blood supply h & d with ligation good

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  • 8/12/2019 Blood Supply h & d With Ligation Good

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    BLOOD SUPPLY OF MAXILLO - FACIAL REGION

    WITH A BRIEF NOTE ON ARTERIAL LIGATION

    CONTENTS:

    INTRODUCTION.

    BLOOD FLOW FROM HEART TO PERIPHERY.

    ARTERIAL SUPPLY.

    COMMON CAROTID ARTERY DIVISION &

    COURSE.

    EXTERNAL CAROTID ARTERY-ANATOMIC

    RELATION & LIGATION.

    BRANCHES :

    SUPERIOR THYROID ARTERY ANATOMIC

    RELATION & BRANCHES

    LINGUAL ARTERY - ANATOMIC RELATION &

    BRANCHES.

    FACIAL ARTERY-ANATOMIC RELATION,

    BRANCHES &LIGATION.

    OCCIPITAL ARTERY-ANATOMIC RELATION,

    BRANCHES .

    POSTERIOR AURICULAR ARTERY-ANATOMIC

    RELATION, BRANCHES.

    ASCENDING PHARYNGIAL ARTERY-ANATOMIC

    RELATION ,BRANCHES.

    SUPERFICIAL TEMsPORAL ARTERY-ANATOMIC

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    RELATION, BRANCHES.

    MAXILLARY ARTERY-ANATOMIC

    RELATION,BRANCHES

    VENOUS DRAINAGE:

    o INTERNAL JUGULAR VEIN- !"#$%!', (!)"s*

    &%*"#'$%!'.

    o FACIAL +COMMON FACIAL VEIN-

    !"#$%!',(!)"s*& %*"#'$%!'.

    o FACIAL +ANTERIOR FACIAL VEIN-

    !"#$%!',(!)"s* &%*"#'$%!'.

    o POSTERIOR FACIAL+RETROMANDIBUTAR

    !"#$%!' & %*"#'$%!'

    o

    EXTERNAL JUGULAR VEIN,o ANTERIOR JUGULAR VEIN

    o COMMUNICATION BETWEEN INTRACRANIAL

    $' EXTRACRANIAL VEIN

    o SINUSES OF THE DURAMATER

    ARTERIAL HAEMORRHAGES & LIGATION OF ARTERIES

    CONCLUSION

    REFERENCES:

    INTRODUCTION

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

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    COMMON CAROTID ARTERIES

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  • 8/12/2019 Blood Supply h & d With Ligation Good

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  • 8/12/2019 Blood Supply h & d With Ligation Good

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  • 8/12/2019 Blood Supply h & d With Ligation Good

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  • 8/12/2019 Blood Supply h & d With Ligation Good

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  • 8/12/2019 Blood Supply h & d With Ligation Good

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  • 8/12/2019 Blood Supply h & d With Ligation Good

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    SUPERFICIAL TEMPORAL ARTERY:

    +A I% s %0* s#$11*" %*"#'$1 5"$'(0 ! %0* *3%*"'$1 ($"!% $"%*"6, % 5*8's

    5*0' %0* '*( ! %0* #$'51* )'*" (!7*" ! %0* 4$"!% 81$'.

    +5 I% ")'s 7*"%($116 )4$"s, ("!ss'8 %0* "!!% ! %0* 968!#$ + 4"*-$)"()1$"

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    +( I' $%!' %! %0* 5"$'(0*s 0(0 s)4416 %0* %*#41*, %0* s($14 %0* 4$"!%

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    .

  • 8/12/2019 Blood Supply h & d With Ligation Good

    15/33

    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    INTERNAL CAROTID ARTERY

    O-(!(m") r!er%: T0s 5"$'(0 ! %0* '%*"'$1 ($"!% $"%*"6 s)441*s %0* *6*5$11 %s

    #)s(1*s, $' %0* 1$("#$1 81$' $' s*'s 5"$'(0*s '%! %0* )44*" 4$"% ! %0* $(*. T0*

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    81$' $' %0* #)s(1*s ! %0* *6*5$11 $"* s)441* 56 %0* 1$("#$1 $"%*"6 $' #)s()1$" 5"$'(0*s.

    P!s%*"!" $' $'%*"!" *%0#! 5"$'(0*s *'%*" %0* '$s$1 ($7%6 %0"!)80 %0* *%0#! !"$#'$.

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    *6*1s, T0* s)4"$!5%$1 5"$'(0 s'8s $"!)' %0* )44*" "# ! %0* !"5%$1 *'%"$'(* '%! %0*

    !"*0*$ 4$ss'8 %0 %0* s)4"$!"5%$1 !"$#*'. I% s)441*s %0* "!'%$1 #)s(1* $' %0* s' !

    %0* !"*0*$

    A "!'%$1 !" s)4"$%"!(01*$", 5"$'(0 1*$7*s %0* !"5% '*$" %0* #*$1 (!"'*" ! %0* *6* $'

    s*'s %s 5"$'(0*s %! %0* s!% %ss)*s ! %0* !"*0*$. T0* s)4"$!"5%$1 $' "!'%$1 5"$'(0*s

    $'$s%!#!ss*s %0 *$(0 !%0*", %0 %0* $'%*"!" 5"$'(0 ! %0* s)4*"($1 %*#4!"$1 $"%*"6 $'

    $("!ss %0* #1'*, %0 %0* $"%*"*s ! %0* !%0*" s*.

    T0* 1$s% $($1 5"$'(0 ! %0* !4%0$1#( $"%*"6 s %0* '$s$1, !" !"s$1 '$s$1, 5"$'(0, 0(0

    (!)"s*s !'$" !' %0* 1$%*"$1 s)"$(* ! %0* '!s* $' $'$s%!#!s*s %0 %0* $'8)1$" $"%*"6 %0*

    %*"#'$1 4$"% ! %0* $($1 $"%*"6. T0* '$s$1 $"%*"6 $' $'8)1$" $"%*"6 $"* ' $ "*(4"!($1 1!($%!'2

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    $1s! %0 %0* '"$!"5%$1 $"%*"6.

    VEINS

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    7*' 0(0, 5*0' %0* s%*"'!(1$7()1$" $"%()1$%!', ;!'s %0* s)5(1$7$' 7*' %! !"# %0*

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  • 8/12/2019 Blood Supply h & d With Ligation Good

    16/33

    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    7$"$51%6 ! %0* 7*'s ' %0* $(* $' '*( "$'* 7*'!)s 51!!, I' !%0*" !"s, $'$s%!#!%(

    5"$'(0*s #$6 $ss)#* 8"*$%*" 4"!4!"%!'s, 0*"*$s 4$"%s ! %0* %64($1 7*'s #$6 #'s0 '

    ($15*" !" *7*' 5*(!#* !5s!1*%*.

    T0* (!#41($%!' ! %0* s6s%*# ! 7*'s ' %0* 0*$ $' '*( $"* )"%0*" *'0$'(* 56 %0*

    $(% %0$% '%"$("$'$1 7*'s, "$''8 %0* 51!! ! %0* 5"$', $' *3%"$("$'$1 7*'s $"* (!''*(%*

    56 #)1%41* $'$s%!#!s*s, 0(0 4*"#% $ 1! ! 51!! ' 5!%0 "*(%!'s. T0* $'$s%!#!s*s

    5*%**' %0* 7*'s ! %0* 5"$', *'(1!s* ' $ "8 5!'6 ($4s)1*, $' %0* *3%"$("$'$1 7*'s $"*

    s$*%6 !)%1*%s. T0*" *3s%$'(* 4"*7*'%s $ "s* ! %0* '%"$("$'$1 4"*ss)"*, 0(0 !)1 !(()"

    %0* '%*"'$1 ;)8)1$" 7*', %0* #$' "$'$8* ! %0* (*"*5"$1 51!!, *"* (!#4"*ss*. I' %0s ($s*

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    $%!' !'* 0$s %! "*#*#5*" %0$% %0* '%"$("$'$1 7*'s, (!11*(%'8 %0* 51!! ! %0* 5"$', $"*

    '!% (!11$4s51*. T0* s')s*s ! %0* )"$#$%*" 0$7*, ' $(%, '! 7$17* ! %0*" !', 5)% $"* s4$(*s

    !" ($'$1s 5*%**' 1$6*"s ! %0* )"$#$%*". T0*6 $"* 1'* 56 *'!%0*1)# (0$"$(%*"s%( ! $11

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    "*'*"s %0*# !4*' $6s !" %0* s4"*$ ! $' '*(%!'.

