Location of the jugular vein in humans. Internal jugular vein

Table of contents of the subject "Venas of a big circle of blood circulation. System of the superior vena cava.":

Internal jugular vein (v. jugularis interna). Tributaries of the internal jugular vein

V. jugularis interna, internal jugular vein, removes blood from the cranial cavity and neck organs; beginning at foramen jugulare, in which it forms an extension, bulbus superior venae jugularis internae, the vein descends, located laterally from a. carotis interna, and further down laterally from a. carotis communis. At the bottom end v. jugularis interna e before connecting it to v. subclavia a second thickening is formed - bulbus inferior v. jugularis internae; in the neck above this thickening in the vein there is one or two valves. On its way to the neck, the internal jugular vein is covered by m. sternocleidomastoideus and m. omohyoideus.

The tributaries of the internal jugular vein are divided into intracranial and extracranial. The first include the sinuses of the hard shell of the brain, sinus durae matris, and the veins of the brain flowing into them, v. cerebri veins of the cranial bones, vv. diploicae veins of the organ of hearing, vv. auditivae, orbital veins, v. ophtalmicae, and veins of the dura, vv. meningeae. The second includes the veins of the outer surface of the skull and the face, which flow into the internal jugular vein along its course.

Between the intracranial and extracranial veins there are connections through the so-called graduates, vv. emissariae passing through the corresponding holes in the cranial bones (foramen parietale, foramen mastoideum, canalis condylaris).

On the way v. jugularis interna receives the following tributaries:

1. V. facialis, facial vein. Its tributaries correspond to branches a. facialis and carry blood from various facial formations.

2. V. retromandibularis, retromaxillary vein, collects blood from the temporal region. Further down in v. retromandibularis, the trunk drains blood from the plexus pterygoideus (dense plexus between mm. pterygoidei), after which v. retromandibularis, passing through the thickness of the parotid gland together with the external carotid artery, below the angle of the lower jaw merges with v. facialis.

The shortest path connecting the facial vein with the pterygoid plexus is anatomical vein (v. anastomotica facialis), which is located at the level of the alveolar margin of the lower jaw.

By connecting the superficial and deep veins of the face, the anastomotic vein can become a pathway for the spread of an infectious agent and therefore is of practical importance.

There are also anastomoses of the facial vein with the ophthalmic veins.

Thus, there are anastomotic connections between the intracranial and extracranial veins, as well as between the deep and superficial veins of the face. As a result, a multi-tiered venous system of the head and a connection between its various divisions are formed.

3. Vv. pharyngeae, pharyngeal veins, forming a plexus (plexus pharygneus) on the pharynx, pour or directly into v. jugularis interna, or fall into v. facialis.

4. V. lingualis, lingual vein, accompanies the artery of the same name.

5. Vv. thyroideae superiores, superior thyroid veins, collect blood from the upper sections of the thyroid gland and larynx.

6. V. thyroidea media, middle thyroid vein, departs from the lateral edge of the thyroid gland and merges into v. jugularis interna. At the lower edge of the thyroid gland there is an unpaired venous plexus, plexus thyroideus impar, the outflow from which occurs through vv. thyroideae superiores V v. jugularis interna, as well as v. thyroideae interiores And v. thyroidea im a into the veins of the anterior mediastinum.

Instructional video on the anatomy of the superior vena cava and its tributaries

The jugular veins are several paired large vessels that are located on the neck. They carry the blood away from it towards the head. Let's take a closer look at these streams.

main branch

Each jugular vein (and there are three in total) belongs to the system of the upper hollow bed. The largest of them is the top one. This jugular vein carries blood to the cranial cavity. The vessel is a continuation of the sigmoid sinus of the dura mater. The superior bulb - the expansion of the jugular vein - is the site of the beginning of the vessel. It is located at the corresponding opening of the skull. From here the jugular vein goes to the sternoclavicular junction. In this case, the vessel is covered in front by the mastoid muscle passing in this zone. In the lower cervical regions, the vein is located in the connective tissue, common with the vagus nerve and carotid artery, the vagina. Behind the sternoclavicular joint, it merges with the subclavian. In this case, we mean the lower bulbous expansion, from which the brachiocephalic vein is formed.

