3.11 Internal Jugular Vein

Question 1

Anatomy of IJV

Answer 1

Formed by unification
Sigmoid sinus
Inferior petrosal sinus

Exits skull
Jugular foramen
Runs down neck within carotid sheath

Together with Internal carotid A.
+ Vagus N.

RLN
medial to sheath

Question 2

A+V relationship varies

Answer 2

Commonest
Vein posterior @ skull base

Lateral in mid neck

anterolateral in lower half neck

Question 3

IJV - Location

Termination

Answer 3

Upper half vessel
superficial
lower half deep to SCM

Terminates
joining w/ Subclavian V.
Behind manubrium sternum
-> brachiocephalic

Question 4

Outline relevance of Vein

Theatre

Answer 4

1. Central access
   easy to ID + Access
2. Placement central line - CVP
3. Multi-lumen catheter - infusions
   vaso irritant - K or Amio
4. Large bore line
   PA sheath - rapid fluid resus
5. Intro Pacing wires
6. Cardic cath study

Question 5

Relevance IJV

ICU

Answer 5

1. Inotropes
2. Flow monitoring
   pulse contour contin cardiac output
3. TPN
4. Jug venous bulb sat measure
5. Sedation
6. RRT
7. ECMO

Question 6

Complications Cannulation

Needle

Answer 6

1. PTX / HaemoTx
   - intrapleural placement
2. Carotid artery puncture
   Intimal dissection
   Flow obstruction
   Emboli
3. Local haematoma neck
4. Nerve injury
   Vagus / RLN
5. Thyroid punture
6. Thoracic duct puncture
   left sided low approach

Question 7

Line

Answer 7

1. Arrythmia on insertion
2. Air embolism
3. Infection
4. Vessel Stenosis
5. Prox flow obstruction
6. Tamponade
   vessel wall erosion from tip line
7. Subclavian Vein cannulation

US guidance recommended reduce incidence