The internal carotid artery (carotis interna, v. cerebralis) is that branch of the common carotid which is distributed to the brain, and to the eye with its appendages. It extends from the place of bifurcation of the common carotid, usually in a straight direction, to the base of the skull, where it ascends in a winding course through the temporal bone, and after entering the cranial cavity, ends by the side of the anterior clinoid process of the sphenoid bone.
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The coronary arteries are small vessels, two in number, which arise near the root or commencement of the aorta, immediately above the semilunar valves. They are called coronary, from the manner in which they encircle the heart near its base, (corona, a wreath or garland). They have likewise been named cardiac, from their destination to the substance of that organ. The two arteries are distinguished as right and left coronary arteries from the direction they take, or from the sides of the heart which they respectively supply.
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The external carotid artery gives origin to eight branches, including the two into which it finally divides. For the purposes of description these may be arranged into three sets. 1. Those which are directed forwards, viz., the superior thyroid, the lingual, and the facial. 2. Those which run backwards, — the occipital and posterior auricular; and 3, those which ascend, viz., the ascending pharyngeal branch with the temporal and internal maxillary, — the two terminal branches.
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The superior mesenteric artery (french : artère mésentérique supérieure) arises from the anterior surface of the aorta, on the middle line, at 2 cm below the origin of the coeliac artery, nearly at the level of the disc between the second and third lumbar, vertebras.
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The external carotid artery (carotis superficialis s. externa, — Haller), is smaller than the internal carotid in young subjects, but about of equal size in the adult. It reaches in the neck from the point of division of the common carotid (opposite the upper margin of the thyroid cartilage) to the neck of the condyle of the lower jaw-bone, or a little lower, where it divides into two branches, the temporal and the internal maxillary. This artery diminishes rapidly in size as it ascends in the neck, owing to the number and size of the branches which spring from it.
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The femoral artery (femoralis s. cruralis ; French: artère fémorale ), is that portion of the artery of the lower limb which lies along the upper two-thirds of the thigh, — its limits being marked, above, by Poupart's ligament, and below, by the opening in the great adductor muscle, after passing through which the artery assumes the name popliteal.
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The leading facts in the foregoing account of the common carotid artery will here be brought together in connection with the performance of an operation for tying the artery, as in a case of aneurism. — As this artery does not, save in very rare instances, furnish any branch, (in a practical or surgical point of view the branches sometimes found to arise close to its upper end may be disregarded,) a ligature can be applied to any part of the vessel except immediately at its commencement or termination.
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Frequent mention has been made of the anastomoses which exist between the branches of the arteries in the lower limb ; and a general view of them may now be taken in order that some idea may be formed of the important influence which they exert in maintaining the circulation of the limb, when the principal artery is obliterated by an operation, or by disease.
It may be remarked, in the first place, that the more important of these anastomoses occur in the neighbourhood of the principal articulations of the limb.
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The common or primitive carotid arteries of the right and left sides of the body (art. carotis dextra et sinistra) are nearly similar in their course and position, whilst they are in the neck ; but they differ materially in their mode of origin, and consequently in their length, and position at their commencement. On the right side the carotid artery commences at the root of the neck behind the sterno-clavicular articulation, at the place of bifurcation of the innominate artery, whilst the carotid of the left side arises, within the thorax, from the highest part of the arch of the aorta, very near the origin of the innominate artery. The left carotid is therefore longer than the right, and ii is at first placed deeply within the thorax.
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From the facts above-mentioned, concerning the peculiarities of the three arteries which supply the leg and foot, it will be seen that all the deviations from the ordinary arrangement, in regard to their size, display a general principle of compensation, by which deficiencies in one vessel are balanced by an increase in the size of another.
It will also be observed, that, whilst the anterior and posterior tibial arteries have a greater tendency to diminish than to increase in size, the peroneal artery, on the contrary, is the vessel which is the most frequently enlarged. The anterior and posterior tibials, however, occasionally assist each other, especially in the supply of arteries to the toes.
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The innominate artery (brachiocephalic artery a. anonyma), the largest of the vessels which proceed from the arch of the aorta, arises from the commencement of the transverse portion of the arch, before the left carotid. From this point the vessel ascends obliquely towards the right, until it arrives opposite the sterno-clavicular articulation of that side, nearly on a level with the upper margin of the clavicle, where it divides into the right subclavian, and the right carotid artery. Its place of bifurcation would, in most cases, be reached by a probe passed backwards through the cellular interval between the sternal and clavicular portions of the sterno-mastoid muscle. The length of the innominate artery is very variable, but usually ranges from an inch and a half to two inches.
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