and not the superior mesenteric,
superior mesenteric is for the mid gut…….apart from that, this is the best anatomy summary anywhere……..good job
guys

Reply

2. dr.omprakash said, on May 10, 2009 at 4:14 PM

simply superb and really educative and very much important not to forget this tips , thanks for giving us this.

Reply

3. Dr. Aman Biswas said, on January 10, 2010 at 10:49 AM

May God bless you for superb hardwork done.It will help many.Good luck

Reply

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About This Site:

This site was made for the Anatomy, Histology, Embryology class in 2nd yr, 1st semester at the University of Debrecen. All
theoretical topics are listed as described on the website of the Anatomy department.

We combined Practical class notes, Moore, Board Review Series textbooks of Gross Anatomy and Embryology, Langman’s,
DiFiore’s, as well as the Lab manual for Histology at Semmelweiss. We believe it to be all inclusive of the material you will
need for your test. We made them for ourselves, but since people asked for them, and emailing them seemed next to
impossible, we decided to post them here.

On the left are the newest topics we’ve added.

To see all the topics we’ve done so far, scroll down and click on the Category you would like to see: Head & "eck,
Thorax, Abdomen, & Pelvis.

Added a search box in the sidebar, so you can search for the item you want.

But the best way to find the topic that you want?

Scroll down and click on the “Link to Topics” Page. There is the list of all topics. If a link to your topic of choice
exists, we’ve started/finished it, else we’re working on it. There! That’s easier, isn’t it?

We’ve added pictures, links, and animations where we have found them.

Hope this helps you, and GOOD LUCK!

(P.s. If you find mistakes, or want to add info, or find something we missed, please comment below the post in question, and
we will fix or add it. )

We are adding more info by the day, so check back in with us!

Created by Sahaja Parsa and Anne H.

contact: sahaja.parsa[at]gmail.com

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