External carotid artery

Maxillary

In the young, the blood comes from Little’s area, a highly vascular area at the anteriorborder of the

nasal septum. With age the site of bleeding moves posteriorly

ο    The nose and sinuses are supplied by branches of the internal and external carotid arteries.

ο      The superiorpart of the nose receives the anterior and posterior ethmoidal arteries – branches of the ophthalmicartery which itself, is a branch of the internal carotid. [FAQ]

ο      The rest of the nose and sinuses is supplied by the greater palatine, sphenopalatine, and superior labial arteries, all of which are branches of the maxillary artery which itself, is a branch of the external carotid.[FAQ]

ο      Significantly there is a plexus of vessels on the anterior septum – Little’s area or Kiesselbach’s plexus – where branches of both the internal and external carotid artery anastomose; this is a frequent site for epistaxis.

ο     Venous drainage of the nose and sinuses is via the ophthalmic and facial veins (dangerous area of face), and the pterygoid and pharyngeal plexuses. Significantly, drainage is such that infection may spread via the veins to the cavernous sinus, leading to cavernous sinus thrombosis

The pterygopalatine fossa is situated between the posterior wall of the maxillary antrum and the pterygoidplates. Its medial margin is the perpendicular plate of the palatine bone; this is perforated by, the sphenopalatine foramen, which connects the fossa with the nasal cavity. Laterally, the pterygopalatine fossa communicates through the pterygomaxillary fissure with the infratemporal fossa. The pterygopalatine fossa also communicates with the middle cranial cavity through the foramen rotundum and pterygoid canal, the orbit through the inferior orbital fissure, and the oral cavity through the pterygopalatine canal. The fossa contains the sphenopalatine ganglion and the third, or pterygopalatine, segment of the maxillary artery.

Facial Artery

Anterior ethmoidal artery is a branch of the ophthalmic artery which is a branch of the internal carotid artery.

The major source of blood supply to the nasal mucosa is the sphenopalatine artery, which is the terminal branch of the maxillary artery. The sphenopalatine artery enters the nasal cavity from the pterygopalatine fossa by passing through the sphenopalatine foramen in the lateral wall of the nasal cavity.

• The facial artery is a direct branch of the external carotid artery. It provides most of the blood supply to the superficial face.
• The superficial temporal artery is a terminal branch of the external carotid artery. The other terminal branch is the maxillary artery. The superficial temporal artery provides blood supply to the temporal region and the lateral portion of the scalp.
• The superior labial artery is a branch of the facial artery. The superior labial artery provides blood supply to the upper lip. It has a septal branch that provides some of the blood supply to the anterior portion of the septal mucosa of the nasal cavity. However, this is not the major blood supply to the nasal cavity.

• Inferior alveolar artery
• Middle meningeal artery
• Deep auricular artery
• Anterior tympanic artery
• Occasionally an accessory meningeal branch.

• Masseteric artery
• Deep temporal branches
• Pterygoid branches
• Buccal artery

• Posterior superior alveolar artery
• Infraorbital artery
• Descending palatine artery
• Greater palatine artery
• Lesser palatine artery
• Sphenopalatine artery
• Lateral posterior nasal arteries
• Posterior septal branches

The arterial supply to the parotid gland is from the external carotid artery and its branches within and near the gland. The veins drain to the external jugular vein via local tributaries.

Middle meningeal artery is a direct branch of the first part of the internal maxillary artery in the infratemporal fossa.

Key derivatives of branchial arches:
 

Ref: Otolaryngology: Basic Science and Clinical Review By Thomas R. Van De Water, Hinrich Staecker, 2006, Page 499.

D i.e. Ascending pharyngeal

B i.e. Palatal branch of maxillary artery

B i.e Maxillary artery

D i.e. 5^th arch is absent in 5% of embryos 

–  All 6 aortic arches are not present simultaneously. In 50% of embryos 5°’ arch is never formed.

– There is formation of maxillary artery from 1^5t arch; hyoid & stapedial arteries from 2^nd arch; common, internal & external carotid from 3^rd arch; arch of aorta & right subclavian artery from left & right 4^th arch respectively; and pulmonary artery from 6°’ aortic archy

Both internal carotid artery and external carotid artery supply the nose but main artery is the external carotid artery.

Branches of the External Carotid Artery Superior thyroid artery

Ascending pharyngeal artery

Lingual artery

Facial artery

Occipital artery

Posterior auricular artery

Superficial temporal artery

Maxillary artery

 Inferior thyroid artery

Ophthalmic artery is the branch of cerebral part of internal carotid artery

Middle meningeal artery

• It is typically the third branch of the first part (retromandibular part) of the maxillary artery, one of the two terminal branches of the external carotid artery.
• After branching off the maxillary artery in the infratemporal fossa, it runs through the foramen spinosum to supply the dura mater and the calvaria.
• The middle meningeal artery is the largest of the three (paired) arteries which supply the meninges, the others being the anterior meningeal artery and the posterior meningeal artery.

Ans. Internal maxillary artery

 Supraorbital

Ans;D).5th arch is absent in 5% of embryos 

This structure is Arch of aorta

•  All 6 aortic arches are not present simultaneously. In 50% of embryos 5°’ arch is never formed.
•  There is formation of maxillary artery from 1st arch;
•  Hyoid & stapedial arteries from 2nd arch; common,
•  Internal & external carotid from 3rd arch;
• Arch of aorta & right subclavian artery from left & right 4th arch respectively;
•  Pulmonary artery from 6th aortic arch