During placement of a central venous catheter via the internal jugular vein, the needle is directed at which landmark using the anterior approach?

• A Medial border of the sternocleidomastoid muscle, directed toward the suprasternal notch
• B Apex of the triangle formed by the two heads of sternocleidomastoid and clavicle, directed toward the ipsilateral nipple ✓
• C Posterior to the sternocleidomastoid at the Erb's point level, directed medially
• D Above the clavicle medial to the subclavian artery, directed posteriorly

Explanation

The central (high) approach to the internal jugular vein targets the apex of the triangle formed by the sternal and clavicular heads of the sternocleidomastoid muscle and the clavicle. The needle is inserted at this triangle apex and directed toward the ipsilateral nipple at approximately 45 degrees to the skin, aiming to enter the IJV just lateral to the carotid artery. The IJV lies lateral to the common carotid artery throughout the neck. The posterior approach enters behind the posterior border of SCM at the junction of its middle and lower thirds.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.