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The examiner should be able to differentiate the internal carotid artery (ICA) from the external carotid artery (ECA).

Ultrasonography cannot show the proximal segment of the left common carotid artery. The left common carotid artery arises from the aortic arch. Ultrasonography can show the most proximal segment of the common carotid artery. The right carotid artery arises from the right brachiocephalic artery. Contractions of the sternocleidomastoid muscle cause poor sonic penetration and make positioning of the probes difficult.Ĭarotid Artery Anatomy and Tips for Differentiating the Internal Carotid Arteries from the External Carotid Arteries The neck of the patients should be relaxed. The optimal patient head position is tilted about 45° away from the artery being examined. In fact, it produces a poorer window for the carotid artery. Between these two choices, the overhead position for Doppler ultrasonography of the carotid artery is recommended.Ī pillow is not necessary. However, the right posterior projection is a bit more difficult. This position makes it easy to control the machines. The examiner uses his right hand for both carotid arteries. The examiner should be familiar with using both hands, which requires some practice.Īnother position is the usual lateral sitting position, which is used for most other ultrasonography examinations. The sonic window can be made wider and offers a clear view of the carotid artery especially from the posterolateral projection. The benefit of this position is that the examiner can use both hands and there are plenty of positions possible for the ultrasonography probe. In this position, the examiner should use his right hand for the right carotid artery and use his left hand for the left carotid artery. One is the overhead position, in which the examiner sits beyond the patient’s head beside the end of the examination table and use two hands for ultrasonography. Starting Carotid Ultrasonography: Patient Positionįor carotid ultrasonography, there are two options for the relative position between the patient and examiner.