If bruit is heard, note whether it is systolic or continuous.

Examine in the upright and supine position.

Auscultate over the aortic and subclavian area to determine whether the bruit is transmitted or originates in the carotid artery.

• Carotid bruit: (Carotid artery stenosis)
• Transmitted murmur: (Aortic stenosis, Subclavian artery stenosis, Arch branch stenosis)
• Venous hum: Continuous thrill and murmur at the root of the neck in sitting position disappearing in supine position and compression. Hyper dynamic state
  • Anemia
  • Thyrotoxicosis
  • Pregnancy