    INTERNAL 1UGULAR VEIN:

    T0s 7*' (!##*'(*s $% %0* ;)8)1$" !"$#*', %0* #$' !)%1*% ! %0* 7*'!)s 51!! ! %0*

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    %0* '%*"'$1 ;)8)1$" 7*' #!7*s "s% %! %0* 1$%*"$1 $' %0*' %! %0* $'%*"!1$%*"$1 ("()#*"*'(* !

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    $s6##*%"6 ! %0* s')s*s ! %0* )"$#$%*".

  • 8/12/2019 Blood Supply h & d With Ligation Good

    17/33

    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    T0* %"5)%!"6 5"$'(0*s ! %0* '%*"'$1 ;)8)1$" 7*' $"* $s !11!s. I'%! %0* s)4*"!" 5)15

    !4*'s %0* '*"!" 4*%"!s$1 s')s, 0(0 1*$7*s %0* s)11 %0"!)80 %0* ;)8)1$" !"$#*' !" ' "!'%

    ! %. V*'s ! %0* 40$"6'3, ! %0* "!!% ! %0* %!'8)* $' ! %0* s)51'8)$1 $"*$ "$' '%! %0*

    )44*" 4$"% ! %0* '%*"'$1 ;)8)1$" 7*'. T0* '*3% 5"$'(0 s %0* $($1 7*', 0(0 "$'s %0* 51!!

    ! %0* s)4*"($1 $' **4 4$"%s ! %0* $(*. I' %0* )44*" (!"'*" ! %0* ($"!% %"$'81* 0*"*

    %0*s* 7*'s *#4%6 '%! %0* '%*"'$1 ;)8)1$" 7*' %0*"* s '!"#$116 $ * $'$s%!#!ss 5*%**'

    %0* '%*"'$1 ;)8)1$" 7*' $' %0* s)4*"($1 *3%*"'$1 ;)8)1$" 7*' ' %0* 1!*" 4$"% ! %0* '*(,

    %0* 7*'s ! %0* 1$"6'3 $' %06"! 81$'s $"* %0* #$' %"5)%$"*s ! %0* '%*"'$1 ;)8)1$" 7*'.

    I'%! %s %*"#'$1 4$"% *#4%6 %0* *3%*"'$1 $' %0* $'%*"!" ;)8)1$" 7*'s.

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    56 %! 7*'s s %0* s)51'8$1 7*', 0(0 $((!#4$'*s %0* 064!81!ss$1 '*"7* !" s!#* s%$'(*.

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    7*'. S!#* 7*'s "!# %0* 40$"6'3 !%*' ;!' %0* 1'8)$1 7*'s, 0*"*$s !%0*"s "$' "*(%16

    '%! %0* '%*"'$1 ;)8)1$" 7*'.

    FACIAL 0 COMMON FACIAL+ VEIN:

    T0s 7*' (!""*s4!'s ' %0* #$' %! %0* $($1 $"%*"6. T0* $($1 7*' %$*s %s

    !"8' "!# %0* ;)'(%!' ! %0* 7*'s ! %0* !"*0*$ $' '!s*. I%s )44*" 4$"% s %*"#* %0*

    $'8)1$" 7*' $' $((!#4$'*s %0* $'8)1$" $"%*"6, %0* %*"#'$1 4$"% ! %0* $($1 $"%*"6. T0*

    $'8)1$" 7*' "*(*7*s %0* "!'%$1 7*', %0* s)4"$!"5%$1 7*', $' 7*'s "!# %0* 1!*" 1 $'

    "!# %0* 5"8* ! %0* '!s*.

    T0* "!'%$1 7*' (!11*(%s %0* 51!! "!# %0* $'%*"!" 4$"%s ! %0* s($14 $' *s(*'s (1!s*

    %! %0* #1'* ' %0* s)4*"($1 $s($ %!$"s %0* ''*" (!"'*" ! %0* *6*. R80% $' 1*% "!'%$1

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  • 8/12/2019 Blood Supply h & d With Ligation Good

    18/33

    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    7*'s $"* )s*, %0* )'4$"* 7*' s %*"#* %0* #*$' "!'%$1 7*'. T0* "!'%$1 7*' s !%*'

    "*$16 7s51* %0"!)80 %0* s'.

    T0* s)4$"!"5%$1 7*', "$''8 %0* 51!! "!# %0* "*8!' ! %0* *6*5"!, *#4%*s *%0*"

    '%! %0* "!'%$1 7*' !" '%! %0* $'8)1$" 7*'. F"!'%$1 $' s)4"$!"5%$1 7*'s $'$s%!#!s* %0"!)80

    * 7*'!)s '*%s %0 %0* !%0*" 7*'s ! %0* s($14, %0* s)4*"($1 %*#4!"$1 4!s%*"!" $)"()1$",

    $' !((4%$1 7*'s.

    W0*"* 4$14*"$1 $' '$s$1 7*'s ;!' $% %0* ''*" (!"'*" ! %0* *6*, %0* $'8)1$" 7*' s (!'

    s%$'%16 ' * (!##)'($%!' %0 %0* s)4*"!" !40%0$1#( 7*'. T0* $($1 7*' 1s 5*0' %0*

    $($1 $"%*"6. I' %0* )44*" 4$"% ! %0* $(* $' $% %0* #$'51*. T0* $"%*"6 $' %0* 7*' $"* '

    (1!s* "*1$%!'. I' %0* #1* 4$"% ! %0* (0*(, 0!*7*" %0* 7*' 1*s $% s!#* s%$'(* 5*0'

    %0* $"%*"6 $' s $1s! #!"* s)4*"($1, %0* *1*7$%!" ! %0* )44*" 14 5*'8 '%*"4!s* 5*%**'

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    7*'s $' 7*'s "!# %0* (0** %s*1.

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    7*', ")'''8 5$($" $' !'$", "*(*7*s %0* s)5#*'%$1 7*' $' 4$1$%'* 7*'s, 0(0

    $1s! "$' %0* %!'s1.

    POSTERIOR FACIAL 0RETROMANDIBULAR+ VEIN:

    T0s 7*' "$'s $44"!3#$%*16 %0* "*8!'s %0$% $"* s)441* 56 %0* #$311$"6 $' %0*

    s)4*"($1 %*#4!"$1 $"%*"*s. T0* "*%"!#$'5)1$" 7*' s #$* )4 56 )'!' ! %0* s)4*"($1

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  • 8/12/2019 Blood Supply h & d With Ligation Good

    19/33

    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    (!'%')*s !'$" !' %0* !)%*" s)"$(* ! %0* s%61!06! $' 8$s%"( #)s(1*s, 5)% %0* $"%*"6

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    41*3)s2 s40*'!4$1$%'* 7*'s "$''8 %0* 4!s%*"!" 4$"% ! %0* '$s$1 ($7%6 $' %0* 8"*$%*" 4$"%

    ! %0* 4$1$%*2 #1* #*''8*$1 7*'s "$''8 %0* )"$ #$%*", 0(0 1*$7* %0* ("$'$1 ($7%6

    %0"!)80 %0* s4'!)s $"$#*'2 $"%()1$" 7*'s "!# %0* "(0 41*3)s ' $' $"!)' %0* ($4s)1* !

    %0* #$'5)1$" ;!'%2 $)"()1$" 7*'s "!# %0* *3%*"'$1 *$", $' %0* %"$'s7*"s* $($1 7*',

    "$''8 %0* 4!s%*"!" 4$"% ! %0* (0** $' %0* 4$"!% 81$'.