outer channel

This jugular vein has a smaller diameter. It is located in the subcutaneous tissue. The external jugular vein on the neck runs along the anterior surface, deviating laterally in the lower sections. In other words, the vessel crosses the posterior edge in the sternocleidomastoid muscle approximately at the level of its middle. The vein is clearly contoured in the process of singing, coughing, screaming. It collects blood from superficial head, facial formations. In some cases, it is used for the introduction of drugs, catheterization. In its lower part, the vein flows into the subclavian, perforating its own fascia.

anterior branch

This vein is small. It is formed from the subcutaneous vessels of the chin. The vein passes down a short distance from the line of the middle of the neck. In the lower sections, the left and right branches form an anastomosis. They call it the jugular arch. After the vessel is hidden under the sternocleidomastoid muscle and flows into the external branch.

Channel connection

The following veins enter the external jugular branch:

Circulatory disorders

The causes of these phenomena should be considered stagnation of blood, which, in turn, is due to the flow around the injured area, due to heart failure or prolonged sitting (for example, during air travel). Atrial fibrillation can provoke a violation of the current in the left atrium or its appendage, which, in turn, can cause thromboembolism. With leukemia, another malignant tumor, cancer, the risk of developing thrombosis is high. The provoking factors in this case can be considered external compression of blood vessels. Less commonly, pathology is caused by a violation of the integrity of the blood flow system. This happens, for example, with cancer of the kidney cells that has grown into the renal veins.

Among the provoking factors, the use of chemotherapeutic and radioactive methods in the treatment of cancer should also be noted. Often they lead to additional hypercoagulability. When a blood vessel is damaged, the body uses fibrin and platelets to form a clot (thrombus) to prevent blood loss. However, under certain circumstances, such "plugs" can form without damage to the blood channels. They can freely circulate along the channel. Jugular vein thrombosis can develop as a result of a malignant tumor, drug use, or as a result of infection. Pathology can lead to all sorts of complications, such as sepsis, optic nerve edema, pulmonary embolism. Despite the fact that with thrombosis the patient experiences pain of a rather pronounced nature, it is quite difficult to diagnose the pathology. This is mainly due to the fact that clot formation can occur anywhere.

Puncture of the jugular vein

This procedure is prescribed for small diameter peripheral veins. Puncture works well enough in patients with reduced or normal nutrition. The patient's head is turned to the opposite side. The vein is pinched with the index finger directly above the collarbone. For better filling of the channel, the patient is recommended to push. The specialist takes a place at the patient's head, treats the surface of the skin with alcohol. Next, the vein is fixed with a finger and pierced. It should be said that the vein has a thin wall, and therefore there may not be a feeling of an obstacle. It is necessary to prick with a needle put on a syringe, which, in turn, is filled with a drug. This can prevent the development of an air embolism. The flow of blood into the syringe is carried out in the process of pulling its piston. After the needle is in the vein, its compression stops. Then the medication is injected. If re-injection is necessary, the vein is again pinched over the collarbone with a finger.

The jugular vein (JV) or the superior cardiac vein is a system of paired cervical vessels that drain blood from the deep superficial vessels of the head, brain, and neck into the system of the superior vena cava.

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Classification, structural features and functions

The JV system consists of three pairs. The internal jugular vein (Internal jugular) is a pair of main large channels with a diameter of 11 to 21 mm. They divert the largest volume of carbonated blood through the sinus (expansion) from the meninges, cranial cavity, cerebral and ocular regions that nourish it.

The walls are easily collapsing, thin, in the gap above the lower bulb and below it there are two valves.

Tributaries of internal nuclear power:

• front;
• thyroid, running along the arteries;
• pharyngeal;
• lingual.

The external jugular vein (External jugular) is a paired vessel of smaller diameter, which is located close to the surface of the skin, starting from the angle of the mandible. It is well visible when turning the head, coughing or straining, screaming, because it lies in the subcutaneous tissue. Provides blood drainage from the back of the head, face skin, chin.

Often used in medical practice for the infusion of pharmacological solutions through a catheter.

