You are placing a central line in the internal jugular vein. Which vessel is indicated by the arrow?
Traditional anatomic techniques for central line access rely on the sternocleidomastoid as the principle landmark. This is readily identified under U/S as well. Two vessels deep to the sternocleidomastoid are identified at the lateral neck; the more lateral, larger, thin walled, superficial vessel which is compressible with light probe pressure represents the internal jugular vein. The medial, deeper, thicker walled vessel with a characteristic pulsation, and higher resistance to collapse represents the common carotid artery.