The value of medical genetics for practical health care. Elimination of embryos and fetuses with hereditary pathology

The neck is the part of the human body that connects the body and the head. Despite its small size, it contains many significant structures, without which the brain would not receive the blood it needs to function. Such structures are the vessels of the neck, which perform an important function - the movement of blood from the heart to the tissues and organs of the neck and head, and then vice versa.

Vessels of the anterior neck

In front of the neck are paired carotid arteries and the same paired jugular veins.

Common carotid artery (CCA)

It is divided into right and left, located on opposite sides of the larynx. The first departs from the brachiocephalic trunk, so it is slightly shorter than the second, departing from the aortic arch. These two carotid arteries are called common, and they make up 70% of the total blood flow going directly to the brain.

Next to the OCA is an internal jugular vein, and between them is nervus vagus. The entire system, consisting of these three structures, makes up the neurovascular bundle of the neck. Behind the arteries is the cervical sympathetic trunk.

OCA does not give branches. And upon reaching the carotid triangle, approximately at the level of the 4th cervical vertebra, the internal and external are divided. On both sides of the neck. The region in which bifurcation occurs is called a bifurcation. This is where the carotid sinus expands.

On the inside of the carotid sinus is the carotid glomus, a small glomerulus rich in chemoreceptors. It reacts to any changes in the gas composition of the blood - the concentration of oxygen, carbon dioxide.

External carotid artery (ECA)

Located closer to the front of the neck. During its movement up the neck, the NSA gives off several groups of branches:

anterior (directed to the front of the head) - upper thyroid, lingual, facial;
posterior (directed towards the back of the head) - occipital, posterior ear, sternocleidomastoid;
middle (final branches of the ECA, division occurs in the temple area) - temporal, maxillary, ascending pharyngeal.

The terminal branches of the ECA are further divided into smaller vessels and supply blood to the thyroid, salivary glands, occipital, parotid, maxillary, temporal regions, as well as the facial and lingual muscles.

Internal carotid artery (ICA)

It performs the most important function in the general blood flow, which is provided by the vessels of the head and neck - the blood supply to a large part of the brain and the human organ of vision. It enters the cranial cavity through the carotid canal, does not give branches along the way.

Once in the cranial cavity, the ICA flexes (damper), penetrates the cavernous sinus, and becomes part of the cerebral arterial circle (circle of Willis).

Branches of the ICA:

eye;
anterior cerebral;
middle cerebral;
back connecting;
anterior villous.

jugular veins

These vessels of the neck carry out the reverse process - the outflow of venous blood. Allocate external, internal and anterior jugular veins. Blood enters the external vessel from the back of the head closer to the ear region. And also from the skin above the shoulder blade and from the anterior zone of the face. Descending below, not reaching the collarbone, the NJV connects to the internal and subclavian. And then the inner one develops into the main one at the base of the neck and bifurcates into the right and left.

The largest main vessel cervical is VYAV. It is formed in the region of the skull. The main function is the outflow of blood from the vessels of the brain.

Most of the branches of the jugular veins are named after the arteries. With those arteries that accompany - lingual, facial, temporal ... the exception is the mandibular vein.

Vessels of the back of the neck

In the region of the cervical spine there is another pair of arteries - the vertebral arteries. They have a more complex structure than sleepy ones. Depart from the subclavian artery, follow behind the carotid, penetrate in the region of the 6th cervical vertebrae into the canal formed by the openings of the transverse processes of the 6th vertebrae. After exiting the canal, the vertebral artery flexes, passes along the upper surface of the atlas, and enters the cranial cavity through the large posterior foramen. Here, the right and left vertebral arteries merge and form a single basilar artery.

The vertebral arteries give off the following branches:

muscular;
spinal;
posterior spinal;
anterior spinal;
posterior cerebellar inferior;
meningeal branches.

The basilar artery also forms a group of branches:

labyrinth artery;
anterior cerebellar inferior;
pontine arteries;
cerebellar superior;
mesencephalic;
posterior spinal.

The anatomy of the vertebral arteries allows them to provide the brain with 30% of the necessary blood. They supply the brain stem, occipital lobes of the hemispheres and the cerebellum. This whole complex system is commonly called vertebrobasilar. "Veterbro" - associated with the spine, "basilar" - with the brain.

At the occipital bone begins the vertebral vein - another of the vessels of the head and neck. It accompanies the vertebral artery, forming a plexus around it. At the end of its path in the neck, it flows into the brachiocephalic vein.

The vertebral vein intersects with other cervical veins:

occipital;
anterior vertebral;
accessory vertebral.

lymph trunks

The anatomy of the vessels of the neck and head includes and lymphatic vessels collecting lymph. Allocate deep and superficial lymphatic vessels. The first pass along the jugular vein and are located on both sides of it. Deep are located in close proximity to the organs from which the lymph departs.

The following lateral lymphatic vessels are distinguished:

pharyngeal;
supraclavicular;
jugular.

Deep lymphatic vessels collect lymph from the mouth, middle ear, and pharynx.

Nerve plexus of the neck

An important function is performed by the nerves of the neck. These are diaphragmatic, muscular and skin structures located on the same level with the first four vertebrae of the neck. They form nerve plexuses from the cervical spinal nerves.

Muscular nerves are close to the muscles and give impulses to carry out neck movements. Diaphragmatic are needed for the movements of the diaphragm, pleura and pericardial fibers. And the skin ones produce many branches that perform individual functions - the ear nerve, occipital, supraclavicular and transverse.

The nerves and vessels of the head and neck are interconnected. So, the carotid artery, the jugular vein and the vagus nerve form an important neurovascular bundle of the neck.

Diseases of the vessels of the neck

Vessels located in the neck are subject to many pathologies. And often lead to a deplorable result - ischemic stroke. From the point of view of medicine, the narrowing of the lumen in the vessels caused for any reason is called stenosis.

If pathology is not detected in time, a person can become disabled. Since the arteries in this area supply blood to the brain and all tissues and organs of the face and head.

Symptoms

Although there are many reasons for the pathological narrowing of the lumen, the result is always the same - the brain experiences oxygen starvation.

