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Chapter 289
The Occipital Artery
The occipital artery (A. occipitalis) is the second in size of the terminals of the carotid. It arises usually just in front of the internal carotid, but in some cases with that artery by a common trunk of variable length. It pursues a somewhat flexuous course to the fossa atlantis, where it divides into anterior and posterior branches. It is related superficially to the submaxillary gland and the mastoido-humeralis, and deeply to the guttural pouch and the rectus capitis anterior major. The internal carotid artery, the inferior cerebral vein, and the accessory, vagus, and sympathetic nerves cross its deep face. It gives twigs to the submaxillary gland, the anterior straight muscles, the guttural pouch and the adjacent lymph glands, and two named collateral branches. The condyloid or prevertebral artery (A. condyloidea) is a small vessel which passes upward and forward on the guttural pouch, and divides into muscular and meningeal branches. The latter enter the cranium through the foramen lacerum and hypoglossal foramen and are distributed to the dura mater. This artery is very variable in its origin. The posterior meningeal or mastoid artery (A. meningea caudalis) is a much larger vessel which runs upward and forward between the small oblique muscle and the paramastoid process, passes through the mastoid foramen into the parieto-temporal canal, enters the cranial cavity, and is distributed to the dura mater.
The posterior or retrograde branch (Ramus descendens) of the occipital passes up through the foramen transversarium of the atlas and joins the vertebral artery. It gives branches to the great oblique muscle of the head, which covers it.
The anterior or occipital branch (Ramus occipitalis) passes through the alar (antero-external) foramen of the atlas and supplies the muscles and skin of the poll, anastomosing with the deep cervical artery and its fellow of the opposite side. In the alar furrow it gives off the cerebrospinal artery, which enters the spinal canal through the intervertebral (antero-internal) foramen of the atlas, perforates the dura mater, and divides into cerebral and spinal branches. The cerebral branch unites with that of the opposite side to form the basilar artery, and the spinal branch similarly forms by union with its fellow the middle spinal artery.
The basilar artery (A. basilaris cerebri) passes forward in the median groove on the ventral surface of the medulla and pons and divides into the two posterior cerebral arteries. The collateral branches of the basilar are:
1. Medullary branches (Rami medullares), ten or twelve in number, distributed to the medulla oblongata.
2. Posterior cerebellar arteries (Aa. cerebelli caudales) which pass outward around the medulla behind the pons to the cerebellum, to which they are distributed after giving twigs to the medulla and pons.
3. The small auditory artery (A. auditiva interna) accompanies the eighth nerve to the internal ear. It often arises from the posterior cerebellar.
4. Anterior cerebellar arteries (Aa. cerebelli nasales). These are very variable in number and origin. There are often two or three on either side and they frequently arise from the posterior cerebrals. They pass outward in front of the pons and supply the anterior part of the cerebellum.
The posterior cerebral arteries (Aa. communicantes caudales) diverge at an acute angle and join the posterior communicating branches of the internal carotid arteries on the inferior surface of the cerebral peduncles. They are connected by a transverse branch and by a network of fine twigs which form often a rete mirabile.