Lingual Artery 29 



carotid triangle, but, as its course and position are there subject to 

 variations, it is better to seek it at a spot where it is sure to lie, and in 

 the depths of an area with very definite boundaries : The head being 

 thrown back, and the face turned to the opposite side, so as to get 

 the angle of the jaw out of the way, a curved incision is made from 

 behind the symphysis to just in front of the angle of the jaw, reaching 

 the middle of the side of the hyoid bone, through skin, superficial fascia, 

 and platysma. The deep fascia is then incised ; a large superficial vein 

 or two may need to be tied and cut. The lower border of the sub- 

 maxillary gland, which is then seen, must be detached with a director 

 and turned up out of the way. Then a very small triangle is made 

 out which is bounded above by the hypo-glossal nerve, behind by the 

 pearly tendon of the digastric, and in front by the posterior border of 

 the mylo-hyoid. The hyo-glossus forms the floor of this triangle. 

 Possibly the digastric tendon may have to be drawn down, the better 

 to expose the depths of the triangle. Then, with the director, the 



Course of ling-, art. ; but underneath hyo-gloss. m. (SMITH and WALSHAM.) 

 Digast. in. Mylo-hyoid m. Hyo-gloss. in. Hypogloss. n. 



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hyo-glossus is scratched through close to the hyoid bone, and the 

 artery is laid bare, resting upon the middle constrictor. 



The facial artery, given off in the superior carotid triangle, has to 

 turn over the maxilla in its course to the inner corner of the orbit, 

 where, as the angular artery, it anastomoses with the nasal branch 

 of the ophthalmic itself a branch of the internal carotid trunk. 

 Winding out of the superior carotid triangle beneath the digastric and 

 stylo-hyoid muscles, it enters the sub-maxillary triangle, embedding 

 itself in the sub-maxillary gland. It then turns up over the maxilla, at 

 the anterior inferior angle of the masseter. It courses beneath the 

 platysma and the zygomatici, and rests upon the buccinator and the 

 elevators of the upper lip. It is accompanied by the facial vein, which 

 is thin-walled, and does not take the tortuous course of the artery. The 

 vein is posterior to the artery and passes superficially to the salivary 

 gland. 



Below the jaw the facial artery gives off an ascending palatine and 