The anterior jugular vein (Jugularis anterior) is formed from small skin canals in the chin area, from where it descends. It was revealed that often the anterior canals on both sides merge into the median jugular vein.

Location and functions

JV is a structure of several branches - two internal, external and anterior.

The internal jugular vein begins with the superior expansion (bulb) at the cranial foramen, passes laterally along the neck near the bed of the carotid artery, reaching the node of the inferior bulb - the site of its connection with the subclavian artery behind the sternoclavicular articulation.

In the lower segment of the cervical trunk, the internal jugular vein lies in a fascial pocket surrounded by lymph nodes, next to the vagus (vagus nerve) and carotid artery.

The external JV, lying in a separate recess in the lower region (gutter), goes along the neck in front, then down to the confluence of the subclavian.

A pair of anterior JVs goes in front from two sides, descending to the sternum, where they are combined into an anastomosis (arc). Two tributaries flow either into the external JV before its connection with the subclavian, or into the latter.

The jugular vein performs the following "basic tasks":

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Diseases

Pathological states of PU are especially dangerous because of their location near the brain. The most severe and frequent pathologies are typical for all major canals. This:

• phlebitis;
• ectasia;
• thrombosis.

Phlebitis

Symptoms of different types of phlebitis:

Causes of the inflammatory process:

ectasia

The state of pathological expansion of the lumen of the vessel (ectasia) in a separate area is not associated with the age of the patient and is congenital.

It develops for the following reasons:

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If the patient has ectasia, the symptoms at the beginning of the disease are implicit. The first symptoms are a painless enlargement of the vessel with a visible fusiform swelling at the bottom and the formation of a "blue pouch" bulge at the top.

cervical thrombosis

It is the formation of platelet clots that block or impede circulation in the vessel.

The reason may be:

The internal jugular vein is more prone to thrombosis when blocked by an infected thrombus or when it is compressed for a long time during a serious injury.

The main danger is embolism or separation of a blood clot from the wall. The thrombus moves through the vessels and, by blocking the coronary, pulmonary or cerebral canals, causes the death of the body.

The main symptom with complete blockage of the lumen is a sharp pain in the neck and collarbone region, radiating to the arm, increasing swelling and swelling, blue skin, itching, feeling cold and sore.

Methods for the treatment of pathologies

Ectasia in the normal state of the patient requires careful observation by specialists (phlebologist, hematologist, surgeon).

In the case of progression of expansion and a negative effect on the body as a whole, the abnormal fragment is “closed” with a graft that restrains subsequent expansion, or is removed surgically, connecting healthy areas.

If inflammation (with phlebitis) is not complicated by suppuration, heat is used in the form of compresses, Troxevasin ointment and capsules, Heparin, Ichthyol, Camphor ointment.

With purulent phlebitis apply:

Often, with insufficient effectiveness of conservative treatment, a resection (excision) of the affected area is performed.

In case of thrombosis use:

Surgical intervention for thrombosis of UC is performed infrequently.

If there are indications, a method for resorption of thrombotic masses is used - endovascular thrombolysis or removal with minor tissue excision (transluminal thrombectomy).

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External jugular vein, v. jugularis externa , is formed at the level of the angle of the lower jaw under the auricle by the fusion of two venous trunks: a large anastomosis between the external jugular vein and the submandibular vein, v. retromandibularis, and the posterior auricular vein formed behind the auricle, v. auricularis posterior .

The external jugular vein from the place of its formation descends vertically down the outer surface of the sternocleidomastoid muscle, lying directly under the subcutaneous muscle of the neck. Approximately at the middle of the length of the sternocleidomastoid muscle, it reaches its posterior edge and follows it; before reaching the clavicle, it penetrates through the superficial fascia of the neck and flows either into the subclavian vein or into the internal jugular vein, and sometimes into the venous angle - the confluence of v. jugularis interna and v. subclavia. The external jugular vein has valves.

The following veins drain into the external jugular vein.

1.Posterior ear vein, v. auricularis posterior, collects venous blood from the superficial plexus located behind the auricle. It has a connection with the mastoid emissary vein, v. emissaria mastoidea.