Therefore, with a disease of the vessels of the neck, the symptoms look the same:

Headaches of any kind. Aching, stabbing, sharp, monotonous, flashing, pressing. The peculiarity of such pains is that the back of the head suffers first, and then the pain goes to the temporal region.
Dizziness.
Loss of coordination, unsteadiness, sudden falls, loss of consciousness.
There may be pain in the neck from the side of the spine. Increases at night and on palpation.
Fatigue, drowsiness, sweating, insomnia.
Numbness of limbs. Most often on one side of the body.
Visual impairment, hearing impairment, incomprehensible tinnitus.
Spots may appear before the eyes. Or circles, sparks, flashes.

Causes

Diseases that provoke narrowing of the lumen in the cervical vessels:

osteochondrosis of the cervical spine;
the formation of a hernia on the spine of the cervical spine;
neoplasms;
alcohol and smoking abuse - substances that cause prolonged vascular stenosis;
heart disease;
previous injuries;
atherosclerosis;
anomalies of the cervical vertebrae;
anomalies in the development of arteries - tortuosity, deformation;
thrombosis;
hypertension;
prolonged neck compression.

As a rule, the vertebral arteries are exposed to external influence. Because they are located in a vulnerable area. Abnormal development of the vertebrae, muscle spasm, extra rib... Many factors can affect the vertebral arteries. In addition, the wrong posture during sleep can provoke their squeezing.

Tortuosity is also characteristic of the vertebral arteries. The essence of this disease is that elastic fibers predominate in the composition of the tissues that make up the vessels. And not put collagen. As a result, their walls quickly become thinner and twisted. Tortuosity is hereditary and may not manifest itself for a long time. Atherosclerosis can provoke tortuosity.

Any anatomical defect of the arteries is dangerous not only for human health, but also for his life. Therefore, when the appearance slightest symptoms you should consult a doctor. Don't wait for the disease to progress.

How to identify pathology

To make a correct diagnosis, doctors resort to various examinations.

Here are some of them:

vascular rheovasography - a comprehensive examination of all vessels;
dopplerography - examination of arteries for tortuosity, patency, diameter;
radiography - detection of disorders in the bone structures of the cervical vertebrae;
MRI - search for foci of insufficiently supplied areas of the brain;
Ultrasound of the brachiocephalic arteries.

Treatment

Treatment method vascular diseases selected individually for each patient.

And, as a rule, consists of the following activities:

Drug therapy: vasodilating, spasmodic, symptomatic and circulatory-improving drugs.
Sometimes laser therapy is prescribed. Laser therapy - best way for the treatment of osteochondrosis of the neck.
Physiotherapy.
It is possible to wear a Shants collar, which reduces the load on the spine.
Physiotherapy.
Massage, if the cause of stenosis is a pathology in the spine.

Treatment should be comprehensive and take place under the strict supervision of a physician.

The anatomy of the neck is complex. Nerve plexuses, arteries, veins, lymphatic vessels - the totality of all these structures provides the relationship between the brain and the periphery. A whole network of vessels provides arterial blood all tissues and organs of the head and neck. Be attentive to your health!

Our brain functions normally due to the circulatory system, which is involved throughout the body. The anatomy of the vessels of the head and neck includes the main arteries that feed both organs, many small vessels and capillaries. But the carotid arteries, which have their own branches, are considered the most important. This is an external vessel that feeds the cervical region and the front part and an internal one that feeds the cranial cavity and eye sockets.

Vascular system of the head and neck

To understand how blood circulates, it is necessary to have at least the slightest knowledge of the anatomical structure of the vascular system. So, the blood moves in the upper cycle through the brachiocephalic arteries, carotid and subclavian left, after which it is cleared directly into the jugular and subclavian veins.

The largest and first is considered the brachiocephalic artery, which forms the right carotid and right subclavian artery. Thanks to a large artery, almost the entire body is supplied with blood, and in particular the brain through the vertebral vessels. And they, in turn, nourish the entire circulatory system of the neck and brain with oxygen.

The carotid arteries are conditionally divided into internal and external vessels. Vessels of the head: anatomy of the external and internal carotid artery:

External carotid arteries supply blood exclusively to the face and neck, are located mainly in the level parotid gland. They also have their own branches: the maxillary vessel and the superficial temporal. External arteries are divided into 3 groups. These are anterior, posterior and medial.
The internal carotid arteries supply blood to the brain and ocular region, and are divided into 4 parts: cervical, cavernous, stony and cerebral. The internal carotid vessel ends in the anterior cerebral artery, which supplies blood to the cerebral hemispheres (medial surface). Another branch can be called the posterior cerebral artery, supplying the temporal, occipital region and midbrain. In addition, there is also the middle cerebral artery, which supplies blood to almost all parts of the brain.

Blood vessels of the head and neck: the anatomy includes the flow of blood within the skull through the jugular vein, which flows from the right and left sides of the scalp, parotid gland and muscular system of the face into the subclavian vein.

Subclavian vessels supply blood to almost the entire body and the brain system of the head and back. They have left and right arteries, and the right one is 4 cm shorter than the left one. There is a transverse vessel of the neck in the subclavian artery, while the right and left branches are intertwined with the external carotid artery, axillary and subscapular vessels. This gives unique opportunity redirect blood flow in a different direction, which is called collateral circulation.

Blood-brain barrier

The anatomy of the vessels of the head and neck includes the BBB, that is, the blood-brain barrier, consisting of a semi-permeable membrane. It is this membrane that controls the entire capillary system. As you know, the capillaries of the circulatory system are lined with endothelial cell formations, but in different parts of the body in different ways. For example, in the whole body, except for the brain, cells have small gaps between themselves. And in the brain region, the cells on the capillaries are in close contact with each other, due to which the most dense connection is created. Endothelial cells are connected with the help of glial cells (astrocytes), due to which a reliable protective barrier is created around all vessels. In addition, astrocytes help transport electrolytes directly from the brain into the bloodstream.

common carotid artery

Particular attention should be paid to the common carotid artery, which is a steam room. For example, the right artery originates at the site of bifurcation in the innominate artery behind the clavicular joints. At the same time, it is tied mainly to the neck. But the artery on the left side begins behind the nameless vessel, but in the upper part of the aortic arch. Thus, the left carotid artery belongs to the thoracic and cervical parts.

Both carotid arteries in the cervical part exit from under the sternum and clavicular joint, rising obliquely upwards. And already at the upper border of the cartilage of the thyroid gland is divided into external and internal carotid artery. As a rule, these arteries do not give branches, but in some cases the vessel can give a branch to the vertebral veins, larynx, thyroid gland or pharynx.

