Neck

Question 1

What important structures may be damaged during insertion of an intrajugular line?

Answer 1

Carotid artery.

Others: Phrenic nerve, Brachial plexus, Pulmonary dome, Thoracic duct, Trachea, Subclavian vessels.

Question 2

What clinical complications may occur from damage to structures during insertion of an intrajugular line?

Answer 2

Pneumothorax, Haemothorax, Air embolism, Bleeding, Haematoma, Airway obstruction, AV fistula, etc.

Question 3

What other complications can occur from central line insertion?

Answer 3

Misplacement, arrhythmias, infection, thrombosis, PE, cardiac tamponade, catheter loss, etc.

Question 4

Describe the course of the internal jugular vein.

Answer 4

Continuation of the sigmoid sinus.

Travels in the carotid sheath, deep to SCM.

Merges with the subclavian vein at the sternal end of the clavicle to form the brachiocephalic vein.

(4/5 bold to pass)