The angular artery is the terminal branch of the facial artery, which supplies the upper regions of the face. It plays a key role in providing blood to the tissues around the nose and the medial corner of the eye.
Location
The angular artery arises as the final extension of the facial artery, starting at the lateral aspect of the nose, near the ala of the nose. It ascends along the side of the nose, running vertically toward the medial canthus (inner corner) of the eye. The artery follows a path alongside the nasolabial fold and terminates at the medial canthus of the eye. Along its course, the angular artery anastomoses with the dorsal nasal artery, a branch of the ophthalmic artery, forming a connection between the external and internal carotid artery systems.
Structure and Anatomy
Origin
The angular artery is the terminal branch of the facial artery, which is a major branch of the external carotid artery. The facial artery travels across the face, originating from the angle of the mandible, and ascends obliquely across the cheek. As it nears the lateral side of the nose, the facial artery transitions into the angular artery at the level of the nasolabial fold. The angular artery represents the final segment of the facial artery’s course, providing blood to the upper face.
Course
The angular artery ascends along the lateral border of the nose, running superiorly toward the medial canthus (the inner corner of the eye). It closely follows the contour of the nasolabial fold, a region between the nose and the upper lip, as it makes its way to the eye. During its ascent, the angular artery passes anterior to the levator labii superioris muscle, which elevates the upper lip, and travels alongside the nasal ala.
As it approaches the eye, the artery lies superficial to the levator labii superioris alaeque nasi muscle, which elevates the upper lip and dilates the nostrils. The artery continues to the medial aspect of the eye, terminating near the medial canthus. Here, the artery is located near the lacrimal sac, which drains tears from the eye into the nasal cavity.
Branches
The angular artery gives off several small branches along its course to supply various facial structures:
- Nasal Branches: As the artery ascends along the side of the nose, it gives off small branches that supply the nasal ala and the dorsum of the nose. These branches provide blood to the skin, cartilage, and connective tissues in this region.
- Labial Branches: Near its origin from the facial artery, the angular artery may give small branches that supply parts of the upper lip. These branches support the muscles and skin involved in lip movement.
- Periorbital Branches: As it reaches the medial canthus of the eye, the angular artery may give off small branches that supply the periorbital region (the area surrounding the eye). These branches help provide blood to the skin and muscles around the eye.
Termination
The angular artery terminates at the medial canthus of the eye, where it forms important anastomoses with other vessels, particularly the dorsal nasal artery, a branch of the ophthalmic artery. This anastomosis allows for the continuation of blood flow between the external carotid system (via the facial artery) and the internal carotid system (via the ophthalmic artery). This connection is critical in maintaining a rich blood supply to the face and periorbital regions.
Anastomoses
The angular artery forms significant anastomoses with nearby arteries, ensuring a robust blood supply to the nasal and periorbital regions. These include:
- Dorsal Nasal Artery: The angular artery anastomoses with the dorsal nasal artery, a branch of the ophthalmic artery, at the medial canthus of the eye. This connection is part of the vascular network that links the external and internal carotid systems, providing collateral circulation to the upper face.
- Infraorbital Artery: In some individuals, the angular artery may also form anastomoses with the infraorbital artery, a branch of the maxillary artery, providing additional blood flow to the midface and nasal region.
- Superior Labial Artery: The angular artery forms connections with branches of the superior labial artery, which arises earlier from the facial artery and supplies the upper lip and nasal septum.
Relationship with Surrounding Structures
As it travels through the face, the angular artery is closely related to several important anatomical structures:
- Nasal Ala and Dorsum of the Nose: The artery runs along the lateral side of the nose, supplying the soft tissues of the nasal ala and the dorsum. These areas receive blood from the small branches of the artery as it ascends.
- Nasolabial Fold: The artery closely follows the nasolabial fold, an important landmark in facial anatomy that separates the upper lip from the cheek. This region is critical in facial expressions and movements, and the artery’s location here ensures that it provides blood to the muscles and skin involved in these actions.
- Levator Labii Superioris Muscle: The angular artery runs superficial to the levator labii superioris muscle, a key muscle involved in elevating the upper lip. This relationship ensures that the muscle receives an adequate blood supply for its function in facial expression.