The organs of the neck and head are supplied with blood by 3 arteries extending from the aortic arch (from right to left): the brachiocephalic trunk, the left common carotid and the left subclavian arteries.

Shoulder head trunk , truncus brachiocephalicus, an unpaired large vessel, goes obliquely to the right and up, being in front of the trachea, covered by the thymus gland in children. At the sternoclavicular joint, it divides into the right common carotid and right subclavian arteries. In 11% from the beginning of the brachiocephalic trunk to the isthmus of the thyroid gland goes a. thyreoidea ima.

common carotid artery , a. carotis communis, steam room. The right common carotid artery originates from the brachiocephalic trunk, the left - independently from the aortic arch. Through apertura thoracis superior, the arteries pass to the neck, located on the sides of the organs in the common neurovascular bundle (v. jugularis interna et n. vagus). To the level of the thyroid cartilage in front they are covered m. sternocleidomastoideus, and then go into the sleepy triangle of the neck. At the level top edge thyroid cartilage are divided into external and internal carotid arteries.

External carotid artery , a. carotis externa, goes up to the temporal mandibular joint(Fig. 158). Near the posterior edge of the branch mandible in fossa retromandibular it passes through the thickness of the parotid gland, located deeper than the hypoglossal nerve, m. digastricus (hind belly) and m. stylohyoideus, as well as medial and anterior to the internal carotid artery. Between them are m. styloglossus and m. stylohyoideus. The branches of the external carotid artery are divided into 4 groups: anterior, posterior, medial and terminal.

Rice. 158. Branches of the external carotid artery. 1-a. temporalis superficialis; 2, 5 - a. occipitalis; 3-a. maxillaris; 4-a. carotis externa; b - a. carotis int.; 7 - muscle that raises the scapula; 8 - trapezius muscle; 9 - middle scalene muscle; 10 - plexus bracnialis; 11 - truncus thyreocervicalis; 12-a. carotis communis; 13-a. thyreoidea superior; 14-a. lingualis; 15-a. facialis; 16 - anterior belly of the digastric muscle; 17 - buccal muscle; 18-a. meningea media

front branches. 1. Superior thyroid artery, a. thyreoidea superior, steam room, begins at the point of origin of the external carotid artery, at the level of the upper edge of the thyroid cartilage. It goes to the midline of the neck and goes down to the right and left lobes of the thyroid gland. Branches depart from it not only to supply blood to the thyroid gland, but also to the hyoid bone, larynx and sternocleidomastoid muscle. Among these branches, the superior artery of the larynx, a. laryngea superior, which, perforating the membrana hyothyreoidea, enters the submucosal layer of the larynx, where it participates in the blood supply to its mucous membrane and muscles.

2. Lingual artery, a. lingualis, steam room, starts from the external carotid artery 1-1.5 cm above the superior thyroid artery. At first, it goes parallel to the large horn of the hyoid bone, and then rises up, passing between m. hyoglossus and m. constrictor pharyngis tedius. Coming out from under the front edge of m. hyoglossus, the artery is located in the triangle described by N. I. Pirogov (see Muscles of the neck). From the triangle, the lingual artery penetrates into the root of the tongue, where it is located on the muscle bundles m. genioglossus. In its course, it forms a series of branches that supply blood to the hyoid bone, the root of the tongue and the palatine tonsils. At the posterior edge m. mylohyoideus, the hyoid artery departs from it, a. sublingualis, which runs forward between the outer surface of m. mylohyoideus and submandibular salivary gland. In addition to these formations, it supplies blood to the sublingual salivary gland, the mucous membrane of the oral cavity, and the anterior part of the gums of the lower jaw. The terminal branch of the lingual artery reaches the apex of the tongue and anastomoses with the artery of the opposite side.

3. Facial artery, a. facialis, steam room, starts from the external carotid artery above the lingual artery by 0.5-1 cm. In 30% of cases, it begins with a common trunk with the lingual artery. The facial artery goes forward and up under m. stylohyoideus, hind belly m. digastricus, m. hyoglossus, reaching the lower edge of the lower jaw at the location of the submandibular gland. At the anterior edge of the chewing muscle, the artery, rounding the edge of the lower jaw, exits to the face, located under the mimic muscles. The facial artery initially lies between the lower jaw and the subcutaneous muscle of the neck, then along outer surface reaches the corner of the mouth. From the corner of the mouth, the artery passes to the medial corner of the eye, where it ends with the angular artery, a. angularis. The latter anastomoses with a. dorsalis nasi (branch from A. ophtalmica). A number of large branches depart from the facial artery in various parts to supply blood to the organs of the facial skull.

1) Ascending palatine artery, a. palatina ascendens, branches off at the beginning of the facial artery, rises under the muscles starting from the styloid process to the arch of the pharynx. It supplies blood to the upper constrictor of the pharynx, muscles and mucous membrane of the soft palate, palatine tonsil. Anastomoses with branches a. pharyngea ascendens.

2) The branch to the tonsil, ramus tonsillaris, starts from the facial artery at the place of its intersection with the posterior belly m. digastricus. Supplies blood to the palatine tonsil.

3) Branches to the submandibular salivary gland, rami submandibulares, in the amount of 2-5 depart from the artery at the place of its passage through the submandibular gland. It supplies blood to the gland and anastomoses with branches of the lingual artery.

4. Mental artery, a. submentalis, originates at the exit of the facial artery from the submandibular gland. The mental artery is located on m. mylohyoideus, reaching the chin. It supplies blood to all muscles above the hyoid bone and anastomoses with a. sublingualis (a branch of the lingual artery), as well as branches of the facial and maxillary arteries that branch off to the lower lip.

5. Inferior labial artery, a. labialis inferior, departs from the facial artery below the corner of the mouth. Heads to the midline of the oral fissure in the submucosa of the lip. Supplies blood lower lip and anastomoses with the artery of the opposite side.

6. Superior labial artery, a. labialis superior, originates from the facial artery at the level of the corner of the mouth. It lies in the submucosal layer of the edge of the upper lip. It anastomoses with the artery of the same name on the opposite side. Thus, due to the two upper and two inferior arteries an arterial ring is formed around the oral fissure.

back branches. 1. Sternocleidomastoid artery, a. sternocleidomastoideus, steam room, branches off at the level of the facial artery, then goes down and enters the muscle of the same name.

