Answer to The Spatchcock Capon
Correct answer is E. The injury is representative of how the lung can be damaged while inserting a central line. The subclavian vein lines deep to the clavicle. If the catheter is inserted too deeply and the subclavian vein is penetrated, the parietal pleura of the lung can be breached. This is what is meant by “dropping a lung”. The patient will suffer a pneumothorax. Given the necessity for a central line in the first place (e.g., patient could be suffering from hypovolemic shock) inducing a pneumothorax may exacerbate the poor condition of the patient.
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Answer to this question is based on material presented in lectures 13 of the Thorax Lecture Series.
= Trachea
= Brachiocephalic a.
= Ascending aorta
= Right atrium
= Cupola of lung