2.Occipital branch, v. occipitalis, collects venous blood from the venous plexus of the head. It empties into the external jugular vein below the posterior auricular. Sometimes, accompanying the occipital artery, the occipital vein flows into the internal jugular vein.

3. Suprascapular vein, V. suprascapularis, accompanies the artery of the same name in the form of two trunks, which are connected into one trunk, which flows into the terminal section of the external jugular vein or into the subclavian vein.

4. Transverse veins of the neck, vv. transversae cervicis, are companions of the artery of the same name, and sometimes they flow into a common trunk with the suprascapular vein.

5. Anterior jugular vein, V. jugularis anterior, is formed from the skin veins of the mental region, goes down near the midline, lying first on the outer surface of the maxillohyoid muscle, and then on the anterior surface of the sternothyroid muscle. Above the jugular notch of the sternum, the anterior jugular veins of both sides enter the interfascial suprasternal space and are connected to each other through a well-developed anastomosis - the jugular venous arch, arcus venosus jugularis. Then the anterior jugular vein deviates outward and, passing behind m. sternocleidomastoideus, flows into the external jugular vein before it flows into the subclavian vein, less often flows into the subclavian vein.

It may be noted that the anterior jugular veins of both sides sometimes merge, forming median vein of the neck.

jugular veins (jugular, vena jugularis) - vascular trunks that carry blood from the head and neck into the subclavian vein. Allocate the internal, external and anterior jugular vein, internal - the widest. These paired vessels are referred to as the upper system.

The internal jugular vein (IJV, vena jugularis interna) is the widest vessel that carries out the venous outflow from the head. Its maximum width is 20 mm, and the wall is thin, so the vessel easily collapses and just as easily expands when stressed. In its lumen there are valves.

The VJV originates from the jugular foramen in the bony base of the skull and serves as a continuation of the sigmoid sinus. After leaving the jugular foramen, the vein expands, forming the superior bulb, then descends to the level of the junction of the sternum and clavicle, located behind the muscle attached to the sternum, clavicle and mastoid process.

Being on the surface of the neck, the VJV is placed outside and behind the internal carotid artery, then it shifts slightly forward, localizing in front of the external carotid artery. From the larynx, it passes in combination with the vagus nerve and the common carotid artery in a wide receptacle, creating a powerful cervical bundle, where the VJV comes from the outside of the nerve, and the carotid artery from the inside.

Before joining with the subclavian vein behind the junction of the sternum and clavicle, the VJV once again increases its diameter (lower bulb), and then unites with the subclavian, from where the brachiocephalic vein begins. In the area of ​​​​the lower expansion and at the place of its confluence with the subclavian internal jugular vein contains valves.

The internal jugular vein receives blood from intracranial and extracranial tributaries. Intracranial vessels carry blood from the cranial cavity, brain, eyes and ears. These include:

• Sinuses of the dura mater;
• Diploic veins of the skull;
• cerebral veins;
• meningeal veins;
• Ocular and auditory.

The tributaries going outside the skull carry blood from the soft tissues of the head, the skin of the outer surface of the skull, and the face. Intra- and extracranial tributaries of the jugular vein are connected through emissary tributaries, which penetrate through the bony cranial foramina.

From the external tissues of the skull, temporal zone, and neck organs, blood enters the EJV through the facial, retromandibular veins, as well as vessels from the pharynx, tongue, larynx, and thyroid gland. The deep and external tributaries of the VJV are combined into a dense multi-tiered network of the head, which guarantees a good venous outflow, but at the same time, these branches can serve as pathways for the spread of the infectious process.

The external jugular vein (vena jugularis externa) has a narrower lumen than the internal one and is localized in the cervical tissue. It transports blood away from the face, outer parts of the head and neck, and is easily visible during exertion (coughing, singing).

The external jugular vein begins behind the ear, or rather, behind the mandibular angle, then goes down along the outer part of the sternocleidomastoid muscle, then crosses it from below and behind, and flows over the clavicle together with the anterior jugular branch into the subclavian vein. The external jugular vein on the neck is equipped with two valves - in its initial section and approximately in the middle of the neck. The sources of its filling are the veins coming from the back of the head, ear and suprascapular regions.