2. Occipital artery, a. occipitalis, steam room, goes up and back to mastoid process, passing between the beginning of the sternocleidomastoid muscle and the posterior belly m. digastricus. Goes into the occipital region between m. trapezius and m. sternocleidomastoideus. In the depths of the neck, the belt muscle of the neck and head pierces. In the occipital region is under m. epicranius. Supplies blood to the skin and muscles of the neck, auricle and hard shell in the area parietal bone; also gives a branch to the dura mater in the posterior cranial fossa, where the artery penetrates through the jugular foramen.

3. Posterior ear artery, a. auricularis posterior, steam room, departs from the carotid artery 0.5 cm above the occipital artery (in 30% of cases, the common trunk with the occipital artery), goes in the direction of the styloid process of the temporal bone, then is located between the cartilaginous part of the external ear canal and the mastoid process of the temporal bone. Passing behind the auricle, it ends with a branching in the occipital region, supplying blood to the muscles and skin of the occiput, the auricle. The artery connects with branches of the occipital artery. On its way, it gives branches to supply blood to the facial nerve and tympanic cavity.

medial branches. Ascending pharyngeal artery, a. pharyngea ascendens, steam room, the thinnest branch of the branches of the external carotid artery. It originates at the same level as the lingual artery, and sometimes at the site of division of the common carotid artery. This artery is directed vertically, being initially located between the internal and external carotid arteries. Then it passes in front of the internal carotid artery, located between it and the upper pharyngeal constrictor. Its terminal branch reaches the base of the skull. It supplies blood to the pharynx, soft palate, and dura mater of the posterior cranial fossa. To the latter, it passes through the jugular foramen.

terminal branches. I. Maxillary artery, a. maxillaris, is located in the infratemporal fossa (Fig. 159), and the final part reaches the pterygopalatine fossa. Topographically and anatomically, the maxillary artery is divided into three parts: mandibular, infratemporal, and pterygopalatine (Fig. 160).

Rice. 159. Maxillary artery and its branches. 1-a. carotis communis; 2-a. carotis interna; 3-a. carotis externa; 4-a. thyreoidea superior; 5-a. lingualis; 6-a. facialis; 7-a. sternocleidomastoidea; 8, 10 - a. occipitalis; 9-a. auricularis posterior; 11-a. stylomastoidea; 12 - branches a. occipitalis; 13-a. temporalis superficialis; 14 - branch to the tympanic cavity; 15-a. carotis interna; 16-a. maxillaris; 17-a. meningea media; 18 - n. mandibulars; 19, 23, 24 - branches a. maxillaris to chewing muscles; 20-a. infraorbitalis; 21-a. alveolaris superior posterior; 22-a. alveolaris superior anterior; 25 - m. pterygoid eus medialis; 26-a. alveolaris inferior; 27-r. mylohyoideus; 28-a. mentalis; 29 - rami dentales; 30 - dura mater encephali; 31-nn. vagus, glossopharyngeus, accessorius; 32 - processus styloideus; 33-v. jugularis interna; 34-n. facialis; 35 - branch, a. occipitalis

The mandibular part of the artery is located between the medial surface of the articular capsule of the mandibular joint and the styloid-maxillary ligament. On this short segment, 3 branches originate from the artery 1. Inferior alveolar artery, a. alveolaris inferior, steam room, initially located between the medial pterygoid muscle and the branch of the lower jaw, and then enters the mandibular canal. In the canal, it gives branches to the teeth, gums and bone substance of the lower jaw. The final part of the inferior alveolar artery leaves the canal through the foramen mentale, forming the artery of the same name (a. mentalis), which goes to the chin, where it anastomoses with the inferior labial artery (from a. facialis). From the lower alveolar artery, before entering the mandibular canal, the maxillo-hyoid branch branches off, a. mylohyoidea, which lies in the groove of the same name and supplies blood to the maxillohyoid muscle.

2. Deep ear artery, a. auricularis profunda, steam room, goes back and up, supplying blood to the external auditory meatus and the tympanic membrane. Anastomoses with the occipital and posterior auricular arteries.

3. Anterior tympanic artery, a. tympanica anterior, steam room, often begins with a common trunk with the previous one. Through fissura petrotympanica penetrates into tympanic cavity and supplies blood to the mucosa.

The infratemporal part of the maxillary artery is located in the infratemporal fossa between the lateral surface of the external pterygoid and temporal muscles. There are six branches from this department:

1) Middle artery of the meninges, a. meningea media, the steam room passes along the inner surface of the external pterygoid muscle and penetrates into the cranial cavity through the spinous foramen. In the arterial sulcus of the scales of the temporal bone, the parietal and greater wing of the sphenoid bone is covered by the dura mater. Supplies blood to the dura mater trigeminal nerve and mucous membrane of the tympanic cavity.

2. Deep temporal arteries, anterior and posterior, aa. temporales profundae anterior et posterior, paired, run parallel to the edges of the temporal muscle, in which they branch.

3. Chewing artery, a. masseterica, steam room, passes down and outward through the incisura mandibulare to the masticatory muscle.

4. Posterior superior alveolar artery, a. alveolaris superior posterior, steam room; several of its branches penetrate into the thickness upper jaw through holes in the tubercle. It supplies blood to the teeth, gums and mucous membrane of the maxillary sinus.

5. Buccal artery, a. buccalis, steam room, goes down and forward, penetrates the buccal muscle. It supplies blood to the entire thickness of the cheeks and gums of the upper jaw. Anastomoses with branches of the facial artery.

6. Pterygoid branches, rami pterygoidei, paired, 3-4 in number, supply blood to the external and internal pterygoid muscles of the same name. Anastomose with the posterior alveolar arteries.

Further, the maxillary artery at the edge of the chewing muscle makes a medial turn and goes to the pterygopalatine fossa, in which its anterior section is located. Arteries originate from the pterygopalatine part:

1. Infraorbital artery, a. infraorbitalis, steam room, penetrates into the orbit through the fissura orbitalis inferior, lies in the infraorbital groove and exits through the hole of the same name on the face. At the bottom of the infraorbital sulcus (or sometimes canal), the anterior superior alveolar arteries originate from the artery, aa. alueolares superiores anteriores going to the front upper teeth and gum. Supplies blood to the muscles in the eye socket eyeball. The terminal branch exits through the fissura orbitalis inferior to the face and supplies blood to the skin, muscles, and part of the upper jaw. Connects with branches a. facialis and a. ophthalmica.

