Journal article
Proximity of the Carotid Bifurcation to the Laryngeal Prominence: Results of a Cadaver Study and Recommendations for Safe Pulse Palpation
Journal of geriatric physical therapy (2001), v 43(4), pp E53-E57
01 Oct 2020
PMID: 31373943
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background/Purpose: The carotid bifurcation (CB) is the location of the carotid sinus and the baroreceptors and is also a major site for atherosclerotic plaque formation. Health care providers have therefore been cautioned to avoid the CB during carotid pulse palpation (CPP) to prevent triggering the baroreflex, occluding an artery, or propagating a thrombus. Potential risks of adverse events during CPP may be greater for older adults due to age-related vascular changes and increased risk of baroreceptor hypersensitivity. The exact location of the CB relative to easily identifiable landmarks has, however, not been well-studied. The purpose of this descriptive study was to identify the location of the CB relative to key landmarks in a cadaver sample and to make recommendations allowing clinicians to avoid the CB during CPP. Methods: The CB and other regional landmarks in 17 male and 20 female cadavers were exposed by dissection and pins were placed at all landmarks. Digital calipers were then used to measure the distance between the CB and all landmarks. Results and Discussion: The mean vertical distance from the laryngeal prominence (LP) to the CB was 25.14 mm for females and 36.13 mm for males. No CBs were located below the LP. Ninety-four percent of female CBs and 100% of male CBs were located above the LP, and 74% of female subjects and 87% of male subjects had CBs greater than 20.00 mm superior to the LP. No clinically relevant relationships were found between the CB and any of the other measured landmarks. Conclusions: Based on this cadaver sample, CPP below the level of the LP in a supine individual would be unlikely to compress the CB and thus unlikely to trigger the baroreflex or occlude the region of greatest atherosclerotic buildup. If a pulse is not palpable below the LP, moving vertically up to 1 cm above the LP in a supine individual would be likely to compress the CB in only a small number of cases.
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Details
- Title
- Proximity of the Carotid Bifurcation to the Laryngeal Prominence: Results of a Cadaver Study and Recommendations for Safe Pulse Palpation
- Creators
- Amy H. Amabile - Thomas Jefferson UniversityRobert L. Dekerlegand - Thomas Jefferson UniversityStephanie Muth - Thomas Jefferson UniversityMichael C. O'Hara - Temple UniversityJacqueline M. Phillips - Temple UniversityAlexis A. Ammons - Thomas Jefferson UniversityAnn-Katrin Jacketti - Thomas Jefferson UniversityOlivia J. Newby - Thomas Jefferson UniversityBenjamin Schreiber - Thomas Jefferson UniversityRyan J. Walter - Thomas Jefferson UniversityAnthony Lombardo - Thomas Jefferson UniversityJamie N. Elcock - Thomas Jefferson University
- Publication Details
- Journal of geriatric physical therapy (2001), v 43(4), pp E53-E57
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Health Sciences; Physical Therapy (and Rehabilitation Sciences)
- Web of Science ID
- WOS:000579195300002
- Scopus ID
- 2-s2.0-85072764564
- Other Identifier
- 991021866821904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Geriatrics & Gerontology
- Rehabilitation