32: Arterial Supply and Venous Drainage

Arterial Supply and Venous Drainage

OBJECTIVES

• To trace the blood from the time it returns from the body to the heart, out, and back until it returns again from the overall body

• To trace the blood supply from the heart to all areas of the oral cavity, including the teeth

• To trace the venous drainage from the teeth and oral cavity back to the heart

• To define hematoma

• To discuss the possible problems associated with a posterior superior alveolar injection

A student of anatomy should have a clear picture of the blood flow to and from the body. Blood enters into the right atrium of the heart from the body. From the right atrium it travels through the right atrioventricular valve (tricuspid valve) to the right ventricle. The right ventricle pumps it out through the pulmonary valve into the pulmonary artery and then to the lungs. There it picks up oxygen and returns to the left atrium of the heart through paired pulmonary veins on each side. From the left atrium, blood passes through the left atrioventricular valve (bicuspid or mitral valve) to the left ventricle, and the left ventricle pumps it out through the aortic valve into the aorta. From the aorta, the blood flows through the thorax and abdomen. In the pelvis the aorta ends as paired common iliac arteries. The common iliacs split into internal and external iliac arteries. The internal iliacs mainly supply the pelvis and nearby areas, while the external iliacs continue as femoral arteries down into the leg. Internal, external, and common iliac veins bring blood back from those regions until it reaches the abdomen, where the veins become the inferior vena cava, which returns blood to the right atrium.

Within the head and neck are many blood vessels, each with numerous branches. In this chapter we will concentrate on those vessels that supply and drain the teeth and oral cavity, starting with the heart and tracing the blood into the head and neck and then back to the heart again.

ARTERIAL SUPPLY

The pathways to the right and left sides of the head and neck are slightly different. On the right side, the brachiocephalic artery (brachio meaning “arm”; cephalic meaning “head”) branches off the arch of the aorta. Coming off the brachiocephalic artery are the right subclavian artery to the right arm, and the right common carotid artery to the right side of the head. The left common carotid artery comes directly off the arch of the aorta on the left side, and the left subclavian artery comes off the arch of the aorta lateral to the left common carotid artery.

Common Carotid Artery

In the neck on both sides, the common carotid artery runs within the carotid sheath, along with the internal jugular vein and the vagus nerve, and lies beneath the sternocleidomastoid muscle, which runs along the side of the neck. At about the level of the larynx, the common carotid divides into the external carotid and the internal carotid arteries.

The internal carotid artery has no branches in the neck but goes up to enter the skull. Once inside the skull, it branches to supply the eyes, the brain, and some limited regions of the coverings of the brain (Fig. 32-1).

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FIG. 32.1 General distribution of arteries from the lower part of the neck up through the skull area. (From DuBrul EL: Sicher’s oral anatomy, ed 7, St Louis, 1980, Mosby.)

Unlike the internal carotid artery, the external carotid artery has a number of branches in the neck, as shown in Figs. 32-1 and 32-2. The best way to study these arteries are by the directions and orders in which they come off of the external carotid artery.

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FIG. 32.2 Branches of the external carotid artery.

The external carotid artery ends by dividing into the maxillary artery and the superficial temporal arteries. However, we will consider in detail only the lingual, facial, and maxillary arteries.

Lingual artery

The lingual artery branches off the external carotid artery below the facial artery. The lingual artery then travels forward and deep, going beneath the hyoglossus muscle of the tongue and ending in three branches: the dorsal lingual artery to the deep posterior part of the tongue, the deep lingual artery to the deep anterior part of the tongue, and the sublingual artery to the ventral surface of tongue and floor of the mouth. The lingual artery supplies the tongue and the tissue in the floor of the oral cavity. If you have ever cut your tongue, you know that there is a well-developed blood supply within this tissue, which is completely supplied by the lingual artery (Fig. 32-3). Quite frequently the lingual and facial arteries come off the external carotid as one branch and then split. This branch is referred to as the linguofacial trunk.

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FIG. 32.3 Lingual artery branches that supply blood to the tongue.

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Related posts:

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  2. 20: Enamel, Dentin, and Pulp
  3. 30: Muscles of Facial Expression
  4. 34: Nervous System
  5. 24: The Tongue
  6. 10: Tooth Identification

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Jan 4, 2015 | Posted by in General Dentistry | Comments Off on 32: Arterial Supply and Venous Drainage

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