2. Descending palatine artery, a. palatina descendens, steam room, goes down the canalis palatinus major to the hard and soft palate, ending in the form of a. palatina major et minor. The large palatine artery reaches the incisive foramen and supplies blood to the mucous membrane of the palate and upper gums. A departs from the initial part of the descending palatine artery. canalis pterygoidei, which supplies blood to the nasal part of the pharynx.

3. Sphenoid-palatine artery, a. sphenopalatina, steam room, penetrates into the nasal cavity through the opening of the same name, branching into aa. nasales posteriores, laterales et septi. They supply blood to the nasal mucosa. Anastomoses with a. palatina major in the region of the incisive foramen.

II. Superficial temporal artery, a. temporalis superjicialis, steam room, the final branch of the external carotid artery, originates at the level of the neck of the lower jaw under the parotid salivary gland, then passes in front of the cartilaginous part of the external auditory canal and is located under the skin in the temporal region. It is divided into several branches.

1. Transverse artery of the face, a. transversa faciei, branches off at the beginning temporal artery, goes forward below the zygomatic arch. Anastomoses with branches of the facial and maxillary arteries.

2. Branches of the parotid gland, rami parotidei, 2-3 small arteries. Branches between the lobules of the gland. They supply blood to the parenchyma and capsule of the gland.

3. Middle temporal artery, a. temporalis media, begins at the level of the root of the zygomatic process of the temporal bone, where, having passed through the temporal fascia, it supplies blood to the temporal muscle.

4. Anterior ear branches, rami auriculares anteriores, 3-5 small arteries, supply blood to the auricle and external auditory canal.

5. Zygomatic-orbital artery, a. zygomaticoorbitalis, branches off above the external auditory canal and goes to the outer corner of the eye. Anastomoses with branches of the ophthalmic artery.

6. Frontal branch, ramus frontalis, one of the terminal branches of a. temporalis superficialis. Goes to the frontal area. Anastomoses with branches of the ophthalmic artery.

7. Parietal branch, ramus parietalis, the second terminal branch of the superficial temporal artery. It anastomoses with the occipital artery and participates in the blood supply to the occipital region.

internal carotid artery , a. carotis interna, steam room, has a diameter of 9-10 mm, is a branch of the common carotid artery. Initially, it is located behind and laterally from the external carotid artery, separated from it by two muscles: m. styloglossus and m. stylopharyngeus. It rises up the deep muscles of the neck near the pharynx to the external opening of the carotid canal. Having passed the sleepy canal, it enters the sinus cavernosas, in which it makes two turns at an angle, first forward, then upward and somewhat backward, perforating the dura mater behind the foramen opticum. Lateral to the artery is the anterior sphenoid process of the sphenoid bone. In the neck area, the internal carotid artery does not give branches to the organs. In the carotid canal, carotid-tympanic branches, rami caroticotympanici, depart from it, to the mucous membrane of the tympanic cavity.

In the cranial cavity, the internal carotid artery is divided into 5 large branches (Fig. 161):

Rice. 161. Artery of the brain (from below), the left hemisphere of the cerebellum and part of the left temporal lobe are removed (according to R. D. Sinelnikov).1-a. carotis interna; 2-a. cerebri media; 3-A. chorioidea; 4-a. communicans posterior; 5-a. cerebri posterior; 6-a. basilaris; 7-n. trigeminus; 8-n. abducens; 9-n. intermedins; 10-n. facialis; 11-n. vestibulocochlear; 12-n. glossopharygeus; 13 - n. vagus; 14-a. vertebralis; 15-a. spinalis anterior; 16, 18 - n. acces-sorius; 17-a. cerebelli inferior posterior; 19-a. cerebelli inferior anterior; 20-a. cerebelli superior; 21-n. oculomotorius; 22 - tractus opticus; 23 - infundibilum; 24 - chiasma opticum; 25 - a.a. cerebri anteriores; 26-a. communicans anterior

1. Orbital artery, a. ophtalmica, steam room, along with the optic nerve penetrates the orbit, located between the superior rectus muscle of the eye and the optic nerve (Fig. 162). In the upper medial 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 gives off 8 branches: 1) lacrimal artery, a. lacrimalis, which supplies blood to the lacrimal gland; 2) central retinal artery, a. centralis retinae, supplying the retina; 3) lateral and medial arteries of the eyelids, aa. palpebrales lateralis et medialis - the corresponding angles of the palpebral fissure; between them there are upper and lower anastomoses, arcus palpebralis superior et inferior; 4) posterior ciliary arteries, short and long, aa. ciliares posteriores breves et longi, supplying blood to the protein and choroid eyeball; 5) anterior ciliary arteries, aa. ciliares anteriores, supplying the albuginea and ciliary body; 6) supraorbital artery, a. supraorbitals, supplying the forehead area (anastomoses with a. temporalis superficialis); 7) ethmoid arteries, posterior and anterior, aa. ethmoidales posterior et anterior, supplying the ethmoid bone and dura mater of the anterior cranial fossa; 8) dorsal artery of the nose, a. dorsalis nasi, supplying the back of the nose (connects with a. angularis in the region of the medial angle of the orbit).

2. Anterior cerebral artery, a. cerebri anterior, steam room, located above the optic nerve in the region of trigonum olfactorium, substantia perforata anterior 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 by the anterior communicating artery, a. communicans anterior (see Fig. 161). Then it lies on the anterior surface of the cerebral hemispheres, bending around the corpus callosum. It supplies blood to the olfactory brain, corpus callosum, cortex of the frontal and parietal lobes of the cerebral hemispheres.

3. Middle cerebral artery, a. cerebri media steam room heading to lateral part hemispheres and passes into the lateral sulcus of the brain. It supplies blood to the frontal, temporal, parietal lobes and the insula of the brain, forming anastomoses with the anterior and posterior cerebral arteries (see Fig. 161).

4. Anterior artery of the choroid plexus, a. chorioidea anterior, steam room, goes back along the lateral side of the legs of the brain between the visual, tract and gyrus hippocampi, penetrates into the lower horn lateral ventricle, where it participates in the formation of the choroid plexus (see Fig. 161).

