Jugular notch

The jugular notch, also known as the suprasternal notch or the sternal notch, is a visible indentation located at the base of the neck, just above the top of the sternum (breastbone). It marks the superior border of the manubrium, which is the uppermost part of the sternum. It serves as a key anatomic landmark and has both structural and functional significance in the body.^[2]

Structure

The jugular notch is located at the midline of the neck, between the clavicles (collarbones) and directly above the sternum. ^[4]It is a shallow depression that is easily visible and palpable (able to be touched or felt). It is formed by the superior border of the manubrium, which is the uppermost part of the sternum. The manubrium is a flat, triangular-shaped bone that articulates with the clavicles at the sternoclavicular joints and with the body of the sternum at the sternal angle.^[6] The jugular notch is bordered by a pair of suprasternal ligaments, which are fibrous bands that connect the manubrium to the clavicles. These ligaments provide stability to the jugular notch and help maintain the position of the manubrium. It is also surrounded by a number of important structures in the neck, including the thyroid cartilage, the larynx (voice box), and the trachea (windpipe).^[8]

Function

The jugular notch serves as an important anatomic landmark in the body and has several functional roles. It is used as a reference point for locating other structures in the neck and chest, such as the thyroid gland, the larynx, and the trachea. The jugular notch is also used to assess the pulse and blood pressure in the neck.^[1] To check the pulse at the jugular notch, a healthcare provider will place their fingers over the notch and feel for the beating of the carotid artery, which is a major blood vessel in the neck that carries oxygenated blood from the heart to the head and neck.^[3] To check the blood pressure at the jugular notch, a healthcare provider will use a sphygmomanometer, which is a device that measures blood pressure by inflating a cuff around the upper arm and measuring the pressure at which the blood flow through the artery is partially blocked.

Clinical Significance

Jugular notch is used as a reference point for various medical procedures and exams, such as thyroid exams, laryngoscopy (examination of the larynx), and tracheal intubation (insertion of a tube into the trachea to help with breathing). In addition, the jugular notch is used to assess the pulse and blood pressure, as mentioned above. Abnormalities in the pulse or blood pressure at the jugular notch can indicate various health conditions, such as hypertension (high blood pressure), hypotension (low blood pressure), and cardiovascular disease.^[5] It is also used to measure the height of the jugular venous pressure (JVP), which is the pressure of the blood in the jugular vein. The JVP is used to assess the status of the heart and the circulatory system and can help diagnose conditions such as congestive heart failure and fluid overload. To measure the JVP, a healthcare provider will place a finger over the jugular notch and observe the height of the vein as it fills with blood.^[7]