    T0* *'s* 7*'!)s 41*3)s s)""!)''8 %0* #$311$"6 $"%*"6 s*"7*s %! 4"!%*(% %0* $"%*"6

    "!# (!#4"*ss!' 0*' %0* #$s%($%!"6 #)s(1*s (!'%"$(%. D)"'8 %0*" (!'%"$(%!' %0* 5)18'8

    #)s(1*s "7* 51!! "!# %0* 7*'s. D)"'8 "*1$3$%!' ! %0*s* #)s(1*s "7* 51!! "!# %0*

    7*'s. D)"'8 "*1$3$%!' ! %0*s* #)s(1*s %0* 7*'s 11 $8$'. S)(0 $ #*(0$'($1 4"!%*(%7*

    )'(%!'s ! 7*'s s 56 '! #*$'s "$"* ' %0* 0)#$' 5!6. A' *3$#41* s %0* 7*'!)s 41*3)s

    s)""!)''8 %0* '%*"'$1 ($"!% ($"!% $"%*"6 ' %0* ($"!% ($'$1.

    E,TERNAL 1UGULAR VEIN:

    T0s 7*' s !'* ! %0* %! s)4*"($1 7*'s ! %0* '*(. I% !"8'$%*s 5*1! %0* 1!5* !

    %0* *$" 56 %0* )'!' ! %0* 4!s%*"!" $)"()1$" 7*'s $' %0* !((4%$1 7*'s, 0(0 (!""*s4!' %!

    %0* $"%*"*s ! %0* s$#* '$#*s. T0* *3%*"'$1 ;)8)1$" 7*' (!)"s*s $1#!s% 7*"%($16 !'$"

    $' %0*"*!"* ("!ss*s %0* s%*"'!(1*!#$s%! #)s(1* $8!'$116. T0s (!)"s* 1*$s %0* 7*'

    %!$"s %0* 4!s%*"!" 5!"*" ! %0* #)s(1* $5!7* %s 's*"%!' %! %0* (1$7(1*2 %0* 7*' ()"7*s

  • 8/12/2019 Blood Supply h & d With Ligation Good

    20/33

    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    $"!)' %0* 4!s%*"!" 5!"*" ! %0* s%*"'!(1*!#$s%! #)s(1* $' 4$ss*s '%! %0* *4%0. F"!#

    %s !"8' %! %0s 4!'% %0* 7*' s (!7*"* !'16 56 %0* 41$%6s#$ #)s(1* $' %0* s' $' s, '

    #$'6 '7)$1s, 7s51* %0"!)80 %0* s' $s $ 51)* 1'*. A5!7* %0* (1$7(1* %0* *3%*"'$1 ;)8)1$"

    7*' 4*"!"$%*s %0* **4 $s($ $' *#4%*s '%! %0* '*"!" *' ! %0* '%*"'$1 ;)8)1$" 7*'

    4!ss*ss*s $ 4$" ! 7$17*s. A s*(!' 4$" ! 7$17*s s s!#* %#*s !)' $% $ 7$"$51* 0*80%, 5)%

    #!s% "*/)*'%16 ' %0* 1!*" 0$1 ! %0* *3%*"'$1 ;)8)1$" 7*'. As* "!# %0* %! 7*'s, 0(0

    56 %0*" )'!' (!'s%%)%* %0* *3%*"'$1 ;)8)1$" 7*', % "*(*7*s !'16 * %"5)%$"*s. O'* s %0*

    7$"$51* ()%*'*!)s 7*' ! %0* '*(, 0(0 "$'s %0* 51!! "!# %0* !((4%$1 "*8!' $' %0*

    '*805!)"'8 $"*$ ! %0* '*( $' "*$(0*s %0* *3%*"'$1 ;)8)1$" 7*' $5!)% 0$1$6 !' %0*

    '*(. A #!"* #4!"%$'% 7*' *#4%6'8 '%! %0* *3%*"'$1 ;)8)1$" 7*' s $' $'$s%!#!%( 5"$'(0

    "!# %0* (!##!' $($1 7*'.

    ANTERIOR 1UGULAR VEIN:

    A S*(!' s)4*"$($1 7*'!)s "$'$8* !' %0* '*( s 4"!7* 56 %0* $'%*"!" ;)8)1$"

    7*'. T0s 7*' 0!*7*" s 7$"$51* $' !%*' $5s*'% !' !'* !" 5!%0 s*s. S!#*%#*s %0* %!

    7*'s )s* $' !"# #*$' 7*' ! %0* '*(. N!% $" $5!7* %0* s%*"'!(1$7()1$" $"%()1$%!', %0*

    $'%*"!" ;)8)1$" 7*' ()"7*s $"!)' %0* $'%*"!" 5!"*" ! %0* s%*"'!(1*!#$s%! #)s(1*s $'

    4*"!"$%'8 %0* **4 $s($, %)"'s 1$%*"$116 %! !4*' '%! %0* 1!*"#!s% 4$"% ! %0* '%*"'$1 ;)8)1$"

    7*', !" '%! %0* $'81* !"#* 56 %0* )'!' ! %0* '%*"'$1 ;)8)1$" $' s)5(1$7$' 7*'s, !" '%!

    %0* %*"#'$1 4$"% ! %0* *3%*"'$1 ;)8)1$" 7*'. T0* $'%*"!" ;)8)1$" 7*' "$'s %0* s' $'

    s)4*"($1 $s($ ! $ '$""! $'%*"!" 4$"% ! %0* '*( (1!s* %! %0* #1'*.

    A5!7* %0* s)4*"!" 5!"*" ! %0* s%*"')#, ' %0* s)4"$s%*"'$1 s4$(* ! B)"'s %0* %!

    $'%*"!" ;)8)1$" 7*'s $"* (!##!'16 )'%* 56 $ %"$'s7*"s* $'$s%!#!ss, %0* ;)8)1$" $"(. I %0*

    $'%*"!" ;)8)1$" 7*'s $"* $5s*'%, %0s %"$'s7*"s* 7*'!)s 7*ss*1 #$6 (!''*(% %0* %! *3%*"'$1 !"

    %0* %! '%*"'$1 ;)8)1$" 7*'s. I %0* $'%*"!" ;)8)1$" 7*'s $"* "*41$(* 56 $ #*$' 7*', %0*

    7*ss*1 7*s ' %0* '%*"$s($1 s4$(* '%! %! 5"$'(0*s %0$% %)"' 1$%*"$116 %! "*$(0 %0* '%*"'$1

    !" *3%*"'$1 ;)8)1$" 7*'

  • 8/12/2019 Blood Supply h & d With Ligation Good

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    VARIATIONS OF THE SUPERFICIAL CERVICAL VEINS:

    T0* 7$"$%!'s ! %0* s)4*"($1 7*'s ! %0* '*( $' %0*" "*1$%!'s %! %0* $($1 7*'s

    $"* ! s!#* #4!"%$'% "!# $ 4"$(%($1 4!'% ! 7*. T0*s* 7$"$%!'s $"* *341$'* 56 %0* $(%

    %0$% s)4*"($1 7*'s *7*1!4 "!# $ "$%0*" )'!"# s)5()%$'*!)s 7*'!)s '*% %0"!)80 $

    *''8 ! s!#* ! %s #*s0*s. M!"*!7*", s)4*"($1 $' **4 (*"7($1 7*'s $"*, $s

    *1s*0*"* ' %0* 5!6, (!''*(%* 56 s*7*"$1 $'$s%!#!%( 5"$'(0*s. T0* #!s% #4!"%$'% $'

    "*/)*'% 7$"$%!'s $"* %0* !11!'8:

    += T0* (!##!' $($1 7*' !*s '!% *3s%. T0* "*%"!#$'5)1$" 7*' (!'%')*s '%!

    %0* *3%*"'$1 ;)8)1$" 7*'2 %0* $($1 7*' !4*' '%! %0* '%*"'$1 ;)8)1$" 7*'.

    +> T0* "*%"!#$'5)1$" 7*' !4*'s '%! %0* '%*"'$1 ;)8)1$" 7*', %0* $($1 7*'

    (!'%')*s '%! %0* $'%*"!" ;)8)1$" 7*', $' $ (!##!' $($1 7*' $8$' s $5s*'%.