- Medial Canthus of the Eye: The artery terminates at the medial canthus, where it is located near the lacrimal sac, the structure responsible for draining tears into the nasal cavity. The artery’s proximity to the medial canthus allows it to supply blood to the skin, muscles, and connective tissues around the eye.
Variations
The anatomy of the angular artery can vary between individuals. In some cases, the artery may follow a more superficial or deeper course along the side of the nose, or it may give off additional branches to supply nearby structures. Additionally, the size and extent of the branches that supply the upper lip or nasal regions can vary. These anatomical variations are important considerations during surgical procedures or cosmetic interventions in the face.
Surrounding Vascular Structures
The angular artery is located near several other key vascular structures in the face, including:
- Facial Artery: The angular artery is the terminal branch of the facial artery, which supplies most of the lower and midface. The facial artery continues its course toward the angular artery after giving off branches that supply the lips, cheeks, and other facial structures.
- Ophthalmic Artery: The dorsal nasal artery, a branch of the ophthalmic artery, forms anastomoses with the angular artery at the medial canthus of the eye, providing a connection between the external and internal carotid artery systems.
- Infraorbital Artery: The angular artery may form anastomoses with the infraorbital artery, a branch of the maxillary artery, which supplies the lower eyelid and midface.
Relations with the Nasal Region and Periorbital Area
The angular artery plays a vital role in supplying the nasal region, particularly the lateral aspects of the nose, nasal ala, and nasal septum. Its branches help maintain the integrity of the nasal tissues, supporting their role in breathing and facial expressions. The artery’s proximity to the medial canthus also allows it to contribute to the blood supply of the periorbital area, providing essential nutrients to the muscles and skin around the eye. This vascular network is critical for maintaining the health of the tissues in the upper face and nasal region.
Function
Blood Supply to the Nasal Region
The angular artery provides critical blood supply to the nasal ala, lateral nasal wall, and dorsum of the nose. As the terminal branch of the facial artery, the angular artery delivers oxygenated blood to the skin and soft tissues of the nose. Through its nasal branches, the artery supports the structural integrity of the nose, nourishing the skin, connective tissues, and muscles involved in nasal movement and facial expressions. This blood supply is particularly important in maintaining the health and function of the nasal tissues, supporting processes like breathing and protecting the nasal cavity from external environmental factors.
Blood Supply to the Medial Canthus and Periorbital Region
The angular artery plays a key role in supplying blood to the medial canthus of the eye, the inner corner where the upper and lower eyelids meet. This region is essential for the proper function of the lacrimal system, which drains tears from the eye into the nasal cavity. By delivering blood to the lacrimal sac and surrounding tissues, the angular artery supports the drainage of tears and helps maintain the moisture balance of the eyes. Additionally, small branches of the angular artery extend into the periorbital region to supply the skin and soft tissues around the eye, contributing to the health of the eyelids and surrounding structures.
Blood Supply to the Upper Lip and Nasolabial Fold
As the angular artery courses along the nasolabial fold, it supplies small branches to the upper lip and the skin and muscles of the nasolabial region. The blood supplied by the angular artery helps maintain the orbicularis oris muscle, which controls movements of the lips and is essential for speech, eating, and facial expressions. This vascularization supports the functionality and health of the upper lip tissues, ensuring they remain well-nourished and resilient. The artery also supplies the skin overlying the nasolabial fold, an area important in facial aesthetics and expression.
Support for Collateral Circulation in the Face
The angular artery plays a crucial role in collateral circulation through its anastomoses with the dorsal nasal artery (a branch of the ophthalmic artery) and, in some cases, with the infraorbital artery. These anastomoses form important vascular connections between the external carotid artery system (via the facial artery) and the internal carotid artery system (via the ophthalmic artery). This collateral circulation ensures a continuous blood supply to the upper face, nose, and eye, even if one of the primary arteries is compromised. The angular artery’s contribution to this vascular network helps protect against ischemic events or blockages in the facial region.
