Carotid Artery exam - Jessica Nishikawa

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the next step is to assess the carotid

pulse again go ahead and look straight

from your Makana you want to avoid

checking up in the higher aspect of the

neck where the carotid sinus is if you

massage the carotid sinus it can cause a

reflexive drop in blood pressure and

heart rate so you want to avoid the

upper half the neck instead so for the

carotid in the lower half the neck

you may need to displace the

sternocleidomastoid muscle in order to

to feel this so palpate right there and

you can also pulpit the other side and

you never want to palpate both sides

simultaneously I can cut off blood flow

to the brain so pump it one side while

your palpating this you you're looking

and feeling for the amplitude and the

upstroke it should be a brisk upstroke

if you're listening to the heart as

while you're feeling this the carotid

upstroke happens right after s1 and

before s2 that is helpful if the heart

rate is is really fast and you can't

differentiate between s1 and s2 while

you're listening you could also you can

listen and feel fill the carotid pulse

ation and you can kind of identify which

one is s 1 and s which one's s 2 next

I'm going to use my stethoscope and

listen over the carotid artery for

brewery's this is important to do in

someone who is middle-aged or older

anybody that you suspect to have

cerebral vascular disease and if you

felt the thrill so part of your

assessment when you're palpating is to

feel for thrills which is a cat's eye a

cat like purring so you'll feel that

sort of cat purring or that vibration

and if that's if you felt that then you

would need to assess for brewery's I'm

going to listen with both the Bell and

the diaphragm of my stethoscope and

again you would listen to both sides not

just one I'm going to listen to just his

right side for for now


and then the Bell

good know that if someone has an aortic

murmur that that radiates a lot of times

a or t'k murmurs will radiate up to the

neck so you you may mistake what you

think is a brewery but it's actually a

cardiac murmur so make sure you listen

well over the cardiac structures to see

if that there's a murmur there that's

just rating up to the neck