Anesthesia Technologist Practice Exam

What is the most direct route to the heart when inserting a PAC percutaneously?

1. Left femoral vein

2. Right internal jugular

3. Right external jugular

4. Left subclavian vein

The correct answer is: Right internal jugular

The right internal jugular vein is considered the most direct route to the heart for the insertion of a pulmonary artery catheter (PAC) percutaneously. This is primarily due to its anatomical positioning and the pathway it provides to the superior vena cava, which leads directly to the right atrium of the heart. When accessing the central venous system, the right internal jugular vein is vital because it runs straight down to the right atrium, allowing for a more straightforward and shorter pathway compared to other veins. This route minimizes complications such as puncture of nearby structures and enhances the ease of catheter advancement, which is essential for accurate placement of the PAC. In addition, the right internal jugular vein often has a larger diameter, enabling easier cannulation and reducing the risk of complications that can arise with smaller veins. The use of ultrasound guidance further enhances the safety and accuracy of this approach, making the right internal jugular vein the preferred site for PAC insertion in most clinical scenarios.