Surgical Anatomy of the Neck
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
The anterior cervical skin is supplied by branches of the superior thyroid artery and the transverse cervical artery. The posterior cervical skin is supplied by branches of the occipital artery and the deep cervical branches from the costocervical trunk. The superior neck skin derives its blood supply from the occipital artery through its branch to the sternocleidomastoid, the superior fibres of which insert into the upper neck skin. The submental and submandibular branches of the facial artery supply the anterior upper neck. The transverse cervical and suprascapular branches of the subclavian artery via the thyrocervical trunk supply the skin of the inferior neck. The venous drainage follows the arterial supply, ultimately draining into the internal and external jugular veins.
Thyroid Microcirculation
John H. Barker, Gary L. Anderson, Michael D. Menger in Clinically Applied Microcirculation Research, 2019
Each thyroid lobe is supplied by arterial blood from two primary sources.1,2 A superior thyroid artery, arising principally from the external carotid artery, supplies blood to the rostral area of the thyroid lobe. An inferior thyroid artery, deriving most often from the thyrocervical trunk, supplies blood to the caudal areas of the thyroid lobe. In addition to these bilateral arterial inputs to the thyroid, a thyroid ima artery may be located anterior to the trachea and, when present, provides blood to the inferior portion of the gland. This accessory artery appears to arise most often from the brachiocephalic artery, the right common carotid artery, or the aortic arch. Significant anastomoses among the arterial inputs to the thyroid gland occur, with the superior thyroid artery uniting with the contralateral artery in the isthmus area and with the inferior thyroid artery on the posterior and anterior surface of the thyroid gland. Anastomoses between thyroid arteries and the tracheal arterial supply (e.g., inferior laryngeal artery and tracheoesophageal artery) also exist.
Surgery for well-differentiated thyroid cancer
Demetrius Pertsemlidis, William B. Inabnet III, Michel Gagner in Endocrine Surgery, 2017
Primary arterial flow to the thyroid is via paired superior and inferior thyroid arteries. On the right and left, the superior thyroid artery descends as the first branch of the external carotid artery to the superior pole of each thyroid lobe, following the path of the external branch of the superior laryngeal nerve (SLN). The posterior branches of the superior thyroid artery may supply the superior parathyroid glands (15%) and are therefore important to preserve. The inferior thyroid arteries come off of the thyrocervical trunk to supply the lower thyroid poles and the inferior parathyroid glands, as well as the superior parathyroid glands in 85% of patients. The thyroid gland is also supplied uncommonly (3%) by a midline thyroidea ima artery that arises from the aortic arch or innominate artery. Anatomic variation of the three paired major thyroid veins is common. The superior and middle veins drain into the internal jugular veins, and the inferior veins into the innominate vein. The vasculature of the thyroid gland can be hypertrophied in disease states such as hyperthyroidism or goiter.
Dynamic observation on collateral circulation construction of patient with vertebral artery restenosis after stenting: case report
Published in International Journal of Neuroscience, 2021
Yan-Wei Yin, Qian-Qian Sun, Da-Wei Chen, Fa-Guo Zhao, Jin Shi
Six months later, the patient suffered from the loss of consciousness again. Repeat DSA confirmed restenosis of at least 70% of the left vertebral artery (Figure 2a). Fortunately, a collateral flow appeared to be constructed from the V2 segment of the left vertebral artery and fed by external carotid collateral branches (occipital artery) (Figure 2b). Although there was no other collateral flow supplying flow to the left vertebral artery besides this, we had a good view of the left thyrocervical trunk (Figure 2c). Whether it played the role of another potential collateral flow was unknown. Due to the precarious nature of the current collateral flow, aggressive medical management still continue in an effort to slow down the unstable stenosis and allow for development of more favorable conditions in which collateral circulation could further occur.
Spinal cord involvement in COVID-19: A review
Published in The Journal of Spinal Cord Medicine, 2023
Ravindra Kumar Garg, Vimal Kumar Paliwal, Ankit Gupta
The spinal cord predominantly receives blood from three main arteries – the anterior spinal artery and two posterior spinal arteries. Reinforcement of blood supply comes from the ascending cervical arteries (branches of the thyrocervical trunk), radicular-medullary branches (branches of the aorta), and the artery of Adamkiewicz (a branch of the aorta) at the level of the lower thoracic or lumbar vertebra. The occlusion of the artery of Adamkiewicz can result in spinal cord ischemia in the thoracolumbar region. Predominantly, this infarction is caused by aortic disease, thoracolumbar surgery, sepsis, hypotension, and thromboembolic disorders. Therefore, we suggest that spinal cord infarction because of hypercoagulability can lead to myelopathy in patients with COVID-19.46,47
Anterolateral approach for subaxial vertebral artery decompression in the treatment of rotational occlusion syndrome: results of a personal series and technical note
Published in Neurological Research, 2021
Sabino Luzzi, Cristian Gragnaniello, Alice Giotta Lucifero, Stefano Marasco, Yasmeen Elsawaf, Mattia Del Maestro, Samer K. Elbabaa, Renato Galzio
Within the left supraclavicular region, the thoracic duct is located posterior to the left carotid sheath. Arching laterally, it becomes posterolateral to it and passes anterior to the anterior scalene muscle, thyrocervical trunk, vertebral and subclavian artery [48–51]. Ammar and colleagues reported that the superiormost aspect of the arc is located at an average of 3.5 cm (range 2.1–5.0 cm) from the midline, 2.4 cm (range, 1.0–5.5 cm) from the inferior border of the cricoid cartilage, and 4.6 cm (range 1.7–11.5 cm) from the sternal notch [50]. Considering that the inferior border of the cricoid cartilage corresponds to the C5-C6 cervical disc, this raises concern for potential damage to the arc of the thoracic duct encroaching a potential pre-sternocleidomastoid retro-jugular corridor, as those suggested by Bruneau and George [4–7], when approaching the V1 ostial (C6) segment of the VA, but also the C5-C6 portion of the V2 segment. The same risk is shared when approaching the anterior cervical spine for selective cervical microforaminotomies [52,53]. Hart and colleagues reported even a case of thoracic duct with an arc ascending up to the superior cornu of the thyroid cartilage, 8.0 cm superior to the clavicle [46].
Related Knowledge Centers
- Inferior Thyroid Artery
- Phrenic Nerve
- Scalene Muscles
- Suprascapular Artery
- Transverse Cervical Artery
- Vertebral Artery
- Subclavian Artery
- Costocervical Trunk