ArticlesAnatomyHead and neckFace and scalpFacial artery

ArticlesAnatomyHead and neckFace and scalpFacial artery

Facial artery

Author: Shahab Shahid, MBBS • Reviewer: Uruj Zehra, MBBS, MPhil, PhD
Last reviewed: July 19, 2023
Reading time: 9 minutes

The facial artery supplies the muscles and skin of the face. It has a crucial function in maintaining these areas, and provides them with oxygen and nutrients. The facial artery is one of the eight branches of the external carotid artery.

The facial artery is also known as the external maxillary artery. It has a tortuous route along the nasolabial fold towards the medial angle of the eye. It passes deep to the digastric and stylohyoid muscles and it will pass through the submandibular gland.

Key facts about the facial artery
Source	External carotid artery
Branches	Cervical branches: - Ascending palatine - Tonsillar - Submental - Glandular Facial branches: - Inferior labial - Superior labial - Lateral nasal - Angular Mnemonic: Anna, PLS SIT (Ascending palatine artery, Premasseteric artery, Lateral nasal artery, Submental artery, Superior labial artery, Inferior labial artery, Tonsillar artery)
Supplies	Muscles and skin of the face

In this article we will explore the anatomy, function and clinical relevance of the vessel.

Contents

Course and relations
Cervical branches
Facial branches
Clinical points
Sources

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Course and relations

The common carotid artery is the first branch of the brachiocephalic trunk on the right side, and the first branch of the arch of the aorta on the left side. It travels superiorly, and divides into the external and internal carotid arteries at the superior border of the thyroid cartilage.

The internal carotid continues to pass upwards, and passes into the skull via the carotid canal. The artery then passes forwards to enter the cavernous sinus, and makes a 180 degrees turn back on itself and emerges lateral to the optic chiasm. The internal carotid artery then trifurcates into its three branches which supply the region of the brain. The external carotid passes upwards and superficially and gives off a number of branches to the face, and scalp.

Branches of the internal and external carotid arteries
Internal carotid artery	Middle cerebral, anterior cerebral, posterior communicating arteries
External carotid artery	Superior thyroid, lingual, ascending pharyngeal, facial, occipital, posterior auricular, maxillary, superficial temporal arteries

The facial artery arises from the anterior surface of external carotid, and has a tortuous route along the nasolabial fold towards the medial canthus of the eye. It moves beneath the digastric and stylohyoid muscles and it will pass through the submandibular gland.

The artery will then curve over the body of the mandible (deep to platysma), as the anteroinferior angle of the masseter, will ascend forwards and upwards across the cheek, to the angle of the mouth and along the side of the nose. It terminates near the medial aspect of the eye. In the region of the head, the facial artery runs roughly parallel to the facial vein, although not adjacent to it.

Learn everything about the arteries of the head and neck with our articles, video tutorials, quizzes and labeled diagrams.

Cervical branches

Key facts about the cervical branches of facial artery
Ascending palatine artery	Supplies: auditory tube, palatine tonsil, superior pharyngeal constrictor, soft palate
Tonsillar branch	Supplies palatine tonsil
Submental artery	Supplies: submental muscle, submental region skin
Glandular branches	Supply: submandibular salivary glands and lymph nodes

Ascending palatine artery

This artery passed superiorly between the styloglossus and stylopharyngeus. It divides close to the levator veli palatini muscle into two branches. One branch pierces the superior pharyngeal constrictor, in order the reach the auditory tube and the palatine tonsil. It will then anastomose with the ascending pharyngeal artery as well as the tonsillar branch of the facial artery.

The other branch runs with the levator veli palatini and passes over the superior pharyngeal constrictor in order to supply the soft palate, finally anastomosing with the maxillary artery (the descending palatine branch).

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Tonsillar branch

This branch ascends between styloglossus and the medial pterygoid muscle, before piercing the superior pharyngeal constrictor to reach the palatine tonsil.

