Outline the anatomy of the subclavian vein relevant to central venous line insertion.

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College Answer

Answers to anatomy questions can be generally structured by considered the origin and 
ending of the structure, the surface landmarks and the relations (medial / lateral / anterior / 
posterior) and this would have worked well in this question. It was expected candidates could 
detail course (from origin to end) and relations of subclavian vein. This could then be used to 
highlight how these features may be relevant to central venous line insertion (proximity of 
subclavian artery or pleura creating the possibility of inadverant arterial puncture or 
pneumothorax. Many candidates failed to mention drainage of external jugular vein and 
thoracic duct and right lymphatic ducts into the subclavian veins. Candidates should ensure 
diagrams are accurate and well labelled and they use appropriate anatomical terminology 
rather than vague terms such as “in front”. Care should be taken ensuring accuracy (e.g. some 
mentioned dome of diaphragm instead of pleura or IVC instead of SVC).