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However, to exactly identify the SVC-RA junction is difficult with low-quality portable chest radiographs in critically ill patients.119-211 Previous investigators have recommended the use of various radiographic landmarks for identifying the cephalad and caudal boundaries of the SVC relevant to CVC positioning.
[12] stated that the use of these structures as radiographic landmarks can lead to substantial errors in CVC tip positioning due to the effect of parallax as these skeletal structures are not located in the same anatomic plane as the SVC.
Exercise eight covers film mounting and radiographic landmarks, an effective application of basic head and neck anatomy.

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