Learning Objective

By the end of this article, students should be able to describe the major arteries supplying the head and neck, their branches, anatomical course, and key clinical correlations.

Arterial Supply to the Head and Neck

The head and neck receive their primary blood supply from the carotid arteries and vertebral arteries. Understanding their course and branches is essential for clinical procedures, including vascular surgery, trauma management, and regional anaesthesia.

1. Carotid Arteries

Artery	Origin	Course	Key Branches	Clinical Relevance
Right Common Carotid	Bifurcation of the brachiocephalic trunk	Ascends laterally to the trachea and oesophagus	Bifurcates at the superior thyroid cartilage into the external and internal carotid arteries	Carotid sinus at the bifurcation detects blood pressure
Left Common Carotid	Arch of the aorta	Ascends laterally to the trachea and oesophagus	Bifurcates into the external and internal carotid at C4	Same as above

Key Points:

Carotid Sinus: Slight dilation at bifurcation; contains baroreceptors for blood pressure regulation.
Carotid Body: Peripheral chemoreceptor detecting blood oxygen.
Carotid Triangle: An anatomical landmark for carotid pulse and procedures.

1.1 External Carotid Artery

Supplies structures external to the cranium.
Terminates in the superficial temporal and maxillary arteries.
Major branches:

1. Superior thyroid artery
2. Lingual artery
3. Facial artery
4. Ascending pharyngeal artery
5. Occipital artery
6. Posterior auricular artery

Clinical Relevance:

Scalp blood supply: Posterior auricular, occipital, superficial temporal, supraorbital, and supratrochlear arteries create a highly vascular area prone to excessive bleeding in injuries.
Middle meningeal artery (MMA): A branch of the maxillary artery; supplies the skull and dura mater. A fracture at the pterion can cause an extradural haematoma.

1.2 Internal Carotid Artery

No branches in the neck.
Enters the cranium via the carotid canal.
Supplies: brain, brainstem, eyes, and forehead.

Clinical Relevance:

Atherosclerosis: Turbulent flow at the carotid sinus increases the risk of plaque formation → stroke or cerebral ischaemia.
Carotid Endarterectomy: Surgical removal of plaque to restore cerebral perfusion.

2. Vertebral Arteries

Paired vessels from the subclavian arteries.
Ascend through the foramen transversarium of the cervical vertebrae.
Enter cranium via foramen magnum → merge to form basilar artery.

Clinical relevance:

Supplies brainstem, cerebellum, and posterior cerebral structures.
No extra-cranial branches.

3. Other Arteries of the Neck

Artery	Origin	Supply
Inferior thyroid artery	Thyrocervical trunk	Thyroid gland
Ascending cervical artery	Inferior thyroid artery	Posterior prevertebral muscles
Transverse cervical artery	Thyrocervical trunk	Trapezius & rhomboid muscles
Suprascapular artery	Thyrocervical trunk	Posterior shoulder region

Key Point:

These branches contribute to collateral circulation of the neck and are important in surgeries or trauma management.

Summary Table – Head and Neck Arterial Supply

Main Artery	Key Branches	Target Structures	Clinical Notes
Right / Left Common Carotid	Bifurcates into external & internal carotid	Neck structures	Carotid sinus & body; risk of atherosclerosis
External Carotid	Superior thyroid, lingual, facial, maxillary, occipital, posterior auricular, superficial temporal	Face, scalp, superficial neck	Scalp bleeding; MMA → extradural haematoma
Internal Carotid	Ophthalmic, anterior cerebral, middle cerebral	Brain, eyes, forehead	Stroke risk with atherosclerosis
Vertebral	Basilar artery	Brainstem, cerebellum, posterior brain	No extra-cranial supply
Thyrocervical trunk	Inferior thyroid, ascending cervical, transverse cervical, suprascapular	Thyroid, neck muscles, and shoulder	Important in surgical planning