hey it's Dr Steve Weiner and the next area that we're going to examine is the preal sulcus Dao inferior labal artery that's right in the marionette area make sure you have the notch pointing to the patient's right and here I am it's not quite as deep as a posterior jawline so you can make the depth a little bit smaller and the Dao is going to be the large spindle shaped muscle and you can ask the patient to frown and you see that muscle gets bigger and smaller when she frowns and let me just point that out to you so this is going to be the Dao right here and always just deep to the Dao muscle is going to be your mental foron and that's a little bit of a break in the bone hold on let me move it over a little bit and you're going to see a little notch in the bone there it is right there let me just get it in Focus so we're looking at the mental framan right now and that's going to be right here and through that mental framan is going to be your mental uh artery and vein as well as the mental nerve let me get a little bit better view of that maybe right there this is the mental framan and it's deep to the Dao almost always so the other significant structure in this area is going to be your inferior labal artery and that's usually deep to the Dao as well so let's put on the vascular and let's do the power doppler and we're going to look for that inferior labal artery which is deep to the Dao muscle I'm going to increase the gain a little bit there it is so this is so what we're finding right here is the inferior labo artery and you see it's deep to the Dao muscle so here's the inferior labal artery and here's the Dao and they the inferior laal arter is going to be the first Branch off of the facial artery so the facial artery is always going to be a little bit lateral to the Dao muscle and I'll see if I can find that now so inferior labal artery deep to the D right there so now if I go a little bit laterally to the Dao you're going to find there it is the facial artery so Dao muscle here facial artery right here here that's always lateral to the Dao that's a landmark that's always there and then if we want to find the facial artery and vein you usually go into that antonial Notch the antonial notch is going to be just anterior to the masser so what you can do is ask the patient to clinch and you go anterior to that that's the way I use uh my landmarks for injections but if you want to use the ultrasound I like to use the ultrasound just at the border of the mandible coming from an inferior um orientation and here we go that's going to probably be your vein right there the vein is compressible so this actually is not compressible so this is the artery the vein is going to be posterior to the artery always so if you go back here clinch relax so what we saw there let's just go a little bit back we saw two vessels that we're next to each other so here's the artery and vein this will be the vein right here and this will be the artery right here um at the jawline they run together but after they go over the jawline they actually split the artery is going to go a little more anterior and the vein is going to go straight shot towards the medial canel area