    +? T0* (!##!' $($ 7*' 1!s*s %s (!''*(%!' %0 %0* '%*"'$1 ;)8)1$" 7*' $'

    *#4%*s 's%*$ '%! %0* *3%*"'$1 ;)8)1$" 7*'.

    +@ T0* "*%"!#$'5)1$" 7*' (!'%')*s '%! %0* *3%*"'$1 ;)8)1$" 7*'2 %0* $($1 7*'

    (!'%')*s '%! %0* $'%*"!" ;)8)1$" 7*'.

    T0* s)4*"($1 7*'s ! %0* '*( $"* #!"* !%*' *"*'% %0$' s6##*%"($1 !' %0* "80%

    $' %0* 1*% s*s.

    SINUSES OF THE DURA MATER

    T0* 51!! ! %0* 5"$' $' %0* *6* s (!11*(%* 56 $ s6s%*# ! s4*($19* 7*'s ' %0*

    )"$ #$%*" ($11* s')s*s. T0*s* s')s*s $"* '!% (!11$4s51* $' %0*" 1)#*' s )'(0$'8*$51*

    5*($)s* %0*" $11s $"* !"#* 56 %0* *'s*, "8 $' '*1$s%( %ss)* ! %0* )"$#$%*". T0*6

    "$' *7*'%)$116 '%! %0* '%*"'$1 ;)8)1$" 7*', 5)% %0*"* $"* ')#*"!)s (!##)'($%!'s 5*%**'

    s')s*s $' %0* *3%"$ ("$'$1 7*'s. A s0!"% *s("4%!' ! %0*s* s')s*s s '*(*ss$"6 %!

    )'*"s%$' %0* (1'($1 #41($%!' ! %0*" (!##)'($%!'s %0 %0* 7*'s ! %0* $(* $' 0*$

    %0$% $"* 1!($%* !)%s* %0* ("$'$1 ($7%6.

    SUPERIOR SAGITTAL SINUS: T0s s')s (!##*'(*s ' %0* "*8!' ! %0* ("s%$8$11

    ! %0* *%0#! 5!'* $', 8"$)$116 8$''8 ' 7!1)#* ()"7*s 4!s%*"!"16 ' %0* #1'* !7*" %0*

    "!'%$1, 4$"*%$1, $' !((4%$1 5!'*s. O' %s $6 % "*(*7*s ')#*"!)s 7*'s "!# %0* (!'7*3%6

    ! %0* 5"$'.

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    INFERIOR SAGITTAL SINUS:

    A '$""! s')s, %0* '*"!" s$8%$1 s')s, s *'(1!s* ' %0* 1!*" "** 5!"*" ! $ s(1*

    s0$4* #*$' !1 ! %0* )"$, %0* $13 (*"*5", 0(0 s*4$"$%*s %0* %! 0*#s40*"*s ! %0*

    (*"*5")#.

    STRAIGHT SINUS:

    W0*"* %0* 1$3 $' %0* %*'%!")#, $ "!)8016 0!"9!'%$1 !1 ! %0* )"$ 5*%**'

    (*"*5")# $' (*"*5*11)#, #**%, %0* '*"!" s$8%%$1 s')s ;!'s %0 $ **4 7*' ! %0* 5"$' $'

    (!'%')*s 5$($" $' !'$" $s %0* s%"$80% s')s. T0* s%"$80% s')s )'%*s %0 %0*

    s)4*"!" s$8%$1 s')s. T0* s%"$80% s')s )'%*s %0 %0* s)4*"!" s$8%$1 s')s $% %0* ''*"

    !((4%$1 *#'*'(*.

    OCCIPITAL SINUS: T0s s#$11 7*' 5*8's !' *%0*" s* ! %0* 8"*$% !((4%$1

    !"$#*' $' $s(*'s ' %0* #1'*. I% *'s $% %0* ''*" !((4%$1 *#'*'(*.

    TRANSVERSE SINUSES:

    T0s 4!'% 0*"* %0* s)4*"!" s$8%%$1 s')s s%"$80% s')s $' !((4%$1 s')s )'%* s

    ($11* %0* (!'1)*'(* ! %0* s')s, $' !((4%$1 s')s )'%* s ($11* %0* (!'1)*'(* ! %0*

    s')s*s. F"!# 0*"* %0* 51!! s "$'* 56 %0* 4$"* %"$'s7*"s* s')s*s. A s6##*%"($1

    $""$'8*#*'% s 0!*7*" %0* *3(*4%!' "$%0*" %0$' %0* ")1*2 #!"* !%*' %0* 7s!' ! %0* 51!!

    s $s6##*%"($1. S!#*%#*s %0* s)4*"!" s$8%%$1 s')s $' %0* s%"$80% s')s ! '!% ;!' 5)%

    (!'%')* *$(0 '%! !'* %"$'s7*"s* s')s. E7*' %0* s')s*s ;!', $ 8"*$%*" $#!)'% ! 51!!

    )s)$116 *'%*"s %0* "80% %"$'s7*"s* s')s %0$' %0* 1*%. As $ (!'s*/)*'(* %0* "80% '%*"'$1 ;)8)1$"

    7*' s !%*' #)(0 1$"8*" %0$' %0* 1*%. I' $ s#$11 ')#5*" ! 4*"s!'s %0* 7s!' ! %0* 51!! s

    "*7*"s*, s! %0$% #!"* 51!! s "$'* %!$" %0* 1*% %0$' %!$" %0* "80% ;)8)1$" 7*'.

    T0* %"$'s7*"s* s')s ")'s $1#!s% 0!"9!'%$116 $("!ss %0* !((4%$1 5!'*, %0*

    '*"!4!s%*"!" (!"'*" ! %0* 4$"*%$1 5!'*, $' %0*' !7*" %0* %*#4!"$1 5!'* %! %0* 4!'% 0*"*

    %0* s)4*"!" ("*s% ! %0* %*#4!"$1 46"$# (!##*'(*. F"!# %0s 4!'% %0* %"$'s7*"s* s')s

    (!'%')*s ' $' S s0$4* ()"7* $s %0* s8#! s')s2 %0* (!'7*3%6 ! %0* )44*" ()"7*

    4!s%*"!"16 *s(*''8 %!$" %0* ("$'$1 5$s*, %0* s8#! s')s (!'%')*s %0"!)80 %0* ;)8)1$"

    !"$#*' '%! %0* '%*"'$1 ;)8)1$" 7*'.

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    CAVERNOUS AND INTERCAVERNOUS SINUSES:

    I' %0* $'%*"!" 4$"% ! %0* ("$'$1 5$s* 1*s $ s*(!' s6s%*# ! 7*'!)s s')s*s, %0* (*'%*"

    ! 0(0 s %0* 4$"* ($7*"'!)s s')s. T0s '$#* $s (0!s*' 5*($)s* %0* ($7*"'!)s s')s s '!%

    $ )'!"#, *-!4*' s4$(* 5)% s s)57* 56 %0' s%"$'s $' %"$5*()1$%* ! (!''*(%7*

    %ss)* '%! $ s6s%*# ! (!##)'($%'8 s#$11*" s4$(*s. W0(0 ("*$%* $ s#1$"%6 %0 $'

    *""*(%7* ($7*"'!)s 5!6. T0* ($7*"'!)s s')s s s%)$%* !' %0* 1$%*"$1 s1!4* ! %0* 5!6 ! %0*

    s40*'! 5!'*, !' *%0*" s* ! %0* s*11$ %)"(($, 0(0 0!)s*s %0* 4%)%$"6 81$'. I' "!'% !

    %0* 81$' $' ' 5$( ! %, "80% $' 1*% ($7*"'!)s s')s*s (!##)'($%* %0 *$(0 !%0*"

    %0"!)80 %0* $'%*"!" $' 4!s%*"!" '%*"($7*"'!)s s')s*s.

    T0* 7*'!)s (0$''*1s "$''8 '%! %0* ($7*"'!)s s')s $'%*"!"16 $"* %! !' *%0*" s*.