Submental artery

This branch runs on the inferior aspect of the chin. This is the largest of the cervical branches of the facial artery. The branch is given off just as the facial artery passes through the submandibular gland. The vessel passes anteriorly on top of the mylohyoid muscle, beneath the digastric muscle and just inferior to the body of the mandible. The artery supplies the muscle surrounding this region, and anastomoses with the sublingual artery as well as the inferior alveolar artery (the mylohyoid branch). The submental vessels supply the skin over the submental area.

The submental artery also divides into the superficial and deep branch. The superficial branch anastomoses with the inferior labial artery. The deep branch also anastomoses with the inferior labial artery as well as the mental branch of the inferior alveolar artery.

Glandular branches

These are 3-4 large branches that supply the submandibular salivary gland, as well as some structures that are found nearby i.e. the lymph nodes and integument.

All the branches of the facial artery can be easily remembered with the following mnemonic: Anna, PLS SIT (Ascending palatine artery, Premasseteric artery, Lateral nasal artery, Submental artery, Superior labial artery, Inferior labial artery, Tonsillar artery).

Facial branches

Key facts about the facial branches of facial artery
Inferior labial artery	Supplies: lower lip, labial glands
Superior labial artery	Supplies: upper lip, nasal septum, ala of the nose
Lateral nasal branch	Supplies: dorsum of the nose, ala of the nose
Angular artery	Supplies: lacrimal sac, orbicularis oculi muscle

Inferior labial artery

This branch of the facial artery arises close to the corner (angle) of the mouth. It then passes superiorly and forwards in order to run beneath the triangularis (depressor anguli oris) muscle and pierces the orbicularis oris muscle. It supplies the mucous membrane and muscles of the lower lip and also supplies the labial glands. The vessel anastomoses with the artery of the opposite side and inferior alveolar artery (the mental branch).

Superior labial artery

This a significantly larger and more tortuous branch of the facial artery when compared to the inferior labial artery. It supplies the upper lip and also gives a few branches that ascend to supply and nasal septum and ala of the nose.

Lateral nasal branch

This branch of the facial artery ascends along the lateral aspect of the nose. It supplies numerous structures, including the dorsum of the nose, the ala, and anastomoses with its contralateral fellow, the infraorbital branch of the internal maxillary artery as well as the dorsal nasal branch of the ophthalmic artery.

Angular artery (terminal branch)

This is the final and terminal branch of the facial artery. On the cheek the artery supplies the lacrimal sac and orbicularis oculi and ultimately anastomoses with the ophthalmic artery (the dorsal nasal branch). It also ascends toward the medial angle of the orbit, and lies within the fibers of the quadratus labii superioris (a broad sheet of muscle that arises from the lateral aspect of the nose to the zygomatic bone). The terminal portion ultimately finishes at the medial canthus of the eye. It is accompanied by the greater occipital nerve, that innervates the scalp and provides sensation.

Ready to test yourself on the arterial supply of the head and neck? Try out our quiz below:

Clinical points

Palpation - Anaesthetists palpate the facial artery against the anteroinferior angle of the masseter muscle against the bony surface of the mandible.

Carotid Artery Vascular disease - Atherosclerosis (vascular disease) of the common carotid artery (commonly at its bifurcation) increases the risk of emboli shooting off and hence strokes occurring. Transient ischaemic attacks (a stroke where the symptoms resolve in less than 24 hours) are also more likely to occur. Treatment includes carotid endarterectomy, or endovascular treatment of the disease.

Sources

All content published on Kenhub is reviewed by medical and anatomy experts. The information we provide is grounded on academic literature and peer-reviewed research. Kenhub does not provide medical advice. You can learn more about our content creation and review standards by reading our content quality guidelines.

References:

Frank H.Netter MD: Atlas of Human Anatomy, 5th Edition, Elsevier Saunders.
Chummy S.Sinnatamby: Last’s Anatomy Regional and Applied, 12th Edition, Churchill Livingstone Elsevier
Richard L. Drake, A. Wayne Vogl, Adam. W.M. Mitchell: Gray’s Anatomy for Students, 2nd Edition, Churchill Livingstone Elsevier
Atlas and textbook of Human Anatomy. J.P McMurrich, D.J.Sobotta.
Knipe H. MD and Jones J. MD et al: Facial artery. Radiopaedia.org (accessed 12/01/2016).

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