Carotid sheath sternum. The four major structures contained in the carotid sheath are: The carotid artery lies medial to the internal jugular vein, and the vagus nerve is situated posteriorly between the two vessels. In the upper part, the carotid sheath also contains the glossopharyngeal nerve (IX), the accessory nerve (XI), and the hypoglossal nerve (XII), which pierce the fascia of the carotid sheath. The ansa cervicalis is embedded in the anterior wall of sheath. It is formed by "descendens hypoglossi" (C1) and "descendens cervicalis" (C2-C3). The three major fascial layers in the neck contribute to the carotid sheath: the investing fascia,
Carotid sinus therapeutic examination tool. In studies of thousands of uses on elderly patients, there were no complications of death or bradycardic events requiring treatment or resuscitation, even though this age group is more likely to be symptomatic from carotid sinus stimulation. A carotid massage can also possibly dislodge a thrombus, or some plaque. This could lead to any number of life-threatening effects, including stroke. Stimulation of the carotid sinus via a slap or a strike, to induce (usually temporary, but sometimes lethal) loss of consciousness is an effective self-defense technique, and is often taught in martial arts such as karate and