[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Common carotid artery [Cardiovascular system](https://durgical.com/en/anatomy/system/cardiovascular-system/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Common carotid artery The common carotid artery runs up each side of the neck carrying blood to the head; it splits in two near the top of the voice box. Official name: Right common carotid artery [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=common_carotid_artery&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The main artery up each side of the neck, in the carotid sheath; its pulse is felt beside the larynx. ## What it does Carries blood to the head; it splits at the level of the upper larynx. ## Key points - At the bifurcation sit the carotid sinus (baroreceptor for blood pressure) and the carotid body (chemoreceptor for O2, CO2 and pH); both signal through the [glossopharyngeal nerve](https://durgical.com/en/anatomy/glossopharyngeal-nerve/) - Carotid sheath: the [common carotid artery](https://durgical.com/en/anatomy/common-carotid-artery/) medially, the internal jugular vein laterally and the vagus nerve behind and between them; the sympathetic trunk lies behind the sheath, not in it - The pulse is felt one side at a time: pressing both can cut blood flow to the brain, and pressure on the sinus can slow the heart and drop the blood pressure - It can be pressed back against the carotid tubercle (anterior tubercle of C6), the level where the omohyoid crosses the sheath ## Key facts **Origin** Right: [brachiocephalic trunk](https://durgical.com/en/anatomy/brachiocephalic-trunk/); left: aortic arch **Branches** No branches; divides at the upper border of the thyroid cartilage (C3–C4) **Supplies** [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) ## Relations **Course** The right one begins behind the right sternoclavicular joint; the left one starts in the thorax from the [aortic arch](https://durgical.com/en/anatomy/aortic-arch/) and enters the neck behind the left sternoclavicular joint. Both climb in the [carotid sheath](https://durgical.com/en/anatomy/carotid-sheath/) beside the [trachea](https://durgical.com/en/anatomy/trachea/) and larynx to the upper border of the [thyroid cartilage](https://durgical.com/en/anatomy/thyroid-cartilage/) **Lateral** [Internal jugular vein](https://durgical.com/en/anatomy/internal-jugular-vein/), in the same sheath, with the [vagus nerve](https://durgical.com/en/anatomy/vagus-nerve/) in the groove behind and between them **Medial** Trachea and oesophagus below, larynx and [pharynx](https://durgical.com/en/anatomy/pharynx/) above; the lobe of the [thyroid gland](https://durgical.com/en/anatomy/thyroid-gland/) overlaps it in front, and the [recurrent laryngeal nerve](https://durgical.com/en/anatomy/recurrent-laryngeal-nerve/) runs in the groove between trachea and oesophagus **Behind** [Sympathetic trunk](https://durgical.com/en/anatomy/sympathetic-trunk/), [longus colli](https://durgical.com/en/anatomy/longus-colli-muscle/) and [longus capitis](https://durgical.com/en/anatomy/longus-capitis-muscle/), and the transverse processes of the cervical vertebrae; at about C6 the [inferior thyroid artery](https://durgical.com/en/anatomy/inferior-thyroid-artery/) passes medially behind the sheath, near the middle cervical ganglion, and below C6 the [vertebral artery](https://durgical.com/en/anatomy/vertebral-artery/) lies deeper; low on the left, the [thoracic duct](https://durgical.com/en/anatomy/thoracic-duct/) arches behind the sheath **Superficial** [Sternocleidomastoid](https://durgical.com/en/anatomy/sternocleidomastoid-muscle/), which overlaps it, and the infrahyoid muscles ([sternohyoid](https://durgical.com/en/anatomy/sternohyoid-muscle/), [sternothyroid](https://durgical.com/en/anatomy/sternothyroid-muscle/), and the [omohyoid](https://durgical.com/en/anatomy/omohyoid-muscle/) crossing at about C6); the [ansa cervicalis](https://durgical.com/en/anatomy/ansa-cervicalis/) lies on the front of the sheath ## How to find it With the person seated and the head turned slightly toward the side examined, the pulse is felt in the carotid triangle: medial to the front edge of the sternocleidomastoid at the level of the thyroid cartilage, pressing gently backwards toward the transverse processes. One side is examined at a time, and low in the neck rather than at the bifurcation, to avoid pressing on the