Head and neck veins

The internal jugular vein (v. jugularis interna) is a large vessel that, like the external jugular vein, collects blood from the head and neck, from areas corresponding to the branching of the external and internal carotid and vertebral arteries.

The internal jugular vein is a direct continuation of the sigmoid sinus of the dura mater of the brain. It begins at the level of the jugular foramen, below which there is a small expansion - the superior bulb of the internal jugular vein (bulbus superior venae jugularis). At first, the vein goes behind the internal carotid artery, then laterally. Even lower, the vein is located behind the common carotid artery in a common connective tissue (fascial) sheath with it and the vagus nerve. Above the confluence with the subclavian vein, the internal jugular vein has a second expansion - the inferior bulb of the internal jugular vein (bulbus inferior venae jigularis), and above and below the bulb - one valve.

Through the sigmoid sinus, from which the internal jugular vein originates, venous blood flows out of the sinus system of the dura mater of the brain. The superficial and deep veins of the brain - diploic, as well as the ophthalmic veins and veins of the labyrinthine, which can be considered as intracranial tributaries of the internal jugular vein, flow into these sinuses.

Diploic veins (w. diploicae) are valveless, and carry blood away from the bones of the skull. These thin-walled, relatively wide veins originate in the spongy substance of the bones of the cranial vault (previously they were called veins of the spongy substance). In the cranial cavity, these veins communicate with the meningeal veins and sinuses of the dura mater of the brain, and externally, through emissary veins, with the veins of the outer coverings of the head. The largest diploic veins are the frontal diploic vein (v. diploica frontalis), which flows into the superior sagittal sinus, the anterior temporal diploic vein (v. diploica temporalis anterior) - into the sphenoparietal sinus, the posterior temporal diploic vein (v. diploica temporalis posterior) - into the mammillary emissary vein and the occipital diploic vein (v. diploica occipitalis) - into the transverse sinus or into the occipital emissary vein.

The sinuses of the dura mater of the brain are connected with the veins located in the outer coverings of the head by means of emissary veins. Emissary veins (w. emissariae) are located in small bone canals, through which blood flows from the sinuses outward, i.e. to the veins collecting blood from the outer coverings of the head. The parietal emissary vein (v. emissaria parietalis) is distinguished, which passes through the parietal opening of the bone of the same name and connects the superior sagittal sinus with the external veins of the head. The mastoid emissary vein (v. emissaria mastoidea) is located in the canal of the mastoid process of the temporal bone. The condylar emissary vein (v. emissaria condylaris) penetrates through the condylar canal of the occipital bone. The parietal and mammillary emissary veins connect the sigmoid sinus with the tributaries of the occipital vein, and the condylar vein also connects with the veins of the external vertebral plexus.

The superior and inferior ophthalmic veins (vv. ophthalmicae superior et inferior) are valveless. The first of them, the larger one, receives the veins of the nose and forehead, the upper eyelid, the ethmoid bone, the lacrimal gland, the membranes of the eyeball and most of its muscles. The superior ophthalmic vein anastomoses with the facial vein (v. facialis) in the region of the medial angle of the eye. The inferior ophthalmic vein is formed from the veins of the lower eyelid, adjacent muscles of the eye, lies on the lower wall of the orbit under the optic nerve and flows into the superior ophthalmic vein, which exits the orbit through the superior orbital fissure and flows into the cavernous sinus.

The veins of the labyrinth (vv. labyrinthi) exit through the internal auditory canal and flow into the nearby inferior petrosal sinus.

Extracranial tributaries of the internal jugular vein:

1. The pharyngeal veins (vv. pharyngeales) are valveless and carry blood from the pharyngeal plexus (plexus pharyngeus), which is located on the back of the pharynx. This plexus receives venous blood from the pharynx, auditory tube, soft palate, and occipital part of the dura mater of the brain;
2. the lingual vein (v. lingualis), which is formed by the dorsal veins of the tongue (vv. dorsales linguae), the deep vein of the tongue (v. profunda linguae) and the sublingual vein (v. sublingualis);
3. the superior thyroid vein (v. thyroidea superior) sometimes flows into the facial vein, is adjacent to the artery of the same name, and has valves. The superior laryngeal vein (v. laryngea superior) and the sternocleidomastoid vein (v. sternocleidomastoidea) flow into the superior thyroid vein. In some cases, one of the thyroid veins runs laterally to the internal jugular vein and flows into it independently as the middle thyroid vein (v. thyroidea media);
4. The facial vein (v. facialis) flows into the internal jugular vein at the level of the hyoid bone. Smaller veins that form in the soft tissues of the face flow into it: the angular vein (v. angularis), the supraorbital vein (v. supraorbital), the veins of the upper and lower eyelids (vv. palpebrales superioris et inferioris), the external nasal veins (vv. nasales externae), the superior and inferior labial veins (vv. labiales superior et iferiores), the external palatine vein (v. palatina externa), the submental vein (v. submentalis), the veins of the parotid gland (vv. parotidei), and the deep facial vein (v. profunda faciei);
5. The retromandibular vein (v. retromandibularis) is a fairly large vessel. It runs in front of the auricle, passes through the parotid gland behind the branch of the lower jaw (outward from the external carotid artery), and flows into the internal jugular vein. The retromandibular vein receives blood from the anterior auricular veins (vv. auriculares anteriores), superficial, middle, and deep temporal veins (vv. temporales superficiales, media et profundae), veins of the temporomandibular joint (vv. articulares temporo-mandibulares), pterygoid plexus (plexus pterygoides), into which the middle meningeal veins (w. meningeae mediae), veins of the parotid gland (vv. parotideae), and veins of the middle ear (vv. tympanicae) flow.

The external jugular vein (v. jugularis externa) is formed at the anterior edge of the sternocleidomastoid muscle by the fusion of its two tributaries - the anterior, which is an anastomosis with the retromandibular vein, which flows into the internal jugular vein, and the posterior, formed by the confluence of the occipital and posterior auricular veins. The external jugular vein runs down the anterior surface of the sternocleidomastoid muscle to the clavicle, pierces the pretracheal plate of the cervical fascia and flows into the angle of confluence of the subclavian and internal jugular veins or by a common trunk with the latter into the subclavian vein. At the level of its mouth and in the middle of the neck, this vein has two paired valves. The suprascapular vein (v. suprascapularis) and the transverse veins of the neck (vv. transversae colli, s. cervicis) flow into the external jugular vein.

The anterior jugular vein (v. jugularis anterior) is formed from small veins of the submental region, flows down the anterior region of the neck, pierces the pretracheal plate of the cervical fascia, and penetrates the interfascial suprasternal space. In this space, the left and right anterior jugular veins are connected to each other by a transverse anastomosis, forming the jugular venous arch (arcus venosus jugularis). This arch flows into the external jugular vein of the corresponding side on the right and left.

The subclavian vein (v. subclavia) is an unpaired trunk, is a continuation of the axillary vein, passes in front of the anterior scalene muscle from the lateral edge of the 1st rib to the sternoclavicular joint, behind which it joins the internal jugular vein. At the beginning and at the end, the subclavian vein has valves, the vein does not have constant tributaries. Most often, the thoracic veins and the dorsal scapular vein flow into the subclavian vein.