Carotid Plexus, Anterior View

Description

Centered in the anterior neck, the common carotid artery ascends deep to the mandible toward its bifurcation into internal and external carotid arteries, and a fine sympathetic meshwork, the carotid plexus, wraps circumferentially along its adventitia. Superiorly, branches track toward the carotid canal and cavernous sinus territory via the internal carotid plexus, while other fibers follow the external carotid artery and its early branches toward the face and scalp. The cervical vertebrae, clavicles, sternum, ribs, and proximal humeri provide bony landmarks, and the skull base and mandible frame the superior extent of the cervical neurovascular corridor. Nerves are rendered as yellow cords and filaments against the upper skeleton. Clinically, this anterior perspective is where you want to orient the relationship of perivascular sympathetic fibers to the carotid sheath during carotid endarterectomy, neck dissection, or anterior approaches to the cervical spine. Injury or blockade of the cervical sympathetic pathway proximal to the carotid plexus can present as Horner syndrome, and irritation of pericarotid sympathetic fibers is a recognized contributor to perioperative dysautonomia and head and neck pain syndromes. Small fibers matter here. Use this plate for teaching cervical sympathetic anatomy in gross anatomy, neuroanatomy, and head and neck surgery modules, or as a figure supporting discussions of the carotid sheath, carotid bifurcation exposure, and autonomic complications in operative reports and review articles. It also reads well in patient-facing surgical education when you need to explain why work on the carotid artery can affect ocular or facial sympathetic function. Anatomical accuracy verified by SciePro's Medical Advisory Board.