A medical student learns to perform carotid sinus massage for termination of supraventricular tachycardia. The carotid sinus, containing the baroreceptors, is located at the bifurcation of the common carotid artery. This bifurcation is palpable at approximately which surface level in the neck?

• A Level of the hyoid bone
• B Level of the first tracheal ring
• C Level of the cricoid cartilage
• D Upper border of the thyroid cartilage ✓

Explanation

The common carotid artery bifurcates into internal and external carotid arteries at the level of the upper border of the thyroid cartilage, corresponding to the C4 vertebra. The dilated carotid sinus sits at this bifurcation, and firm pressure applied here triggers vagally mediated slowing of the heart rate. The hyoid bone at C3 lies above the bifurcation, and the cricoid cartilage at C6 lies well below it, so pressing at those levels will not engage the baroreceptor region.

Reference: Snell's Clinical Anatomy by Regions, 10th ed.

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Written and medically reviewed by the StethoPrep medical team.