5. Posterior communicating artery, a. communicans posterior, steam room, goes back and connects with the posterior cerebral artery (branch a. vertebralis) (see Fig. 161).

Rice. 162. Branches of the ophthalmic artery (the lateral wall of the orbit is removed). 1-a. carotis interna; 2 - processus clinoideus posterior; 3 - optic nerve; 4-a. ophthalmica; 5-a. ethmoidalis posterior; 6, 18 - aa. ciliares; 7-a. lacrimalis; 8, 9 - a. supraorbitalis; 10-a. dorsalis nasi et a. palpebralis; 11 - a.a. palpebrales mediales; 12-a. angularis; 13 - a.a. eiliares; 14-a. infraorbitalis; 15-a. facialis; 16-a. maxillaris; 17- optic nerve; 19-a. centralis retinae

subclavian artery , a. subclavia, steam room, begins to the right of the truncus brachiocephalicus behind the sternoclavicular joint, to the left of the aortic arch. The left subclavian artery is longer and deeper than the right one. Both arteries go around the top of the lung, leaving a groove on it. Then the artery approaches the I rib and penetrates into the space between the anterior and middle scalene muscles. In this space, the brachial plexus is located above the artery. The subclavian artery gives off 5 branches (Fig. 163).

Rice. 163. Subclavian artery, common carotid artery and branches of the external carotid artery.1-a. temporalis superficialis; 2-a. occipitalis; 3-a. vertebralis; 4-a. carotis interna-5 - a. carotis externa; 6-a. vertebralis; 7-a. cervicalis profunda; 8-a. cervicalis superficialis; 9-a. transversa colli; 10-a. suprascapular; 11-a. subclavia; 12, 13 - a. supraorbitalis14 - a. angularis; 15-a. maxillaris; 16-a. buccalis; 17-a. alveolaris inferior; 18-a. facialis; 19-a. lmguahs; 20-a. thyreoidea superior; 21-a. carotis communis; 22-a. cervicalis ascendens; 23-a. thyreoidea inferior; 24 - truncus thyreocervicalis; 25-a. thoracica interna

1. Vertebral artery, a. vertebralis, steam room, starts from the upper semicircle of the subclavian artery before entering it into the interstitial space. Anteriorly, it is covered by the common carotid and inferior thyroid arteries. At the outer edge of the long muscle of the neck, it enters the foramen transversarium of the VI cervical vertebra and passes through the transverse foramina of six cervical vertebrae. Then it lies in the sulcus arteriae vertebralis of the atlas, perforating the membrana atlantoccipitalis and the dura mater, enters the cranial cavity through the foramen magnum. At the base of the skull, the artery is located ventrally medulla oblongata. At the posterior edge of the bridge, both vertebral arteries merge into one main artery, a. basilaris.

branches vertebral artery supply blood to the spinal cord and its membranes, deep muscles of the neck, cerebellum. The main artery, starting at the lower edge of the bridge, ends at its upper edge, breaking up into two posterior cerebral arteries, aa. cerebri posteriores. They go around the outside of the legs of the brain, go to the dorso-lateral surface of the occipital lobes of the hemisphere. Supply blood to the occipital and temporal lobe, nuclei of the hemispheres and legs of the brain, are involved in the formation of the choroid plexus. The main artery gives off branches to the pons, labyrinth, and cerebellum.

The arterial circle of the brain, circulus arteriosus cerebri, is located between the base of the brain and the Turkish saddle of the skull. A.A. take part in his education. carotis internae (aa. cerebri anteriores etmedii) and a. basilaris (aa. cerebrae posteriores).

The anterior cerebral arteries are connected by the ramus communicans anterior, and the posterior cerebral arteries by the ramus communicans posterior.

2. Internal thoracic artery, a. thoracica interna, departs from the lower surface of the subclavian. artery at the same level as the vertebral artery goes to chest cavity behind the clavicle and subclavian vein, where it is located on the inner surface of the I-VII costal cartilages, receding outwards from the edge of the sternum by 1-2 cm. It supplies blood to the thymus gland, bronchi, pericardial sac, diaphragm and chest. On its way, it gives off a number of branches: aa. pericardiacophrenica, musculophrenica, epigastrica superior. The latter forms an anastomosis on the anterior abdominal wall with the inferior epigastric artery.

3. Thyroid-cervical trunk, truncus thyreocervicalis, paired, branches off near the medial edge of m. scalenus anterior from the upper surface of the artery. It has a length of 0.5-1.5 cm. It divides into 3 branches: a) the inferior thyroid artery, a. thyreoidea inferior, - to the thyroid gland, from which branches extend to the pharynx, esophagus, trachea, larynx; the last branch anastomoses with the superior laryngeal artery; b) ascending cervical artery, a. cervicalis ascendens, - to the deep muscles of the neck and spinal cord; c) suprascapular artery, a. suprascapularis, which crosses the lateral triangle of the neck and, above the superior scapular notch, penetrates into the infraspinatus fossa of the scapula.

4. Costo-cervical trunk, truncus costocervicalis, paired, departs in the interstitial space from the posterior periphery of the artery. It goes to the head of the 1st rib. The trunk is divided into branches: a) deep cervical artery, a. cervicalis profunda, - to back muscles neck and spinal cord; b) the most superior intercostal artery, a. intercostalis suprema, - to the I and II intercostal spaces.

5. Transverse artery of the neck, a. transversa colli, steam room, branches off from the subclavian artery when it leaves the interstitial space. Penetrates between branches brachial plexus, goes to the supraspinous fossa of the scapula. Supplies blood to the muscles of the scapula and back.

The human neck is the part of the body that connects the head and body. Its upper border begins at the edge of the lower jaw. In the trunk, the neck passes through the jugular notch of the manubrium of the sternum and passes through the upper surface of the clavicle. Despite its relatively small size, there are many important structures and organs that are separated by connective tissue.

Form

If the anatomy of the neck is generally the same for any person, then its shape may differ. Like any other organ or part of the body, it has its own individuality. This is due to the peculiarities of the constitution of the body, age, gender, hereditary characteristics. The cylindrical shape is the standard form of the neck. in the nursery and young age the skin in this area is firm, elastic, tightly fits cartilage and other protrusions.