Nutrient Delivery and Waste Removal
As with all arteries, the angular artery ensures the delivery of oxygen, glucose, and essential nutrients to the tissues it supplies. By providing a continuous flow of oxygenated blood to the nose, upper lip, and periorbital region, the artery helps maintain the health of these tissues and supports their daily functions. In addition to nutrient delivery, the angular artery also plays a role in waste removal, ensuring that metabolic byproducts like carbon dioxide and lactic acid are removed from the tissues. This exchange of nutrients and waste products is critical for preventing tissue damage and ensuring the overall vitality of the facial and nasal structures.
Contribution to Thermoregulation
The angular artery also plays a role in thermoregulation of the face, particularly in the nasal and periorbital regions. Blood flow through the artery helps to dissipate heat in warmer environments or during periods of physical exertion. Increased blood flow to the skin of the nose and face allows excess heat to be released, maintaining the overall temperature balance of the face. Conversely, reduced blood flow conserves heat in colder conditions, helping protect the skin and tissues from temperature fluctuations. This thermoregulatory function is particularly important in exposed regions like the face, which is often subject to environmental changes.
Support for Tissue Healing and Repair
The angular artery plays a significant role in tissue healing and repair, particularly in the nasal and periorbital regions. In the event of injury, such as lacerations or trauma to the nose or face, the blood supplied by the angular artery helps deliver the oxygen, nutrients, and growth factors necessary for tissue regeneration. This blood flow also brings immune cells to the area, helping to fight infection and support the healing process. The artery’s contribution to tissue repair is critical for maintaining the structural integrity and function of the facial tissues after injury or surgery.
Blood Supply for Facial Movements and Expressions
The angular artery supports facial movements and expressions by supplying the muscles involved in these actions. Specifically, it provides blood to the levator labii superioris alaeque nasi muscle and other small muscles around the nose and upper lip that control the elevation of the lip and nostrils. These movements are crucial for facial expressions, such as smiling, frowning, and flaring the nostrils. By delivering oxygen and nutrients to these muscles, the angular artery ensures that they remain functional and responsive during facial movements.
Support for Lacrimal Function
By supplying blood to the lacrimal sac and the surrounding tissues of the medial canthus, the angular artery plays an indirect role in maintaining lacrimal function. The lacrimal sac is responsible for draining tears from the eye into the nasal cavity, and adequate blood flow from the angular artery ensures that the sac and nearby structures remain healthy and functional. This blood supply helps support the tear drainage system, which is essential for keeping the eyes properly moisturized and preventing tear overflow.
Contribution to Aesthetic Appearance
The angular artery plays an important role in maintaining the aesthetic appearance of the face, particularly in the nasal, periorbital, and nasolabial regions. By supplying blood to the skin and soft tissues, the artery helps maintain skin elasticity, tone, and overall appearance. Its role in supporting tissue health and providing adequate blood flow to these areas contributes to the natural aesthetic of the face. This is particularly relevant in cosmetic procedures, where the angular artery’s location and function must be considered to ensure optimal results and minimize the risk of vascular complications.
Clinical Significance
The angular artery is clinically significant due to its role in supplying blood to the nose, medial canthus, and periorbital region. Its superficial course near the nose and eye makes it relevant in both medical and surgical contexts.
Facial and Cosmetic Surgery
The angular artery is critical in cosmetic procedures, such as rhinoplasty (nose surgery), facelifts, or dermal filler injections in the nasolabial fold and periorbital regions. Surgeons and practitioners must carefully avoid damaging the artery to prevent complications like vascular occlusion, skin necrosis, or excessive bleeding. Its proximity to the medial canthus makes it a key consideration in surgeries involving the eye.
Trauma and Facial Injuries
In cases of trauma to the nose or face, the angular artery can be injured, leading to significant bleeding. Proper identification and management of the artery are crucial to control hemorrhage and prevent complications.
Collateral Circulation
The angular artery plays an essential role in the collateral circulation between the external and internal carotid artery systems, particularly through its anastomosis with the dorsal nasal artery. This connection is vital for maintaining blood flow in cases of arterial blockages or compromised blood supply in the face or eye.
