The common carotid artery

14 The common carotid artery



14.1 Anatomy review



14.1.1 Origin


The common carotid arteries (Fig. 14.1) arise:



• on the right, from the brachiocephalic trunk


• on the left, directly from the arch of the aorta, which makes the left carotid longer.


image

Fig. 14.1 Common carotid artery.



14.1.2 Pathway


The common carotid artery ascends along the tracheoesophageal axis, inside the sternocleidomastoid muscle. It follows a more or less straight line from the sternoclavicular joint to a point just behind the condyle of the mandible.



14.1.3 Termination


The common carotid artery ends where it bifurcates into internal and external branches, between the hyoid bone and the thyroid cartilage, between C3 and C4. Note that:



• 67% of bifurcations occur cephalad of the thyroid cartilage at C4


• 20% appear at the level of the hyoid bone, approximately C3.



14.1.4 Relations


The common carotid arteries are covered by the following muscles:



• omohyoid


• sternohyoid


• sternothyroid


• sternocleidomastoid


• platysma of the neck.



14.1.5 Carotid triangle


At the level of the carotid triangle, the common carotid artery is covered only by skin and superficial cervical fascia (Fig. 14.2). The triangle is bounded by these muscles:



• sternocleidomastoid


• omohyoid


• posterior belly of digastric.


image

Fig. 14.2 Carotid triangle.



14.1.6 Features


The common carotid artery, internal jugular vein, and vagus nerve are enveloped in a common fibrous sheath. Because of this, it is difficult not to include the nervous system in carotid artery manipulation, especially knowing the sympathetic fibers neighboring the vagus nerve are in the direct vicinity.



14.1.7 Terminal branches


The common carotid arteries have no collaterals, but simply bifurcate into the internal and external carotid arteries.



14.2 Manual approach



14.2.1 Palpation


The patient is in decubitus, hands on the abdomen. The patient turns their head slightly towards the artery being palpated. Palpate the artery with two or three fingerpads. The sternocleidomastoid muscle crosses the common carotid artery like an X. Palpation varies depending on whether your fingers are cephalad, medial, or caudad in relation to this muscle crossing (Fig. 14.3).


image

Fig. 14.3 Palpation of the common carotid artery.



Caudad part


At this level the common carotid artery can be palpated between the two heads of the sternocleidomastoid muscle by pushing the clavicular head laterally just above the clavicle.


Place two or three fingerpads immediately outside the trachea, inside the sternal head of the sternocleidomastoid. Due to the obliqueness of this muscle, the common carotid artery approximates its anterior border.


Progressively glide your fingers cephalad to check the pulse of the artery.

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Nov 7, 2016 | Posted by in MANUAL THERAPIST | Comments Off on The common carotid artery

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