    A1!'8 %0* 4!s%*"!" *8* ! %0* 1*ss*" '8 ! %0* s40*'! 5!'* ")'s %0* s40*'!4$"*%$1 s')s

    '%! %0* $'%*"!1$%*"$1 (!"'*" ! %0* ($7*"'!)s s')s. A% %s 5*8'''8 %0* s40*'!4$"*%$1 s')s

    (!##)'($%*s %0 $ 5"$'(0 ! %0* #1* #*''8*$1 7*'.

    T0* #!s% #4!"%$'% %"5)%!"6 ! %0* ($7*"'!)s s')s s %0* !40%0$1$#( 7*'. I%

    !"8'$%*s "!# %0* )'!' ! $ 1$"8*" s)4*"!" $' $ s#$11*" '*"!" !40%0$1#( 7*', 0(0 "$'

    %0* *6*5$11 $' %s $)311$"6 !"8$'s. T0* !40%0$1#( 7*' "*$(0*s %0* ($7*"'!)s s')s %0"!)80

    %0* s)4*"!" !"5%$1 ss)"*. S!#*%#*s s)4*"!" $' '*"!" !40%0$1#( 7*'s !4*' s*4$"$%*16

    '%! %0* ($7*"'!)s s')s.

    SUPERIOR AND INFERIOR PETROSAL SINUSES: T0* 51!! %0$% 0$s 5**'

    (!11*(%* ' %0* ($7*"'!)s s')s s "$'* 4!s%*"!"16 56 %! *'!)s s')s*s !' *%0*" s*, %0*

    s)4*"! $' %0* '*"!" 4*%"!s$1 s')s*s. T0* s)4*"!" 4*%"!s$1 s')s !"8'$%*s "!# %0*

    4!s%*"!s)4*"!" (!"'*" ! %0* ($7*"'!)s s')s, 0*"* %0* 1$%%*" 5*'s %! (!'%')* '%! %0*

    s8#! s')s. N*$" %0* $4*3 ! %0* 46"$#, %0* s')s 5"8*s %0* %"8*#'$1 '!%(0.

    T0* '*"!" 4*%"!s$1 s')s s s0!"%*" 5)% *" %0$' %0* s)4*"!". I% $"s*s "!# %0*

    '*"!4!s%*"!" (!"'*" ! %0* ($7*"'!)s s')s $' !11!s %0* 4*%"!-!((4%$1 ss)* 5$($" %!

    %0* $'%*"!" 5!"*" ! %0* ;)8)1$" !"*#$'. I% 4$ss*s %0"!)80 %0* #!s% $'%*"!" 4!"%!' ! %0s

    !"$#*' !" %0"!)80 %0* 4*%"!-!((4%$1 ss)"* ' "!'% ! %0* ;)8)1$" !"$#*', ("!ss*s %0*

    81!ss!40$"6'8*$1, 7$8)s $' $((*ss!"6 '*"7*s $' *#4%*s '%! %0* s)4*"!" 5)15 ! %0* '%*"'$1

    ;)8)1$" 7*'.

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    T0"!)80 %0* ($7*"'!)s s')s ")'s %0* '%*"'$1 ($"!% $"%*"6, s)""!)'* 56 %0* ($"!%

    41*3)s ! s6#4$%0*%( '*"7*s. L$%*"$1 %! %0* S-()"7* $"%*"6. T0* $5)(*'% '*"7* %"$7*"s*s %0*

    s')s ' $' $1#!s% s$8%%$1 "*(%!'. D)"'8 %0*" 4$ss$8* %0"!)80 %0* s')s, %0* '%*"'$1 ($"!%

    $"%*"6 %0* s6#4$%0*%( 41*3)s, $' %0* $5)(*'% '*"7* $"* (!7*"* 56 *'!%0*1)#.

    O(()1!#!%!", %"!(01*$", $' !4%0$1#( '*"7*s $"* s%)$%* ' %0* "!! $' %0* 1$%*"$1 $11 ! %0*

    s')s $' 0$7* %0*"*!"* 1*ss '%#$%* "*1$%!'s %! %0* s')s.

    T0* '%*"'$1 ($"!% $"%*"6 *'%*"s %0* s')s %0"!)80 %s 4!s%*"!'*"!" $11 $' 1*$7*s

    %0"!)80 %0* $'%*"!" 4$"% ! %s "!!. T0* $5)(*'% '*"7* *'%*"s %0* #!s% $'%*"!" 4$"% ! %0*

    '*"!" 4*%"!s$1 s')s !' %0* (17)s $' %0*' ")'s '%! %0* ($7*"'!)s s')s. I% 1*$7*s %0*

    ($7*"'!)s s')s %0"!)80 %s $'%*"!" $11, 0(0 5!"*"s %0* s)4*"!" !"5%$1 ss)"*, 0*"* %0*

    $5)(*'% '*"7* (!'7*"8*s %0 %0* !(()1!#!%!" %"!(01*$" $' !40%0$1#( '*"7*s.

    BASILAR PLE,US : A 1!!s* '*%!" ! 7*'s %0* 5$s1$" 41*3)s *3%*'s !' %0*

    (17)s "!# %0* ($7*"'!)s s')s %! %0* $'%*"!" 5!"*" ! %0* !"$#*' #$8')# $' "$'s 0*"*

    '%! %0* 7*'s ! %0* 7*"%*5"$1 ($'$1.

    COMMUNICATIONS BETWEEN INTRACRANIAL AND E,TRACRANIAL

    VEINS

    T0* (!''*(%!'s 5*%**' %0* s')s*s $' %0* 7*'s !)%s* %0* ("$'$1 ($7%6 $"*

    #4!"%$'% !)%1*%s !" %0* 51!! ! %0* 5"$' 5)% $"* $1s! 4!%*'%$1 4$ss$8*s !" '*(%!'s '%! %0*

    ("$')#. T0*6 $"* #$'16 ! !)" %64*s.

    S0!"% 5)% s!#*%#*s * 7*'s !"# $ "*(% (!##)'($%!' 5*%**' $ s')s $' $ 7*'

    !' %0* !)%s* ! %0* 5"$' ($4s)1*. T0*s* (!#)'($%'8 7*'s $"* %*"#s *#ss$"6 7*'s !"

    *#ss$"*s.

    C"$'$1 '*"7*s $' %0* '%*"'$1 ($"!% $"%*"6 $"* s)""!)'* 56 7*'!)s 41*3)s*s 0*"*

    %0*6 1*$7* !" *'%*" %0* s)11. T0*s* 7*'s $"* $ s*(!' 5)% 1*ss #4!"%$'% (!''*(%!' 5*%**'

    '%"$("$'$1 $' *3%"$("$'$1 7*'s.

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    T0* !)"%0 $' 1$s% '"*(% 5)% 08016 #4!"%$'% (!''*(%!' s #*$%* 56 %0*

    !4%0$1$#( 7*'s, 0(0 "$' '%! %0* ($7*"'!)s s')s 5)% $'$s%!#!s* %0 7*'s ! %0* $(*.

    Veno$s em"ssr"es :

    T0* *#ss$"*s $"* (0$"$(%*"9* 56 %0' $11s %0$% $"* %80%16 $%%$(0* %! %0*

    s)""!)''8 5!'* !" 5"!($"%1$8* $' $"* %0*"*!"* '!% (!11$4s51*. T0* 4$"*%$1 *#ss$"6

    4*"!"$%*s %0* 4$"*%$1 5!'* $' 4!s%*"!" %0"s ! %0* s$8%%$1 s)%)"*. I% (!''*(%s %0* s)4*"!"

    s$8%%$1 s')s %0 $ 5"$'(0 ! %0* s)4*"($1 %*#4!"$1 7*'. T0* 4$"*%$1 *#ss$"6 "*/)*'%16 s

    #ss'8 !' !'* !" 5!%0 s*s.

    T0* #$s%! *#ss$"6 s !)' ' %0* s)%)"* 5*%**' %0* !((4%$1 5!'* $' %0* #$s%!

    41$%* ! %0* %*#4!"$1 5!'* !" ' %0* #$s%! 41$%* (1!s* %! %0* s)%)"*. I% s $ (!''*(%!' 5*%**'

    %0* s8#! s')s $' $ 5"$'(0 ! %0* !((4%$1 7*'s.

