Airway management: positioning for internal jugular cannulation: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Airway management: positioning for internal jugular cannulation

Sample item

Before right internal jugular vein cannulation in an adult, the patient is placed head down by about 15 degrees. What is the main benefit?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. It distends the vein and lowers the risk of air embolism

The head-down position increases venous filling and keeps central venous pressure above atmospheric, which enlarges the vein and reduces the chance of air entrainment. It is avoided in patients with raised intracranial pressure or severe respiratory compromise.

Option by option

  • A. It reduces carotid artery pulsation

    Position does not reduce arterial pulsation.

  • B. It raises the diaphragm to avoid pneumothorax

    Head-down tilt does not protect the pleura.

  • C. It lowers the central venous pressure

    Head-down tilt raises the venous pressure.

  • D. It distends the vein and lowers the risk of air embolism (correct)

    Correct. Venous distension makes cannulation easier and lowers the air embolism risk.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, It distends the vein and lowers the risk of air embolism. The head-down position increases venous filling and keeps central venous pressure above atmospheric, which enlarges the vein and reduces the chance of air entrainment.

Why is "It reduces carotid artery pulsation" not the answer?

Position does not reduce arterial pulsation.

Why is "It raises the diaphragm to avoid pneumothorax" not the answer?

Head-down tilt does not protect the pleura.

Why is "It lowers the central venous pressure" not the answer?

Head-down tilt raises the venous pressure.

What concept does this question test?

It tests Airway management: positioning for internal jugular cannulation in Anaesthesia. It is avoided in patients with raised intracranial pressure or severe respiratory compromise.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Airway management: positioning for internal jugular cannulation?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.