Lea Alhilali, MD
Lea Alhilali, MD

@teachplaygrub

10 Tweets 61 reads Oct 17, 2023
1/Time to go with the flow!
Hoping no one notices you don’t know the anatomy of internal carotid (ICA)?
Do you say “carotid siphon” & hope no one asks for more detail?
Here’s a thread to help you siphon off some information about ICA anatomy!
2/ICA is like a staircase—winding up through important anatomic regions like a staircase winding up to each floor Lobby is the neck.
First floor is skullbase/carotid canal. Next it stops at the cavernous sinus, before finally reaching the rooftop balcony of the intradural space.
3/ICA is divided into numbered segments based on landmarks that denote transitions on its way up the floors.
C1 is in the lobby or neck.
You can remember this b/c the number 1 looks elongated & straight like a neck.
4/C2 is the petrous or horizontal segment. This is where the ICA gets to the next floor, the skullbase.
I remember this b/c the ICA makes a curve forward here, like a swan’s neck--and number 2 has a forward, swan like curve that looks just like the curve of the petrous segment.
5/C3 is the lacerum segment—from above foramen lacerum to petrolingual ligament.
It’s easy to remember b/c lacerum comes from the Latin word for torn (b/c foramen lacerum is irregular like a tear or laceration)
Number 3 zig zags like a laceration or torn edge, so C3 = lacerum
6/C4 is the cavernous segment
Cavernous segment has the anterior genu. Here, the ICA makes a curve back, so it looks like a knee (genu is Latin for knee)
You can remember C4 is cavernous b/c the number 4 has a curve back like the anterior genu of the cavernous ICA, like a knee.
7/C5 is the clinoid segment—at the ant. clinoid process
Clinoid process gets its name from its sloped shape. It’s from the same Latin root as recline (CLIN)
And we all take a break (take five some might say😉) by sitting back or reclining.
Take FIVE & reCLINE. C5 is CLINoid.
8/C6 is the ophthalmic segment.
I remember this b/c the circle of the number 6 looks like eyes and its curve looks like eyebrows.
So, 6 is an eye = ophthalmic
9/C7 is the communicating or terminal segment.
You can remember this bc the number 7 looks like the ICA ending & giving off the PCOMM.
The number 7 has the shape of a turn off right before the road ends—& the ICA gives off the PCOMM in its C7 segment right before terminating.
10/Now you can remember all the segments of the ICA!
Hopefully this will help you to be precise in your localization and siphon away the term “carotid siphon”!!

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