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Groshongs may be left in place for extended periods and are used when long-term intravenous therapy is needed, such as for chemotherapy.Similar to the Hickman line, the tip of the catheter is in the superior vena cava, and the catheter is tunneled under the skin to an incision on the chest wall, where the distal end of the catheter exits the body.
The exit area is where the lumen (single, double or multiple) comes out of the thoracic wall. The catheter at the entrance is then inserted back through the entrance site and advanced into the superior vena cava, preferably near the junction of it and the right atrium of the heart. The entrance incision is sutured.
Specific types of long-term central lines are the Hickman catheters, which require clamps to make sure that the valve is closed, and Groshong catheters, which have a valve that opens as fluid is withdrawn or infused and remains closed when not in use. Hickman lines also have a "cuff" under the skin, to prevent bacterial migration.
This must be done, because most catheters have a memory in the plastic, which will cause the catheter to try to resume its natural straight form. If the arterial limb is placed laterally, this will cause the arterial inlet to float up against the vein wall, or even up against the rim of the inlet of the atrium.
Catheter access, sometimes called a CVC (central venous catheter), consists of a plastic catheter with two lumens (or occasionally two separate catheters) which is inserted into a large vein (usually the vena cava, via the internal jugular vein or the femoral vein) to allow large flows of blood to be withdrawn from one lumen, to enter the dialysis circuit, and to be returned via the other lumen.
The side of the patients' chest the port is implanted in will usually be chosen to avoid damage to the port and the veins by the seat belt in case of accident when seated as the driver. Thus, there is a potential conflict by left- and right-hand traffic as the rule of the road. [clarification needed] [6] [7] Ports can be put in the upper chest ...
The cavoatrial junction (CAJ) is the point at which the superior vena cava meets and melds into the superior wall of the cardiac right atrium. Both the superior and inferior vena cavae enter the right atrium, but only the superior entry is called the cavoatrial junction .
The bony skeletal part of the thoracic wall is the rib cage, and the rest is made up of muscle, skin, and fasciae.. The chest wall has 10 layers, namely (from superficial to deep) skin (epidermis and dermis), superficial fascia, deep fascia and the invested extrinsic muscles (from the upper limbs), intrinsic muscles associated with the ribs (three layers of intercostal muscles), endothoracic ...