Why is right IJV larger than left?

[knock0ut]

Got this pimp question .... any help?

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[deleted407021]

I dropped a line in a patient with a markedly larger right IJV, though I wasn’t aware the variation existed. Looking online, it’s also more superficial and some people recommend it for all CVCs if possible

 

[mrbreakfast]

Shorter distance/straighter shot to the heart = less vascular resistance = preferential flow increasing caliber over lifetime would be my answer.

 

[nimbus]

Relation between bilateral differences in internal jugular vein caliber and flow patterns of dural venous sinuses

We measured the calibers of the left and right internal jugular veins (IJV) and sizes of the left and right transverse sinuses (TS) in 91 cadavers, compared them between the left and right sides, and also evaluated the drainage patterns of the superior ...

www.ncbi.nlm.nih.gov

 

[Medic741]

Straighter shot from RV leads to backpressure seen on JVP waves, do that over a lifetime and you got adaptation? Dunno

 

[shortcoatdream15]

Relation between bilateral differences in internal jugular vein caliber and flow patterns of dural venous sinuses

We measured the calibers of the left and right internal jugular veins (IJV) and sizes of the left and right transverse sinuses (TS) in 91 cadavers, compared them between the left and right sides, and also evaluated the drainage patterns of the superior ...

www.ncbi.nlm.nih.gov

Turns out that in most people, the right IJV is bigger. It also turns out that in most people the superior sagittal sinus drains blood into the right transverse sinus, which drains into the right sigmoid sinus, which drains into the right IJV. In contrast, the straight sinus (from the inferior sagittal sinus) drains into the left transverse/sigmoid/IJV. Superior sagittal drains more blood than inferior sagittal, so the right sided track has a larger caliber.

 

[Instatewaiter]

What a clinically insignificant pimp question... We're talking like 1-2 mm difference

 

[shortcoatdream15]

What a clinically insignificant pimp question... We're talking like 1-2 mm difference

It’s not all that clinically insignificant when evidence shows patients who receive central veins in the right IJV do better than the left

 

[nimbus]

It’s not all that clinically insignificant when evidence shows patients who receive central veins in the right IJV do better than the left

There is?

 

[nimbus]

What a clinically insignificant pimp question... We're talking like 1-2 mm difference

Not every pimp question needs to be clinically significant. Sometimes it’s fun to be an anatomy nerd.

 

[WheezyBaby]

It’s not all that clinically insignificant when evidence shows patients who receive central veins in the right IJV do better than the left

First I've heard this. Citation

 

[Instatewaiter]

It’s not all that clinically insignificant when evidence shows patients who receive central veins in the right IJV do better than the left

Citation needed.

Also, Still is clinically insignificant. The reason why people would have an easier time with the right IJ is it is a straight shot to the right atrium. It doesn't have to make the turn to the SVC. Not because it is a millimeter larger .

 

[nimbus]

Come on guys & girls, we should all be capable of performing a simple PubMed search on things like this as opposed to repeating the same request, which adds zero to the conversation.


A randomized study of left versus right internal jugular vein cannulation in adults.

I’m not sure that paper from 2000 is still relevant now that we use ultrasound for every central line. In my hands there’s no difference.