    T0* (!'61$" *#ss$"6 4*"!"$%*s %0* 1$%*"$1 4$"% ! %0* !((4%$1 5!'* ' $' $1#!s%

    0!"9!'%$1 (!)"s* "!# %0* 4!s%*"!"4$"% ! %0* ;)8)1$" '!%(0 %! %0* (!'61$" !"$#*' 5*0' %0*

    !((4%$1 (!'61* $' (!''*(%*s %0* %*"#'$1 4$"% ! %0* s8#! s')s %0 !'* ! %0* **4

    !((4%$1 !" (*"7($1 7*'s.

    T0* '(!'s%$'% !((4%$1 *#ss$"6 s )'4$"*. I% 4*"!"$%*s %0* !((4%$1 5!'* (1!s* %!

    %0* '%*"'$1 !((4%$1 4"!%)5*"$'(* $' !"#s $ (!##)'($%!' 5*%**' %0* (!'1)*'(* ! %0*

    s')s*s $' $' !((4%$1 7*'.

    I' "!'% ! $' #*$1 %! %0* !"$#*' !7$1*, %0* 8"*$%*" '8 ! %0* s40*'! 5!'* s

    4*"!"$%* +!"$#*' ! 7*s$1)s 56 %0* '(!'s%$'% s40*'! *#ss$"6, 1''8 %0* ($7*"'!)s

    s')s $' %0* 4%*"68! 7*'!)s 41*3)s. I' !%0*" 's%$'(*s %0* s40*'! *#ss$"6 4*"!"$%*s %0*

    5"!($"%1$8* ! %0* !"$#*' 1$(*")#.

    I' %0* (01 !'16, %0* $'%*"!" *' ! %0* s)4*"!" s$8%%$1 s')s (!##)'($%*s %0 %0*

    '$s$1 7*'s %0"!)80 %0* !"$#*' (*()#. T0* (!##)'($%'8 *#ss$"6 s '!' $s

    )(*"1$'s 7*'.

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    VENOUS PLE,USES:

    I' (!'%"$s% %! %0* *#ss$"*s, %0* 7*'s %0$% (!''*(% %0* s')s*s $' %0* *3%"$("$'$1 7*'s

    $1!'8 %0* '%*"'$1 ($"!% $"%*"6 $' ,#$'6 ! %0* ("$'$1 '*"7*s $"* 1!!s*16 (!''*(%* %0 %0*

    s)""!)''8 %ss)*s $' $"* %0*"*!"* (!11$4s51*. T0s s *s4*($116 !57!)s ' %0* ($"!% 41*3)s

    ! 7*'s, 0(0 s ' $(%, $ (!#4"*ss51* ()s0!''8, $11!'8 !" %0* (0$'8*s ' 7!1)#* ! %0*

    $"%*"6 )"'8 %s 4)1s$%!'. D)"'8 s6s%!1* %0* *34$''8 $"%*"6 *#4%*s %0* 7*'s ! %0*

    $((!#4$'6'8 41*3)s2 )"'8 $s%!1*, 0*' %0* $"%*"6 '$""!s, 51!! $8$' 11s $"*

    s)""!)''8 7*'s.

    T0* '%*"'$1 ($"!% 41*3)s ! 7*'s. A'!%0*" #!"* #4!"%$'% 41*3)s ! 7*'s

    $((!#4$'*s %0* 064!81!ss$1 '*"7* %0"!)80 %0* 064!81!ss$1 ($'$1.

    DIPLOIC VEINS:

    T0* 41!( 7*'s $"* * 7$17*1*ss, $' '!'(!11$4s51* 7*'s ' %0* 1$% 5!'*s ! %0*

    ("$'$1 "!!. T0* 41!( 7*'s $"* 7$"$51*. T0*6 $"* s%)$%* ' %0* 41!*, %0* s4!'86 1$6*" !

    %0* ("$'$1 5!'*s $' "$' 4$"%16 '%! $ '*805!"'8 s')s, 4$"%16 %! %0* !)%s* '%! $' $;$(*'%

    7*'. T0)s %0*6 4"!7* $' '"*(% (!##)'($%!' ! %0* '%"$("$'$1 $' *3%"$("$'$1 7*'s.

    T0* "!'%$1 41!( 7*' *s(*'s ' %0* s/)$#$ ! %0* "!'%$1 5!'* (1!s* %! %0* #1'*

    $' "$'s '%! %0* s)4*"!" s$8%%$1 s')s$' !'* ! %0* "!'%$1 7*'s.

    I' %0* %*#4!"$1 "*8!' $' $'%*"!" $' $ 4!s%*"!" %*#4!"$1 41!( 7*' $"* !)'. T0*

    $'%*"!" %*#4!"$1 41!( 7*' s (!'%$'* ' %0* 4!s%*"!" 4$"% ! %0* "!'%$1 s/)$#$ $'

    *#4%*s '%! %0* s40*'!4$"*%$1 s')s $' %0* #1* %*#4!"$1 7*'. A 4!s%*"!" %*#4!"$1

    41!( 7*' ' %0* 4!s%*"!" 4$"% ! %0* 4$"*%$1 5!'* s*'s %s 51!! %! %0* s8#! s')s $' %!

    $' !((4%$1 7*'.

    A' !((4%$1 41!( 7*' s%)$%* ' %0* !((4%$1 s/)$#$ (!''*(%s %0 %0* %"$'s7*"s*

    s')s $' $ 5"$'(0 ! %0* !((4%$1 7*'.

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    COMMUNICATIONS OF THE OPHTHALAMIC VEINS:

    T0* (!##)'($%!'s ! %0* !40%0$1$#( 7*'s %0 %0* $($1 $' "*%"!#$'5)1$" 7*'s

    $"* ! s4*($1 #4!"%$'(* ' %0* 4$%0!1!86 ! $($1 '*(%!'s. A (!##)'($%!' s *s%$51s0*

    7$ !40%0$1#( 7*'s 5*%**' %0* s6s%*# ! %0* $($1 7*'s $' %0* ($7*"'!)s s')s, '%! 0(0

    %0* !40%0$1#( 7*'s "$'. T0* s)4*"!" !40%0$1#( 7*' s, $% %0* ''*" (!"'*" ! %0* *6*, '

    (!'s%$'% $' * (!##)'($%!' %0 %0* $'8)1$" 7*', 0(0 (!'%')*s '%! %0* $($1 7*'.

    T0* '*"!" !40%0$1#( 7*' 0$s '(!'s%$'% $'$s%!#!s*s %0 %0* '"$!"5%$1 7*'s !" %0*

    '*"!" 4$14*5"$1 7*'s $% %0* 1!*" 5!"*" ! %0* !"5%$1 *'%"$'(* $' %0)s 0$s '"*(%

    (!''*(%!'s %0 %0* $($1 7*'s.

    O */)$1 #4!"%$'(* s $' $'$s%!#!ss 5*%**' %0* 7*'s ! %0* !"5% $' %0*

    "*%"!#$'5)1$" 7*' %0$% (!''*(%s %0* 4!s%*"!" *' ! %0* '*"!" !40%0$1#( 7*' %0 %0*

    4%*"68! 41*3)s ! 7*'s, "!# 0(0 %0* "*%"!#$'5)1$" 7*' "*(*7*s #!s% ! %s 51!!. T0*

    $'$s%!#!s'8 5"$'(0 4$ss*s %0"!)80 %0* '*"!" !"5%$1 ss)"* $' 1's %0* s6s%*# ! %0*

    "*%"!#$'5)1$" 7*' %0 %0* ($7*"'!)s s')s 5*0' %0* !"5%.

    ARTERIAL HAEMORRHAGES AND LIGATION OF ARTERIES

    INTRODUCTION.

