Central venous access: anatomy and ultrasound
- By: Alexander Davey, Christopher Boyd
As a simulated patient in a recent course on ultrasound guided central venous access I learnt the basics of gross and surface anatomy of the venous system; the use of ultrasound imaging to view blood vessels; and the use of ultrasound guidance for venepuncture and insertion of central venous and peripherally inserted central catheters. This quiz covers gross, surface, and ultrasound anatomy of the internal jugular vein with regard to central venous access.
Consider the clinical scenario of a patient who has recurrent deep vein thrombosis and cannot receive oral anticoagulants. The patient will need central venous access to place a filter in the inferior vena cava to prevent pulmonary embolism.
With the landmark method, however, structures that accompany the vein or lie close to it, such as arteries, nerves, and other organs are at risk of damage. Also the vein may not lie in the expected region, be thrombosed,