Neck Appreciation Post Part I – The Carotids

There’s something I’ve developed in my time of assisting with post mortem examinations that I’ve never really spoke about until now. I think the neck is just really cool. On the outside you might think it’s just there to hold your head up but inside it’s a wonder of everything contained in this small space making sure you breath and eat amongst many many other things.

Of course I am including a dorky selfie of some type

For my assessment at the start of this week, in the build up before the big day, I became slightly obsessed with one thing. The carotid arteries. Each time I eviscerated I would hunt them down, look forward to finding them and looking at the little structures. I then thought, wouldn’t it be an interesting topic to bring to write about!

The carotid arteries, or common carotid arteries, are found leading from the aorta as it arches away from the heart and before it descends along the spine. There is a left and a right, which then further split each at a bifurcation into the internal and external. They are responsible for the blood supply to the head and neck. The internal carotids leading to the brain and the external leading to the face.

The ascending aorta rises from the heart, arches and then descends through the body

The common carotids are important at post mortem as they can indicate a problem with the blood supply to the brain if found to be unhealthy and atherosclerotic or in other words to have a build up of plaque. They can be examined either in situ in the neck or removed to be examined externally, but they will always be examined to a point above the bifurcation in order to identify the internal carotid. As I found out on Monday, a problem with the blood flow to the brain can lead to strokes.

The way to tell the internal and externals apart is in size, the internal is larger than the external, and also by looking at the branches coming off. The external has branches while the internal does not.

The other main significance of these arteries is their use in embalming someone after post mortem, the embalmer needs to locate them in order to effectively embalm the face and head. During embalming a trocar, or needle, is placed into these arteries to pump the embalming fluid through. An embalmers life is made easier if the arteries are not removed above the bifurcation (sorry embalmers!) and if there is a clean cut to the artery (which there should be). I’ve seen this process once and it was fascinating.

An example of an embalming trocar

The carotids are just one of many neck structures I will be covering so watch this space! If I’ve made any errors or mistakes in this please do comment below, I’m learning too and it’s good to share and learn together. You can add any random facts you know too about these wonderful little things we all have!

MG x

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