    S*7*"$1 $"%*"$1 0*#!""0$8*s )"'8 #$;!" !4*"$%!'s ($' 5* 4"*7*'%* 56 $

    4"*4$"$%!"6 18$%!' ! %0* "*s4*(%7* $"%*"6.%0* ')#*"!)s $'$s%!#!s*s! $11 $($1 $"%*"*s %0

    !'* $'!%0*" $' %0 %0* (!'%"$ 1$%*"$1 $"%*"*s #$* 51$%*"$1 18$%!'s '*(*ss$"6.0$*#!""0$8*s

    ! s!#*%#*s !(()" )"'8 %0* 1$'('8 ! $5(*ss*s '!% *'!)80 (!'s*"$%!' s 87*' %! %0*

    %!4!8"$40( "*1$%!' ! %0* '(s!' %! '*805!)"'8 51!! 7*ss*1s. A((*'%s, %!!, )"'8 "!)%'*

    !4*"$%!'s !' %0* %**%0 !" ';)"*s s)s%$'* 56 *3%*"'$1 !"(* #$6 #$* %0* 18$%!' ! $'

    $"%*"6 '*(*ss$"6. T0*"*!"* !'* 0$s %! (!'s*", "s%, %0* $"*$s ' 0(0 $' $((*'%$1 s*7*"'8 !

    $' $"%*"6 s 4!ss51* $' %0* #*$'s %! $7! s)(0 $' !(()"$'(*, $', s*(!', %0* $'$%!#( 5$ss

    !" 18$%'8 %0* $*"$'% $"%*"*s ! %0* $($1 "*8!'.

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    ARTERIES ENDANGERED DURING MINOR SURGICAL PROCEDURES OR

    DURING DENTAL TREATMENT

    T0"** $"%*"*s $"* *'$'8*"* )"'8 #'!" s)"8($1 4"!(*)"*s !" ' $((*'%s !(()"'8

    )"'8 %"*$%#*'%2 %0* $'%*"!" 4$1$%'* $"%*"6, %0* s)51'8)$1 $"%*"6, $' %0* $($1 $"%*"6.

    ANTERIOR PALATINE ARTERY :

    T0* $'%*"!" 4$1$%'* $"%*"6 *'%*"s %0* !"$1 ($7%6 %0"!)80 %0* #$;!" 4$1$%'* !"$#*'

    0(0 s s%)$%* 1'8)$1 %! %0* 1$s% #!1$" ! %0* )44*" ;$ $' $% %0* 5!"*" 5*%**' %0* ''*"

    41$%* ! %0* $17*!1$" s*'s %s 5"$'(0*s #*$116 $' 1$%*"$116. T0* '(s!' ! $ 4$1$%'* $5s(*ss,

    $"s'8 !" 's%$'(* "!# %0* 1'8)$1 "!!% ! %0* "s% #!1$", #)s% '*7*" 5* #$* ' $ %"$'s7*"s*

    "*(%!' 5)% ' $' $'%*"!4!s%*"!" 1'*. T0* '(s!' ! $ 41$%'* $5s(*ss, $"s'8 !" 's%$'(*

    "!# %0* 1'8)$1 "!!% ! %0* "s% #!1$", #)s% '*7*" 5* #$* ' $ %"$'s7*"s* "*(%!' 5)% ' $'

    $'%*"!4!s%*"!" 1'*. T0* '(s!' s0!)1 $1s! 5* #$* $s '*$" %! %0* "** #$"8' ! %0* 8'87$

    $s 4!4s51* %0!)% #ss'8 %0* $5s(*ss. F)"%0*" #!"*, %0* *8* ! %0* '* s0!)1 5* "*(%*

    !)%$" $' )4$" $' '!% s%"$80% )4$". I %0*s* ")1*s $"* *4% ' #', $' $((*'%$1

    ';)"6 %! %0* $'%*"!" 4$1$%'* $"%*"6 11 5* $7!*. I %0* $"%*"6 s ()%, % s $1#!s% #4!ss51*

    %! s%!4 %0* 0*#!""0$8* 56 1!($1 (1$#4'8 ! %0* $"%*"6 !" 56 %$#4!'$*, $' s!#*%#*s

    "*(!)"s* 0$s %! 5* %$*' %! 18$%!' ! %0* *3%*"'$1 ($"%! $"%*"6.

    SUBLINGUAL ARTERY.

    I';)"6 %! %0* s)51'8)$1 $"%*"6 0$s 5**' !5s*"7* 0*' s0$"4 's%")#*'%s

    !" "!%$%'8 ss s14 ! $ 1!*" %!!%0 $' ';)"* %0* 1!!" ! %0* #!)%0. I %0s ';)"6 s ' %0*

    "*8!' ! %0* 4"*#!1$"s !" %0* "s% #!1$", %0* s)51'8)$1 $"%*"6 #$6 5* s*7*"* 0*"* % s !

    (!'s*"$51* 7!1)#*.%0* 0$*#!""0$8* "!# %0s $"%*"6 #$6 %0*' 5* $ s*"!)s '(*'%. L!($1

    (1$#4'8 ! $' $"%*"6 ($' 5* $%%*#4%*, $1%0!)80 % s "$%0*" ()1%. I $%%*#4%s %! s%!4 %0*

    51**'8 $% %0* 41$(* ! ';)"6 $1, %0* 1'8)$1 $"%*"6 #$6 5* 18$%*.#*'%!' #)s% 5* #$*,

    0!*7*", ! $ 7$"$%!' ' %0* 51!! s)4416 ! %0* s)51'8)$1 "*8!' 5*($)s* %0s 7$"$%!' #$6

    ")s%"$%* $' $%%*#4% %! s%!4 51**'8 ! %0* s)51'8)$1 "*8!' 56 18$%'8 %0* 1'8)$1 $"%*"6. T0*

    s)51'8)$1 $"%*"6 s s!#*%#*s $ s#$11 $' 's8'($'% 5"$'(0 !%0* 1'8)$1 $"%*"6$' #$6 *7*'

    5* #ss'8 $1%!8*%0*".I% s %0*' "*41$(* 56 5"$'(0*s ! %0* s)5#*'%$1 $"%*"6, $ 5"$'(0 ! %0*

    $($1 $"%*"6.

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    T0* s)51'8)$1 $"%*"6 s s%)$%* #*$1 $' s180%16 '*"!" %! %0* s)5#$'5)1$"

    )(% $' 1'8)$1 '*"7* $' s*'s %s 5"$'(0*s %! %0* s)51'8)$1 81$' $' %0*

    #61!06!,8*'!06!, $' 8*'!81!ss)s #)s(1*.' %s (!)"s* %0* $"%*"6 s $"16 (1!s* %! %0*

    ''*" $' )44*" s)"$(* ! %0* #61!06! #)s(1*. O' %0* !)%*" $' ''*" s)"$(* ! %0*

    #61!06! #)s(1* ")'s %0* s)5#*'%$1 $"%*"6, 0(0 $"s*s "!# %0* $($1 $"%*"6 0*"* %0* 1$%%*"

    4$ss*s !7*" %0* s)5#$'5)1$" 81$'.%0* s)5#*'%$1 $"%*"6 s)441*s #$'16 %0* #61!06!

    #)s(1*s, %0* $'%*"!" 5*116 ! %0* 8$s%"( #)s(1*, $' %0* 16#40 '!*s ! %0* s)5#$'5)1$"

    "*8!'. T0* s)51'8)$1 $' %0* s)5#*'%$1 $"%*"*s, $1#!s% 4$"$11*1 ' %0*" (!)"s*,$"* '!"#$116

    1'* 56 %0*" 5"$'(0*s %! %0* #61!06! #)s(1*. T0* $'$s%!#!s*s ! %0*s* #)s()1$" 5"$'(0*s

    $"* %0* 5$ss !" %0* "*41$(*#*'% ! !'* ! %0*s* $"%*"*s 56 $ 5"$'(0 ! %0* !%0*", 0(0

    4*"!"$%*s %0* #61!06! #)s(1*.T0)s %0* s)5#*'%$1 $"%*"6 #$6 5* "*41$(* 56 $ 5"$'(0 ! %0*

    s)51'8)$1 $"%*"6, ;)s% $s %0* s)51'8)$1 $"%*"6 #$6 5* "*41$(* 56 $ 5"$'(0 ! %0* s)5#*'%$1

    $"%*"6.

