FACIAL. 451 



a complication that not unfrequently happens in this class of wounds, or severe hemorrhage 

 which cannot be restrained by ordinary means, may ensue from a wound, or deep ulcer, of the 

 tongue. In the former case, the primary wound may be enlarged if necessary, and the bleeding 

 vessel secured. In the latter case, it has been suggested that the lingual artery should be tied near 

 its origin. Ligature of the lingual artery is also occasionally practised, as a palliative measure, in 

 cases of tumor of the tongue, in order to check the progress of the disease. The operation is a 

 difficult one, on account of the depth of the artery, the of number important parts by which it is 

 surrounded, the loose and yielding nature of the parts upon which it is supported, and its occa- 

 sional irregularity of origin. An incision is to be made^ about two and a half inches in length, 

 running obliquely downwards and backwards, and having its centre opposite the point of the 

 great cornu of the hyoid bone, which is the guide to the artery. The parts being gradually 

 dissected, the hypoglossal nerve will first come into view, and then the artery must be carefully 

 sought for among the loose tissue at the bottom of the wound, care being taken not to open the 

 pharynx. Large veins, the internal jugular or some of its branches, may be met with, and prove 

 a source of embarrassment. 



Troublesome hemorrhage may occur in the division of the frsenum in children, if the ranine 

 artery, which lies on each side of it, is cut through. The student should remember that the 

 operation is always to be performed with a pair of blunt-pointed scissors, and the mucous mem- 

 brane only is to be divided by a very superficial cut, which cannot endanger any vessel. The 

 scissors, also, should be directed away from the tongue. Any further liberation of the tongue, 

 which may be necessary, can be effected by tearing. 



The Facial Artery (Fig. 276) arises a little above the lingual, and ascends 

 obliquely forwards and upwards, beneath the body of the lower jaw, to the 

 submaxillary gland, in which it is imbedded ; this may be called the cervical 

 part of the artery. It then curves upwards over the body of the jaw at the 

 anterior inferior angle of the Masseter muscle, ascends forwards and upwards 

 across the cheek to the angle of the mouth, passes up along the side of the 

 nose, and terminates at the inner canthus of the eye, under the name of the 

 angular artery. This vessel, both in the neck, and on the face, is remarkably 

 tortuous; in the former situation, to accommodate itself to the movements of 

 the pharynx in deglutition ; and in the latter, to the movements of the jaw, and 

 the lips and cheeks. 



Relations. In the neck, its origin is superficial, being covered by the integu- 

 ment, Platysma, and fascia; it then passes beneath the Digastric and Stylo- 

 hyoid muscles, and the submaxillary gland. On the face, where it passes over 

 the body of the lower jaw, it is comparatively superficial, lying immediately 

 beneath the Platysma. In this situation, its pulsation may be distinctly felt, 

 and compression of the vessel effectually made against the bone. In its course 

 over the face, it is covered by the integument, the fat of the cheek, and, near 

 the angle of the mouth, by the Platysma and Zygomatic muscles. It rests on 

 the Buccinator, the Levator Anguli Oris, and the Levator Labii Superioris 

 Alasque Nasi. It is accompanied by the facial vein throughout its entire course; 

 the vein is not tortuous like the artery, and, on the face, is separated from that 

 vessel by a considerable interval. The branches of the facial nerve cross the 

 artery, and the infra-orbital nerve lies beneath it. 



The branches of this vessel may be divided into two sets, those given off 

 below the jaw (cervical), and those on the face (facial). 



Cervical Branches. facial Branches. 



Inferior or Ascending Palatine. Muscular. 



Tonsillar. Inferior Labial. 



Submaxillary Inferior Coronary. 



Submental. Superior Coronary. 



Lateralis Nasi. 

 Angular. 



The inferior or ascending palatine (Fig. 279) passes up between the Stylo- 

 glossus and Stylo-pharyngeus to the outer side of the pharynx. After sup- 

 plying those muscles, the tonsil, and Eustachian tube, it divides, near the 

 Levator Palati, into two branches; one follows the course of the Tensor Palati, 

 and supplies the soft palate and the palatine glands ; the other passes to the 



