PhysioguidebydivyaA

Common Carotid Artery Beginning, course and termination It is a branch of brachiocephalic trunk on right side and a direct branch of arch on the left side. The artery runs upwards along medial border of sternocleidomastoid muscle enclosed within the carotid sheath. The artery ends by dividing into internal carotid and external carotid at the upper border of thyroid cartilage Area of distribution :- This artery has only two terminal branches. These are internal carotid and external carotid. 

  Tracheostomy: It is an operation in which the trachea is opened and a tube inserted into it to facilitate breathing.  It is most commonly done in the retro thyroid region after retracting the isthmus of the the thyroid gland.  A supra thyroid tracheostomy is liable to stricture, and an infra thyroid one is difficult due to the depth of the trachea and is also dangerous because numerous vessels lie anterior to the trachea here 

  Lumbar puncture in adult : Patient is lying on side with maximally flexed spine. A line is taken between highest points of iliac spine at L4 level. Skin locally anaesthetized, and lumbar puncture needle with trocar inserted carefully between L3 and L4 spines.  Needle courses through skin fat, supraspinous and interspinous ligaments, ligamentum flava, epidural space, dura, arachnoid, subarachnoid space to release CSF