    FACIAL ARTERY

    W0*"* %0* $($1 $"%*"6 ("!ss*s %0* 1*7*1 ! %0* '*"!" 7*s%5)1$" !"'3 '

    %0* "*8!' ! %0* "s% #$'5)1$" #!1$",%0* $"%*"6 ($' 5* s*7*"* $((*'%$116 )"'8 !4*"$%7*

    4"!(*)"*s !' %0* 1!*" 4"*#!1$"s !" #!1$"s $' 's%")#*'% *'%*"s %0* (0** ' %0s "*8!'.%

    0$s 5**' "*4!"%* %0$% %0* $($1 $"%*"6 $s s*7*"* )"'8 $%%*#4%s %! !4*' $ 5)(($1 $5s(*ss !

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    %0* 7*s%5)1* )"'8 %0* *7*1!4#*'% ! $' $5s(*ss s *4% ' #', %0* ")1* !11!*s %0$% %0*

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    '* s0!)1 '!% 5* $11!* %! 4*'*%"$%* %0* 1$%*"$1 !" %0*'*"!" $11 ! %0* $5s(*ss.

    L"!"on o' !(e ')" r!er% :

    T0* $($1 $"%*"6 ($' 5* *$s16 *34!s* $% %0* 4!'% 0*"* % ("!ss*s %0* 1!*" 5!"*"

    ! %0* #$'51* %! 4$ss "!# %0* s)5#$'5)1$" "*8!' '%! %0* $(*.T0s 4!'% s s%)$%*$'%*"!" %! %0* $%%$(0#*'% ! %0* #$ss*%*" #)s(1* %! %0* #$'51*. H*"*, %0* 4)1s* ! %0* $"%*"6

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    ($' 5* *1%, *s4*($116 %0* (!'%"$(%* #$ss*%*" #)s(1* s )s* $s $ 1$'#$".%0* $"%*"6 s

    $((!#4$'* 56 %0* $($1 7*', 0(0 1*s 4!s%*"!" %! %0* $"%*"6. T0* $"%*"6 $' %0* 7*' $"*

    ("!ss* s)4*"($116 56 %0* #$"8'$1 #$'5)1$" 5"$'(0 ! %0* $($1 '*"7*. T0s "$%0*" s#$11

    '*"7* ")'s $44"!3#$%*16 4$"$11*1 %! %0* 1!*" 5!"*" ! %0* #$'51*, s!#*%#*s s180%16 $5!7*

    %0s 5!"*",s!#*%#*s s180%16 5*1!.T0* '*"7* $' 7*ss*1s $"* (!7*"* 56 %0* 41$%6s#$

    #)s(1*,%0* s)5()%$'*!)s %ss)*, $' %0* s'.

    S'(* %0* #$'5)1$" 5"$'(0 ! %0* $($1 '*"7* s)441*s %0* #)s(1*s

    ! %0* 1!*" 14, % s '*(*ss$"6 %! 41$' %0* !4*"$%!' ' s)(0 $ $6 %0$% %0s '*"7* s '!% '

    $'8*" ! 5*'8 ()%. T! $(0*7* %0s *', %0* '(s!' s #$* $% 1*$s% 0$1 '(0 5*1! %0* 5!"*"

    !%0* #$'51* $' 4$"$11*1 %! %. T0* s', 41$%6s#$ #)s(1* ,$' **4 $s($ $"* ()%,$' %0*' %0*

    s!% %ss)*s $"* 51)'%16 "*%"$(%* )4$" )'%1 %0* 4$14$%'8 '8*" ($' **1 %0* 4)1s* ! %0* $"%*"6.

    T0* $"%*"6 %0*' ($' 5* s!1$%*,%*, $' ()%.

    LIGATION OF THE LINGUAL ARTERY:

    T0* *34!s)"* ! %0* 1'8)$1 $"%*"6 s !'* ' %0* s)5#$'5)1$" +8$s%"( %"$'81*. T0s

    "*8!' ! %0* '*( s 5!)'* 56%0* 1!*" 5!"*" ! %0* #$'51* $' %0* %! 5*11*s ! %0*

    8$s%"(s #)s(1*. %0* 4!s%*"!" (!"'*" ! %0s %"$'81* 5*0' %0* $'81* ! %0* #$'51* s '

    !4*' (!##)'($%!' %0 %0* "*%"!#$'5)1$" !ss$.

    S)"8($116,%0* 4"!(*)"* !" *34!s'8 %0* 1'8)$1 $"%*"6 s $s !11!s. T0*

    s)5#$'5)1$" 81$' s 4$14$%* %0"!)80 %0* s',$' $' '(s!' s #$* %0$% ("(1*s %0* 1!*"

    4!1* ! %0s 81$'.%0* 4!s%*"!" 4$"% ! %0* '(s!' s0!)1 4!'% %!$" %0* %4 ! %0* #$s%!

    4"!(*ss2%0* $'%*"!" 4$"% ! %0* '(s!' s0!)1 4!'% %!$" %0* (0'. %0* s', 41$%6s#$, $'

    **4 $s($ $"* '(s*.%0* 1!*" 4!1* ! %0* s)5#$'5)1$" 81$' s *34!s*. I %0* 81$' s

    1%* "!# %s 5* 56 51)'% ss*(%!' $' %0* *'%"* 1$4 s "*%"$(%* )4$", %0* %*'!' ! %0*

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  • 8/12/2019 Blood Supply h & d With Ligation Good

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    .

    LIGATION OF THE E,TERNAL CAROTID ARTERY

    I';)"*s %! %0* )44*" 4$"% ! %0* '*( !" ! %0* s)4*"($1 $' **4 s%")(%)"*s ! %0* $(*

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    0(0 %0* *3%*"'$1 ($"!% $"%*"6 ($' 5* *34!s* $' %*.!'* #*%0! *34!s*s %0* $"%*"6 $% %s

    !"8' "!# %0* (!##!' ($"!% $"%*"6,%0* 18$%)"* 5*'8 41$(* $5!7* %0* !"8' ! %0* s)4*"!"

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    %0* *3(*4%!' ! %0* s)4*"!" %06"!-%0* 1'8)$1,$($1,$' #$311$"6 $"%*"*s $' %0*

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    %0* s)11.

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    s%$'(* "!# %0* 4!s%*"!" $' '*"!" 5!"*"s ! %0* #$'51*. A%*" %0* s($14*1 0$s 4$ss*

    %0"!)80 %0* s' $' s!#* ! %0* 4!s%*"!" 5*"s ! %0* 41$%6s#$ #)s(1*, %0* "*%"!#$'5)1$"

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    4$"!% 81$', s "*%"$(%* $'%*"!"16 $' )4$". I##*$%*16 )'*"'*$%0 %0* 4$"!% 81$', %0*

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    s%61!06! #)s(1* 5*(!#* 7s51*. A5!7* ! %0* s%61!#$'5)1$" 18$#*'% ($' 5* 4$14$%*,

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    1$"8*" 7*'.

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    !(()"'8 )"'8 %0* s)"8*"6.

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    BLOOD SUPPLY OF MAXILLO-FACIAL REGION:

    REFRENCES:

    = L$s%s $'$%!#6 "*8!'$1 $' $441*R M H M(MINN %0*%!'

    > GRAYS ANATOM- s*(!' *%!'.

    ? LEE M( GREGORS SYNOPSIS OF SURGICAL ANATOMY =>%0

    *%!'

    @ C$1!)" $%1$s $' %*3% 5!! ! !"$1 $'$%!#6 0s%!1!86 $' *#5"6!1!86.

    s*(!' *%!'

    RICHARD S SNELL (1'($1 $'$%!#6 !" #*($1 s%)*'%s@%0*%!'

    SICHEER $' D) BRULS !"$1 $'$%!#6. %0 *%!'.

    B D CHACRASIAS 0)#$' $'$%!#6 7!1 ? s*(!' *%!'.

    CUNNINGHAMS #$')$1 ! 4"$(%($1 $'$%!#6 7!1.? %0 *%!'.

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