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ANATOMIC REVIEW OF ARTERIES AND VEINS AND LYMPHATICS

Arteries of the Head and Neck

  • Blood supply to the head and neck (Fig. 25-1, Table. 25-1)

  • The internal carotid artery (ICA)

  • External carotid artery (ECA) and their branches

  • Intimate anastamoses between ICA and ECA in the region of the upper central face (nose, glabella, periorbital, and forehead)

  • These connections are important clinically in that

    • Infections in this area may extend intracranially via ICA

    • Steroid injections in the periorbital skin may embolize to the retinal artery and cause blindness

  • Named arteries give rise to unnamed branches and perforators that nourish overlying muscles, fascia, subcutaneous fat, and skin

    • Septocutaneous arteries: travel through septa to skin

    • Musculocutaneous arteries: perforate muscles to skin

    • Subdermal plexus arteries: at the junction of the subcutaneous fat and the deep reticular dermis

      • – Arise from septocutaneous and musculocutaneous arteries

      • – Main blood supply to the skin

      • – Undermine at least below midfat to preserve the subdermal plexus as immediate subdermal undermining may compromise the subdermal plexus

TABLE 25-1Branches of the Carotid Artery

Venous System of the Lower Extremities

  • Consists of the superficial (above muscular fascia) and deep (below muscular fascia) venous system (Fig. 25-2, Table. 25-2)

  • The superficial and deep systems are connected via perforator veins

  • Flow is unidirectional due to bicuspid valves in veins

    • Superficial veins drain into the deep veins via the perforators

    • Deep veins merge to form the common femoral vein

    • Venous valves permit only one-way flow (upward), when competent

    • Greatest density in the calf and progressively fewer valves in the thigh

  • Calf muscles act as a muscular pump to propel venous blood upward

    • Venous blood is moved only during muscle contraction

    • Lying still or standing still does not drain the venous system

FIGURE 25-2

Venous system of lower extremities.

TABLE 25-2Leg Veins

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