The anterior jugular vein is located slightly outside the midline of the neck and carries blood from the chin. by fusion of subcutaneous vessels. The anterior vein is directed down the anterior part of the maxillohyoid muscle, slightly lower - in front of the sternohyoid muscle. The connection of both anterior jugular veins can be traced above the upper edge of the sternum, where a powerful anastomosis is formed, called the jugular venous arch. Occasionally, two veins join into one - the median vein of the neck. The venous arch on the right and left anastomoses with the external jugular veins.

Video: lecture on the anatomy of the veins of the head and neck

jugular vein changes

The jugular veins are the main vessels that carry out the outflow of blood from the tissues of the head and brain. The external branch is viewed subcutaneously on the neck, is available for palpation, so it is often used for medical manipulations - for example.

In healthy people, young children, swelling of the jugular veins can be observed when screaming, straining, crying, which is not a pathology, although mothers of babies often experience anxiety about this. Lesions of these vessels are more common in people of the older age group, but congenital features of the development of venous highways are also possible, which become noticeable in early childhood.

Among the changes in the jugular veins describe:

1. Thrombosis;
2. Expansion (dilatation of the jugular veins, ectasia);
3. Inflammatory changes (phlebitis);
4. congenital defects.

jugular vein ectasia

Jugular vein ectasia is an expansion of the vessel (dilatation), which can be diagnosed in both a child and an adult, regardless of gender. It is believed that such phlebectasia occurs when the valves of the vein fail, which provokes an excessive amount of blood, or diseases of other organs and systems.

jugular ectasia

Older age and female sex predispose to jugular vein ectasia. In the first case, it appears as a result of a general weakening of the connective tissue base of the vessels along with, in the second - against the background of hormonal changes. Among the possible causes of this condition are also long-term air travel associated with venous congestion and disruption of normal hemodynamics, trauma, tumors that compress the lumen of the vein with the expansion of its overlying sections.

It is almost impossible to see the ectasia of the internal jugular vein due to its deep location, and the external branch is perfectly visible under the skin of the anterior-lateral part of the neck. This phenomenon does not pose a danger to life; rather, it is a cosmetic defect, which may lead to medical attention.

Symptoms of phlebectasia the jugular vein is usually sparse. It may not exist at all, and the most that worries its owner is an aesthetic moment. With large ectasias, a feeling of discomfort in the neck may appear, aggravated by tension, screaming. With significant expansion of the internal jugular vein, voice disturbances, soreness in the neck, and even breathing difficulties are possible.

Not posing a threat to life, phlebectasia of the cervical vessels does not require treatment. In order to eliminate a cosmetic defect, one-sided ligation of the vessel can be performed without subsequent disturbance of hemodynamics, since the outflow of venous blood will be carried out by the vessels of the opposite side and collaterals.

jugular vein thrombosis

This is a blockage of the lumen of the vessel with a blood clot that completely or partially disrupts blood flow. Thrombogenesis is usually associated with the venous vessels of the lower extremities, however, it can also occur in the jugular veins.

The causes of jugular vein thrombosis can be:

• Violation of the blood coagulation system with hypercoagulability;
• Medical manipulations;
• tumors;
• Prolonged immobilization after injuries, operations, due to severe disorders of the nervous system and musculoskeletal system;
• Injection of drugs into the neck veins;
• Taking medication (hormonal contraceptives);
• Pathology of internal organs, infectious processes (sepsis, severe heart failure, thrombocytosis and polycythemia, systemic diseases of the connective tissue), inflammation of the ENT organs (otitis media, sinusitis).

The most common causes of neck vein thrombosis are medical interventions, catheter placement, and oncological pathology. When the external or internal jugular vein is blocked, the venous outflow from the cerebral sinuses and structures of the head is disturbed, which is manifested by severe pain in the head and neck, especially when turning the head to the side, increased cervical venous pattern, swelling of the tissues, puffiness of the face. Pain sometimes radiates to the arm from the side of the affected vessel.

