Ascending pharyngeal artery

Where is it located and how does it run?

The ascending pharyngeal artery originates from the posterior (in some classifications, medial) circumference of the external carotid artery. Its origin is located near the bifurcation of the common carotid artery.

Vessel topography:

• It lies adjacent to the posterior wall of the fascial sheath of the external carotid artery.
• It ascends along the lateral wall of the pharynx.
• It is located medial to the stylopharyngeus muscle.
• It passes in close proximity to the tonsillar fossa (fossa tonsillaris), where the ascending pharyngeal and facial arteries run nearby.

What branches does the artery give off?

Along its course, the arterial trunk gives off several branches supplying various structures of the head and neck:

• Pharyngeal branches (rr. pharyngeales) — run toward the pharyngeal wall and the palatine tonsil.
• Posterior meningeal artery (a. meningea posterior) — an additional source of blood supply to the dura mater, forming numerous anastomoses with the main source, the middle meningeal artery (a. meningea media).
• Inferior tympanic artery (a. tympanica inferior) — runs toward the medial wall of the tympanic cavity.

Participation in the blood supply to the pharynx

The ascending pharyngeal artery acts as the main artery of the pharyngeal wall. However, the blood supply to this organ is complex and provided by multiple sources.

• Arterial inflow: In addition to the a. pharyngea ascendens, branches of the facial (a. facialis), maxillary (a. maxillaris), and superior thyroid (a. thyroidea superior) arteries participate in the nutrition of the pharynx. The palatine tonsil receives blood from the pharyngeal branches and the ascending palatine artery (a branch of the facial artery).
• Venous and lymphatic drainage: Venous blood drains into the pharyngeal plexus (plexus pharyngeus) and from there into the internal jugular vein (v. jugularis interna). Lymph drains into the cervical lymph nodes.
• Innervation: The pharyngeal plexus is formed by branches of the glossopharyngeal (n. glossopharyngeus) and vagus (n. vagus) nerves and sympathetic fibers.

Participation in the blood supply to the tympanic cavity

Via its branch — the inferior tympanic artery (a. tympanica inferior) — the ascending pharyngeal artery supplies the medial wall of the tympanic cavity. The blood supply to the walls of this cavity is provided by a whole network of vessels from different basins:

• a. tympanica anterior (arising from the maxillary artery);
• r. caroticotympanicus (from the internal carotid artery);
• a. tympanica superior (from the middle meningeal artery);
• a. tympanica posterior (from the stylomastoid artery, a. stylomastoidea);
• a. tympanica inferior (from the ascending pharyngeal artery).

Clinical significance

• Pharyngeal surgery (tonsillectomy): The topography of the ascending pharyngeal and facial arteries near the pharyngeal wall corresponding to the fossa tonsillaris is important during the removal of the palatine tonsils.
• Collateral cerebral circulation: In stenosis of the internal carotid artery (ICA), blood can flow from the external carotid artery system into the ICA distal to the stenosis site. This ensures continuous brain perfusion. One such blood flow pathway is the anastomoses of the ascending pharyngeal artery with meningeal branches of the ICA.
• Angiographic feature: Due to their small size, these arteries are not distinguishable on angiograms. They are assigned a collective name — the inferolateral trunk.

Class and exam questions

What else to study on this topic

• External carotid artery
• Blood supply to the pharynx
• Blood Supply to the Dura Mater
• Tympanic cavity

Other topics in the "Anatomical Structures" section

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