- Carotid sinus
Infobox Anatomy
Name = PAGENAME
Latin = sinus caroticus
GraySubject =
GrayPage =
Caption = Arteries of the neck. The carotid sinus is at the origin of theinternal carotid artery .
Caption2 =
Precursor =
System =
Artery =
Vein =
Nerve =branch of glossopharyngeal nerve to carotid sinus
Lymph =
MeshName = Carotid+Sinus
MeshNumber = A07.231.114.186.456
DorlandsPre = s_12
DorlandsSuf = 12738619
Inhuman anatomy , the carotid sinus is a localized dilation of theinternal carotid artery at its origin, thecommon carotid artery bifurcation .Functions
It contains numerous
baroreceptors , which function as a "sampling area" for many homeostatic mechanisms for maintainingblood pressure . The carotid sinus baroreceptors are innervated by the sinus nerve of Hering, which is a branch of IX (glossopharyngeal nerve ). The glossopharyngeal nerve synapses in the nucleus tractus solitarius (NTS) located in the medulla of the brainstem. The NTS modulates the activity of sympathetic and parasympathetic (vagal) neurons in the medulla. These neurons then regulate the autonomic control of the heart and blood vessels. The aortic arch baroreceptors are innervated by the aortic nerve (Nerve of Cyon), which combines with X (vagus nerve ) and travels to the NTS.Disease of the carotid sinus
The carotid sinus often has
atherosclerotic plaque s because of disturbedhemodynamics (lowwall shear stress , flow reversal/recirculation). [Glagov S, Zarins C, Giddens DP, Ku DN. Hemodynamics and atherosclerosis. Insights and perspectives gained from studies of human arteries. biod degradable Arch Pathol Lab Med. 1988 Oct;112(10):1018-31. PMID 3052352] Since these plaques, if large and unstable, predispose to ischemic strokes andtransient ischemic attack s, carotid endarterectomies are frequently done forprophylaxis .The carotid sinus can be oversensitive to manual stimulation, a condition known as carotid sinus hypersensitivity, carotid sinus syndrome or carotid sinus syncope, in which manual stimulation causes large changes in
heart rate and/orblood pressure .Carotid sinus massage
Massage of the carotid sinus, carotid sinus massage is used to diagnose carotid sinus syncope and is sometimes useful for differentiatingsupraventricular tachycardia (SVT) fromventricular tachycardia . It, like thevalsalva maneuver , is a therapy for SVT. [Lim SH, Anantharaman V, Teo WS, Goh PP, Tan AT. Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage. Ann Emerg Med. 1998 Jan;31(1):30-5. PMID 9437338] However, it is less effective than pharmaceutical management of SVT withverapamil oradenosine . [Ballo P, Bernabo D, Faraguti SA. Heart rate is a predictor of success in the treatment of adults with symptomatic paroxysmal supraventricular tachycardia. Eur Heart J. 2004 Aug;25(15):1310-7. PMID 15288158]Carotid sinus reflex death
Carotid sinus reflex death is a disputed mechanism of
death in which manual stimulation of the carotid sinus allegedly causes strongvagus nerve impulses leading to terminalcardiac arrest . Carotid sinus reflex death has been pointed out as a possible cause of death in cases of strangulation andhanging , but such deductions remain controversial. Studies have however suggested that the carotid sinus reflex can be a contributing factor in other mechanisms of death by reducingblood pressure andheart rate , especially in theelderly or in people suffering from carotid sinus hypersensitivity. A carotid massage can also possibly dislodge a thrombus, or some plaque. This could lead to any number of life threatening effects, including, but not limited topulmonary embolism ,heart attack , andstroke . All of these are potentially lethal. [Passig, K. [http://www.datenschlag.org/howto/atem/english/csr.html Carotid sinus reflex death - a theory and its history.] URL last accessedFebruary 28 2006 .]See also
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Carotid body
*Baroreflex References
External links
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* (NormanAnatomyFig|livingneck)
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