When the external jugular vein is blocked, it is possible to feel the area of ​​​​the seal on the neck corresponding to its course, swelling, soreness, increased venous pattern on the side of the lesion will indicate thrombosis of the internal jugular vein, but it is impossible to feel or see the thrombosed vessel.

Signs of neck vein thrombosis expressed in the acute period of the disease. As the thrombus thickens and blood flow is restored, the symptoms weaken, and the palpable formation thickens and somewhat decreases in size.

Unilateral jugular vein thrombosis does not pose a threat to life, so it is usually treated conservatively. Surgical operations in this area are extremely rare, since the intervention carries a much greater risk than the presence of a blood clot.

The danger of damage to nearby structures, nerves, arteries makes it necessary to abandon surgery in favor of conservative treatment, but occasionally operations are performed when the vein bulb is blocked, combined with. Surgical operations on the jugular veins tend to be carried out using minimally invasive methods - endovascular thrombectomy, thrombolysis.

Drug elimination of neck vein thrombosis consists in prescribing analgesics, drugs that normalize the rheological properties of blood, thrombolytic and anti-inflammatory drugs, antispasmodics (papaverine), broad-spectrum antibiotics at the risk of infectious complications or if the cause of thrombosis is, for example, purulent otitis media. Venotonics (detralex, troxevasin), anticoagulants in the acute phase of pathology (heparin, fraxiparin) are shown.

Thrombosis of the jugular veins can be combined with inflammation - phlebitis, which is observed with injuries to the tissues of the neck, violation of the technique of introducing venous catheters, drug addiction. Thrombophlebitis is more dangerous than thrombosis due to the risk of spreading the infectious process to the sinuses of the brain, and sepsis is not excluded.

The anatomy of the jugular veins predisposes to their use for drug administration, so catheterization can be considered the most common cause of thrombosis and phlebitis. Pathology occurs when the technique of introducing a catheter is violated, it is too long in the lumen of the vessel, careless administration of drugs, the entry of which into soft tissues causes necrosis (calcium chloride).

Inflammatory changes - phlebitis and thrombophlebitis

thrombophlebitis of the jugular vein

The most frequent localization thrombophlebitis or phlebitis jugular vein is considered to be its bulb, and the most likely cause is purulent inflammation of the middle ear and tissues of the mastoid process (mastoiditis). Infection of a thrombus can be complicated by the ingress of its fragments with the blood flow into other internal organs with the development of a generalized septic process.

Clinic of thrombophlebitis consists of local symptoms - pain, swelling, as well as general signs of intoxication, if the process has become generalized (fever, tachycardia or bradycardia, shortness of breath, hemorrhagic skin rash, impaired consciousness).

With thrombophlebitis, surgical interventions are carried out aimed at removing the infected and inflamed vein wall along with thrombotic overlays, with purulent otitis media, the affected vessel is ligated.

jugular vein aneurysm

An extremely rare pathology is considered true jugular vein aneurysm which can be found in young children. This anomaly is considered one of the least studied in vascular surgery due to its low prevalence. For the same reason, differentiated approaches to the treatment of such aneurysms have not been developed.

Jugular vein aneurysms are found in children aged 2-7 years. It is assumed that the cause of everything is a violation of the development of the connective tissue base of the vein during fetal development. Clinically, an aneurysm may not manifest itself in any way, but in almost all children, a rounded expansion in the jugular vein can be felt, which becomes especially noticeable to the eye when crying, laughing or screaming.

Among aneurysm symptoms, impeding the outflow of blood from the skull, headaches, sleep disturbances, anxiety, and rapid fatigue of the child are possible.

In addition to purely venous, malformations of a mixed structure may appear, consisting of arteries and veins at the same time. Their frequent cause is trauma when there is a message between the carotid arteries and VJV. Progressive venous congestion in such aneurysms, swelling of facial tissues, exophthalmos are a direct consequence of the discharge of arterial blood flowing under high pressure into the lumen of the jugular vein.

For treatment of venous aneurysms resections of the malformation are performed with the imposition of an anastomosis that discharges venous blood, and vascular prosthetics. In traumatic aneurysms, observation is possible if surgery poses a greater risk than expectant management.