CLINICAL MEDICINE

Detailed explanation-1: -With light pressure, place the stethoscope’s bell over the right carotid artery in the middle third of the neck, just medial to the sternomastoid muscle, but closer to the muscle than the trachea. This location is anatomically determined, see Figure 4.2. The bell should be used because vascular sounds are low-pitched.

Detailed explanation-2: -To check for a carotid bruit, your provider gently presses the end of a stethoscope against several different areas in your neck. You may need to inhale and then hold your breath for a few seconds as your provider listens to your blood flow through the stethoscope.

Detailed explanation-3: -Use either the bell or the diaphragm when listening for the carotid bruit, at a point just lateral to the Adam’s apple. Listen for the murmur of aortic stenosis at the second right intercostal space (2RICS). An early systolic bruit is associated with a 50% decrease in carotid artery luminal diameter.

Detailed explanation-4: -The bell of the stethoscope is best for picking up bruits. The diaphragm is more attuned to relatively high-pitched sounds; the bell is more sensitive to low-pitched sounds like bruits. When using the bell, apply it lightly over the area of the body you’re listening to.