When tilting the head on the midline of the neck, the horns and body of the hyoid bone are clearly defined, the cartilages of the thyroid gland are cricoid, tracheal. Below the body, a fossa is visible - this is the jugular notch of the sternum. In people of medium and thin build, muscles are clearly visible on the sides of the neck. It is easy to notice and located near the skin.

Neck anatomy

This part of the body contains large vessels and nerves inside, it is made up of organs and bones that are important for human life. Developed muscular system allows you to make a variety of movements of the head. The internal structure of the neck consists of such departments as:

pharynx - taking part in the oral speech of a person, which is the first barrier to pathogenic microorganisms, performs a connecting function for the digestive system;
larynx - plays a significant role in the speech apparatus, protects the respiratory organs;
trachea - a conductor of air to the lungs, an important component of the respiratory system;
thyroid gland - an organ of the endocrine system that produces hormones for metabolic processes;
esophagus - part of the digestive chain, pushes food to the stomach, protects against reflux in the opposite direction;
spinal cord - element supreme human, responsible for the mobility of the body and the activity of organs, reflexes.

In addition, nerves, large vessels and veins pass through the neck area. It is made up of vertebrae and cartilage, connective tissue and fat layer. This is a part of the body that is an important connecting link "head - neck", thanks to which the spinal cord and brain are connected.

neck parts

Allocate the anterior and posterior regions of the neck, as well as many "triangles", which are limited to the lateral edges of the trapezius muscles. The front part looks like a triangle with the base turned upside down. It has limitations: from above - by the lower jaw, from below - by the jugular notch, on the sides - by the edges of the sternocleidomastoid muscle. The middle line divides this part into two medial triangles: right and left. The lingual triangle is also located here, through which access to the lingual artery can be opened. It is limited in front by the hyoid muscle, above by the hyoid nerve, behind and below by the tendon of the digastric muscle, next to which the carotid triangles are located.

The scapular-tracheal region is limited by the scapular-hyoid and sternocleidomastoid muscles. In the scapular-clavicular triangle, which is part of the paired lateral triangle, there is a jugular vein, suprascapular vein and artery, thoracic and lymphatic ducts. In the scapular-trapezoid part of the neck there is an accessory nerve and a cervical superficial artery, and a transverse artery passes through its medial part.

The region comprises the interscalene and prescalene spaces, within which both the suprascapular and phrenic nerves pass.

The posterior section is limited by the trapezius muscles. Here are the internal carotid artery and the jugular vein, as well as the vagus, hypoglossal, glossopharyngeal, accessory nerves.

Neck bones

It also consists of 33-34 vertebrae that pass through the entire body of a person and serve as a support for him. Inside is the spinal cord, which connects the periphery with the brain and provides higher reflex activity. The first section of the spine is just inside the neck, thanks to which it has high mobility.

The cervical region consists of 7 vertebrae, in some of them rudiments have been preserved, which are fused with the transverse processes. Their front part, which is the boundary of the hole, is a rudiment of the rib. The body of the cervical vertebra is transversely elongated, smaller than its counterparts and has a saddle shape. This provides the cervical region with the greatest mobility compared to other parts of the spinal column.

The openings of the vertebrae together form a canal that serves as protection for the vein. The passage of the spinal cord is formed by the arcs of the cervical vertebrae, it is quite wide and resembles a triangular shape. The spinous processes are bifurcated, due to which many muscle fibers are attached here.

Vertebra "Atlant"

The first two cervical vertebrae differ in structure from the other five. It is their presence that allows a person to make a variety of head movements: tilts, turns, rotations. The first vertebra is a ring of bone tissue. It consists of an anterior arch, on the convex part of which the anterior tubercle is located. On the inside, there is a glenoid fossa for the second odontoid process of the cervical vertebra.

The atlas vertebra on the posterior arch has a small protruding part - the posterior tubercle. The superior articular processes on the arc replace the oval articular fossae. They are articulated with the condyles of the occipital bone. The lower articular processes are pits that connect to the next vertebra.

Axis

The second cervical vertebra - the axis, or epistrophy - is distinguished by a developed odontoid process located in the upper part of its body. On each side of the processes are articular surfaces of a slightly convex shape.

These two structurally specific vertebrae are the basis of neck mobility. In this case, the axis plays the role of the axis of rotation, and the atlas rotates together with the skull.

Muscles of the neck

Despite the rather small size, the human neck is rich in muscles of various types. The superficial, middle, lateral deep muscles, as well as the medial group, are concentrated here. Their main purpose in this area is to hold the head, provide conversational speech and swallow.

Superficial and deep muscles of the neck

Name of the muscle	Location	Functions performed
long neck muscle	Anterior spine, extending from C1 to Th3	Allows flexion and extension of the head, antagonist of the back muscles
long head muscle	Originates on the tubercles of the transverse processes C2-C6 and inserts on the inferior basilar part of the occiput
Staircase (front, middle, back)	It starts at the transverse processes of the cervical vertebrae and is attached to the I-II rib	Involved in flexion of the cervical spine and raises the ribs when inhaling
sternohyoid	Comes from the sternum and attaches to the hyoid bone	Pulls the larynx and hyoid bone down
Scapular-hyoid	Scapula - hyoid bone
Sternothyroid	Attaches to the sternum and thyroid cartilage of the larynx
Thyrohyoid	Located in the region of the larynx to the hyoid bone
Geniohyoid	Begins on the lower jaw and ends at the attachment to the hyoid bone
Digastric	It originates at the mastoid process and attaches to the lower jaw	Pulls the larynx and hyoid bone up and forward, lowers the lower jaw while fixing the hyoid bone
Maxillofacial	Starts on the lower jaw and ends on the hyoid bone
stylohyoid	Located on the styloid process of the temporal bone and attaches to the hyoid bone
Subcutaneous cervical	It originates from the fascia of the deltoid and pectoralis major muscles and is attached to the fascia of the masseter muscle, the edge of the lower jaw and facial muscles	Tightens the skin of the neck, prevents squeezing of the saphenous veins
Sternocleidomastoid	Attaches from the upper edge of the sternum and the sternal end of the clavicle to the mastoid process of the temporal bone	Its contraction on both sides is accompanied by pulling the head back, unilateral - by turning the head in the opposite direction.

Muscles allow you to hold your head, make movements, reproduce speech, swallow and breathe. Their development prevents cervical osteochondrosis and improves blood flow to the brain.

