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5. Describe the superficial vasculature (arteries and veins) of the face.
5. Describe the superficial vasculature (arteries and veins) of the face.
The superficial temporal v. typically accompanies the superficial temporal a. and the auriculotemporal n. superior to the parotid gland. The superficial temporal v. typically unites with the maxillary v. to form the retromandibular v. The retromandibular v. may divide into anterior and posterior divisions. The anterior division of the retromandibular v. typically unites with the facial v. before joining the internal jugular v. The posterior division of the retromandibular v. typically unites with the posterior auricular v. to form the external jugular v.
The superior thyroid a., the lingual a., and the facial a. are typically the first three anteriorly oriented branches of the external carotid a. The facial a. traverses the submandibular triangle before emerging over the body of the mandible (anterior to the masseter m.), accompanied by the facial v., deep to the branches of the facial n. The artery ascends and supplies structures of the face.
The facial a. has several branches. Major branches include the: inferior labial br., superior labial br., and the nasal br. The labial branches adjacent to the modiolus of the mouth and run courses between the orbicularis oris m. and the mucous membrane. The labial branches often anastomose with their contralateral counterparts. The lateral nasal br. often arises lateral to the nose, and anastomoses with its contralateral counterpart. In some cases, the lateral nasal br. may arise from the superior labial br. The angular a. is the terminal branch of the facial a. that courses toward the medial canthus of the eye.
The facial v. and its branches mirror the distribution of the facial a. and its branches. The angular v. is valveless and receives the supra-orbital v. and supratrochlear v. to drain the forehead and regions medial to the eye. The deep facial v. serves as a connection between the facial v. and pterygoid plexus of veins, and joins the facial v. anterior to the masseter m. Anastomoses between facial v. branches may allow infections a direct route into the cavernous sinus. For example, anastomoses between the angular v. and the superior and inferior ophthalmic vv. may allow infections from the ‘danger area of the face’ a direct route into the cavernous sinus. Likewise, infections may move through the deep facial v. through the pterygoid plexus of veins into the cavernous sinus.
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