Duplex carotid vertebral jagular extracranial vessel Ultrasound assessment of the extracranial cerebral circulation Intima media complex IMC Superior thyroid branch Dicrotic notch internal carotid artery External carotid artery Common Carotid artery Atherosclerotic disease (stenosis) Non-Atherosclerotic disease fibromuscular dysplasia dissection vasospasm aneurysm pseudoaneurysm AVF arteritis carotid body tumour idiopathic carotidynia carotid stenosis signs Plaque surface Smooth Irregular ulcerated Intraplaque haemorrhage.Surface ulcerations Intraluminal thrombus formation vertebral artery Subclavian steal syndrome stenosis occlusion Dissection Kinking Short neck decrease size or contour of the neck Internalization of flow externalization of flow Color “Bleed” Disturbed Flow ALIASING INTERNAL JUGULAR VEINS Assymetry with ectatic diltation Jugular vein thrombosis Abnormal waveform Internal Jugular Vein Impingement Cardiac disease manifestation