carotid sinus. ## Examination - Pulse character: a slow-rising, small-volume pulse suggests aortic stenosis; a bounding, collapsing pulse suggests aortic regurgitation - Auscultation over the bifurcation: a bruit can mean stenosis, but its absence does not exclude a tight narrowing, and a heart murmur can radiate here - Carotid sinus massage (by clinicians, with ECG monitoring, one side at a time): it can slow some supraventricular tachycardias; a long pause or a marked fall in blood pressure suggests carotid sinus hypersensitivity ## On imaging Duplex ultrasound shows the common carotid, the carotid bulb and both branches, with wall thickness and plaque; CT or MR angiography maps the whole course from the aortic arch to the skull base. ## Clinical notes - Carotid sinus hypersensitivity: in older adults, turning the head, a tight collar or shaving can trigger a reflex slowing of the heart, a fall in blood pressure and fainting - Central venous access: the internal jugular vein lies lateral to the palpable carotid; ultrasound guidance reduces accidental puncture of the artery - A carotid body tumour (paraganglioma) at the bifurcation splays the internal and external carotid arteries apart (lyre sign) and moves side to side but not up and down - Penetrating neck injuries are described by zones; zone II (cricoid cartilage to angle of the mandible) holds most of the common carotid and is the easiest to explore - The omohyoid crossing divides it: below, it lies deep under the sternocleidomastoid and infrahyoid muscles; above, in the carotid triangle, it is superficial and is where it is usually exposed or tied ## Anatomical variants - A shared origin of the brachiocephalic trunk and the left common carotid artery (the so-called bovine arch) is the commonest aortic arch variant - The bifurcation level varies: it can lie as high as the hyoid bone or below the thyroid cartilage, which matters for surgery and ultrasound ## Development The common carotid and the first part of the internal carotid come from the third pharyngeal arch arteries. ## Memory aid Carotid sheath contents: "I See 10 CC's in the IV" (Internal Carotid above, cranial nerve 10 = vagus, Common Carotid, Internal jugular Vein). ## Related conditions - [Carotid artery stenosis](https://durgical.com/en/conditions/carotid-artery-stenosis/) - [Penetrating trauma (stab and gunshot wounds)](https://durgical.com/en/conditions/penetrating-trauma/) ## Test yourself Think of the answer, then tap the question to see it. ## What are the origins of the right and left common carotid arteries? Right: the brachiocephalic trunk, behind the right sternoclavicular joint. Left: the aortic arch, in the thorax. ## How are the contents of the carotid sheath arranged around the common carotid artery? Common carotid medially, internal jugular vein laterally, vagus nerve behind and between them; the sympathetic trunk is behind the sheath, not in it. ## At what level does the common carotid artery divide? At the upper border of the thyroid cartilage (C3–C4); it has no branches before that. ## Why is the carotid pulse felt one side at a time and low in the neck? Pressing both can cut blood flow to the brain, and pressure on the carotid sinus can slow the heart and drop the blood pressure. ## Against which bony landmark can the common carotid artery be pressed? The carotid tubercle (anterior tubercle of C6), where the omohyoid crosses the carotid sheath. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/anatomy/right-common-carotid-artery/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** carotis communis dextra TA2 4181 **Official Spanish (DeCS)** Arteria Carótida Común DeCS D017536 **English (TA2)** Right common carotid artery **Also called** Carótida primitiva ## Related - [Carotid sheath](https://durgical.com/en/anatomy/carotid-sheath/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=30798); [Anatomy, Head and Neck, Anterior: Common Carotid Arteries](https://www.ncbi.nlm.nih.gov/books/NBK546613/); [Anatomy, Head and Neck: Carotid Arteries](https://www.ncbi.nlm.nih.gov/books/NBK545238/); Tratado de anatomía humana (9.ª ed.), tomo II, Libro IV, sección 2 Arterias, caps. I-III (sistema de la arteria pulmonar; aorta y ramas del cayado hasta la carótida interna). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/right-common-carotid-artery/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/right-common-carotid-artery/