Anaes SAQs · Applied anatomy
Neck anatomy and central venous access
Primary — carotid sheath (carotid artery medial, IJV lateral, vagus posterior); IJV deep to SCM, joins subclavian behind sternoclavicular joint; subclavian vein ANTERIOR to anterior scalene, artery behind, pleural dome above (pneumothorax); right side preferred (right brachiocephalic short and vertical, thoracic duct on LEFT); ultrasound distinguishes compressible vein from pulsatile carotid; complications = arterial puncture, pneumothorax, nerve injury, chylothorax (left), air embolism (negative-pressure vein, head-down prevents).
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Describe the contents of the carotid sheath and the anatomy relevant to internal-jugular and subclavian central venous access. Explain why the right internal jugular route is usually preferred, and list the four principal anatomical complications of central venous cannulation.
[7]References4ShowHide
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- [3]de Oliveira AJM, et al. Thoracic duct and brachial plexus anatomical relationship. Brain Spine, 2026.PMID 42292289
- [7]Arora P, et al. Internal jugular vein collapsibility index versus common carotid artery peak systolic velocity variation for prediction of post-spinal hypotension: A prospective observational study. J Anaesthesiol Clin Pharmacol, 2026.PMID 42088168
- [8]Rundblad LIS, et al. Fatal cerebral air embolism from central venous catheter mishandling. Case Rep Crit Care, 2026.PMID 42327854