Fascia of the neck

Due to the variety of organs passing through this area, the anatomy of the neck suggests the presence of a connective sheath that limits and protects organs, vessels, nerves and bones. This is an element of the "soft" skeleton that performs trophic and support functions. Fascia grow together with numerous veins of the neck, thereby preventing them from intertwining with each other, which would threaten a person with a violation of the venous outflow.

Their structure is so complex that the anatomy is described in different ways by the authors. Consider one of the generally accepted classifications, according to which the connecting sheaths are divided into fascia:

Superficial - a loose, thin structure that limits the subcutaneous muscle of the neck. It passes from the neck to the face and chest.
Own - attached from below to the front of the sternum and collarbone, and from above to the temporal bone and lower jaw, then goes to the face. WITH back side neck connects with the spinous processes of the vertebrae.
Aponeurosis scapular-clavicular - looks like a trapezoid and is located between the sides of the scapular-hyoid muscle and the hyoid bone, and from below divides the space between the surface of the sternum from the inside and two collarbones. It covers the anterior part of the larynx, thyroid gland and trachea. Along the midline of the neck, the scapular-clavicular aponeurosis fuses with its own fascia, forming a white line.
Intracervical - envelops everything internal organs neck, while it consists of two parts: visceral and parietal. The first closes each organ separately, and the second together.
Prevertebral - provides cover for the long muscles of the head and neck and merges with the aponeurosis.

Fascia separate and protect all parts of the neck, thereby preventing the "confusion" of blood vessels, nerve endings and muscles.

blood flow

The vessels of the neck provide the outflow of venous blood from the head and neck. They are represented by the external and internal jugular vein. Blood in the external vessel comes from the back of the head in the ear area, the skin over the shoulder blade and the front of the neck. A little earlier than the clavicle, it connects to the subclavian and internal jugular veins. The latter eventually develops into the former at the base of the neck and divides into two brachiocephalic veins: the right and left.

The vessels of the neck, and especially the internal jugular vein, play an important role in the processes of hematopoiesis. It originates at the base of the skull and serves to drain blood from all vessels of the brain. Its tributaries in the neck are also: superior thyroid, lingual facial, superficial temporal, occipital vein. The carotid artery passes through the neck region, which has no branches in this area.

Nerve plexus of the neck

The nerves of the neck make up diaphragmatic, skin and muscle structures, which are located at the level of the first four cervical vertebrae. They form plexuses that originate from the cervical spinal nerves. Muscular innervates nearby muscles. The neck and shoulders are set in motion with the help of impulses. The phrenic nerve influences the movements of the diaphragm, pericardial fibers, and pleura. The cutaneous branches give rise to the auricular, occipital, transverse, and supraclavicular nerves.

The lymph nodes

The anatomy of the neck also includes part of the body's lymphatic system. In this area, it is made up of deep and superficial nodes. The anterior ones are located near the jugular vein on the superficial fascia. The deep lymph nodes of the anterior part of the neck are located near the organs from which the outflow of lymph comes, and have the same name with them (thyroid, preglottal, etc.). The lateral group of nodes is pharyngeal, jugular and supraclavicular, next to which is the internal jugular vein. In the deep lymph nodes of the neck, lymph is drained from the mouth, middle ear and pharynx, as well as the nasal cavity. In this case, the fluid first passes through the occipital nodes.

The structure of the neck is complex and thought out to every millimeter by nature. The totality of plexuses of nerves and blood vessels connects the work of the brain and the periphery. In one small part of the human body, all possible elements of systems and organs are located at once: nerves, muscles, blood vessels, lymphatic ducts and nodes, glands, spinal cord, the most “mobile” section of the spine.

Vessels of the neck are a collection of venous and arterial branches that come from the cranial cavity and are responsible for the inflow and outflow of blood flows from the brain. Here are the vessels that represent the human lymphatic system.

The vessels passing through the neck are part of the entire vascular system of the body. Vascular system goes all over human body. Many diseases are directly related to the state of blood vessels.

Vienna

The venous system, passing at the level of the neck, is a collection of numerous veins, they are all interconnected and arranged in two layers. All of them go near the carotid artery and get their names based on the artery. The main pairs of jugular veins are distinguished:

internal;

front;

outdoor.

Internal veins are the largest. These are the main vessels that carry blood out of the skull. They run from the jugular foramen of the skull and form a bulbous ramification to the sternum. At the bottom of the neck, they are united with the common carotid artery through the connective tissue sheath. Further, the internal veins pass into the brachiocephalic vein. The vagus nerve is located in the neck.

The anterior vein has smallest dimensions and is formed from the veins passing in the chin area. It runs along the entire neck near the middle of the neck. This pair of veins forms an arc between themselves and flows into the external vein.

External veins are smaller and are enveloped in fiber. They are in the front of the neck. These pair of veins can be seen visually with any tension in the neck. They are responsible for collecting blood that nourishes the face, neck and head, below it becomes the subclavian vein.

arteries

There are several main arteries in the neck that feed upper part torso. The main ones are the two carotid arteries. They have two branches:

the internal artery, which is responsible for feeding the orbital region and the skull;

external artery, which nourishes the main part of the neck, face and outer part of the head.

The carotid arteries passing in the neck are very similar in appearance, passing from the sternoclavicular joint, and are divided into arcs near the thyroid cartilage. In the lower part of the neck they are separated by the trachea, at the top they are separated by vessels. The carotid arteries are in the sheath. On the side of them is the vagus nerve and veins. At the bottom of the neck, the arteries are deeper and have different integuments. In the upper part they are closer to the surface.

Between arteries and vessels are capillaries that feed nearby tissues. These vessels allow blood supply to the neck and face.

lymphatic system

This system is a means of removing interstitial fluid. It is a collection of vessels, crevices and nodes, which are the means of movement of the lymph. It flows through very thin vessels, and the speed of movement is much less than that of blood.

All lymphatic neck vessels go to nodes. Lymph nodes are found along the cervical region and spine. The main lymphatic trunks run parallel to the internal jugular veins, flowing into the venous angles.

To study the vessels of this area, ultrasound is performed. It is possible to conduct three types of ultrasound, they are based on the same principle, but differ from each other. Also, for the study of many diseases, an MRI is performed, which makes it possible to more accurately determine the state of the vessels of the neck. It is in this area that all the main vital vessels flow. Since the neck has a very complex structure, then surgical intervention has certain risks.

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.