Location of the jugular vein in humans. Internal jugular vein

Table of contents of the topic "Veins of the systemic 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 cavity of the skull and neck organs; starting at the foramen jugulare, in which it forms an extension, bulbus superior venae jugularis internae, the vein descends, located lateral to a. carotis interna, and further down laterally from a. carotis communis. At the lower end v. jugularis interna e before connecting it to v. subclavia a second thickening is formed - bulbus inferior v. jugularis internae; in the neck area above this thickening there are one or two valves in the vein. 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 dura mater of the brain, sinus durae matris, and the cerebral veins flowing into them, v. cerebri, veins of the cranial bones, vv. diploicae, veins of the hearing organ, vv. auditivae, veins of the orbit, v. ophtalmicae, and veins of the dura mater, vv. meningeae. The second group includes the veins of the outer surface of the skull and face, which flow into the internal jugular vein along its course.

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

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

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

2. V. retromandibularis, retromandibular vein, collects blood from the temporal region. Further down in v. retromandibularis flows into a trunk that carries blood from the plexus pterygoideus (thick 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 mandible 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 edge of the lower jaw.

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

There are also anastomoses of the facial vein with the orbital 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, flowing 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, blood is collected from the upper parts of the thyroid gland and larynx.

6. V. thyroidea media, middle thyroid vein, departs from the lateral edge of the thyroid gland and flows 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 by v. thyroideae interiores And v. thyroidea im a into the veins of the anterior mediastinum.

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

The jugular veins are several paired large vessels that are located in the neck. They carry blood away from it towards the head. Next, we will consider these channels in more detail.

Main branch

Each jugular vein (and there are three in total) belongs to the superior caval system. 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 - an extension 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, which passes through this zone. In the lower cervical regions, the vein is located in the connective tissue, common with the vagus nerve and carotid artery. Behind the sternoclavicular joint it merges with the subclavian joint. In this case, we mean the inferior bulbous extension, from which the brachiocephalic vein is formed.

External channel

This jugular vein has a smaller diameter. It is located in the subcutaneous tissue. The external jugular vein in 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 and facial formations. In some cases, it is used for administering medications and 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 runs down a short distance from the mid-neck line. In the lower sections, the left and right branches form an anastomosis. They call it the jugular arch. The vessel then disappears under the sternocleidomastoid muscle and flows into the external branch.

Connection of channels

The following veins flow into the external jugular branch:

Blood supply disorders

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

Among the provoking factors, the use of chemotherapy and radioactive methods in the treatment of cancer should also be noted. They often 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 some circumstances, such “plugs” can form without damaging the blood channels. They can circulate freely along the riverbed. Jugular vein thrombosis can develop due to a malignant tumor, drug administration, or as a result of infection. Pathology can lead to various kinds of complications, for example, sepsis, papilledema, pulmonary embolism. Despite the fact that with thrombosis the patient experiences quite severe pain, diagnosing the pathology is quite difficult. This is mainly due to the fact that clot formation can occur anywhere.

Jugular vein puncture

This procedure is prescribed for small diameter peripheral veins. The puncture works quite well in patients with low or normal nutrition. The patient's head is turned in the opposite direction. The vein is pinched with the index finger directly above the collarbone. For better filling of the bed, the patient is recommended to push. The specialist takes a place at the patient’s head and treats the surface of the skin with alcohol. Next, the vein is fixed with a finger and punctured. It should be said that the vein has a thin wall, and therefore there may not be a sensation of an obstacle. It is necessary to inject with a needle placed on a syringe, which, in turn, is filled with medicine. This can prevent the development of an air embolism. Blood enters the syringe by pulling out its piston. Once the needle is in the vein, its compression stops. Then the medication is administered. If it is necessary to re-inject, the vein is again pinched above the collarbone with a finger.

The jugular vein (JV) or 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 nuclear power system consists of three pairs. The internal jugular vein (Internal jugular) is a pair of main large canals with a diameter of 11 to 21 mm. They drain the largest volume of carbon dioxide-rich blood through the sinus (expansion) from the meninges, cranial cavity, cerebral and ocular areas that feed it.

The walls are easily collapsible, thin, in the lumen above and below the lower bulb there are two valves.

Influxes of internal nuclear waste:

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

The external jugular vein is a paired vessel of smaller diameter that is located close to the surface of the skin, starting from the angle of the lower jaw. It is clearly visible when turning the head, coughing or straining, screaming, since it lies in the subcutaneous tissue. Provides blood drainage from the back of the head, facial skin, and chin.

Often used in medical practice for 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

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

The internal jugular vein begins with the superior extension (bulb) at the cranial foramen, passes along the side of the neck next to 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 joint.

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 nerve and the carotid artery.

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

A pair of anterior PUs run from the front on both sides, going down to the sternum, where they unite into an anastomosis (arch). Two tributaries flow either into the external PU before its connection with the subclavian, or into the latter.

The jugular vein performs the following “basic tasks”:

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Diseases

Pathological conditions of nuclear weapons are especially dangerous due to their location near the brain. The most severe and frequent pathologies are typical for all large canals. This:

• phlebitis;
• ectasia;
• thrombosis.

Phlebitis

Symptoms of different types of phlebitis:

Causes of the inflammatory process:

Ectasia

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

It develops for the following reasons:

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If the patient has ectasia, the symptoms at the onset of the disease are subtle. The first symptoms are a painless enlargement of the vessel with a visible fusiform swelling at the bottom and the formation of a bulge in the form of a “blue bag” 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 likely to thrombose when it is blocked by an infected blood clot or when it is subjected to prolonged compression during serious trauma.

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

The main symptom of complete blockage of the lumen is sharp pain in the neck and collarbone area, radiating to the arm, increasing swelling and bulging, bluish skin, itching, feeling of coldness and soreness.

Methods of treating pathologies

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

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

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

For purulent phlebitis use:

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

In case of thrombosis use:

Surgical intervention for venous thrombosis is performed infrequently.

If indicated, a method is used to resolve thrombotic masses - 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 mandible under the auricle by the fusion of two venous trunks: a large anastomosis between the external jugular vein and the mandibular 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 halfway along 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 into either the subclavian vein or 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 auricular 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 flows into the external jugular vein below the posterior auricular vein. 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 connect into one trunk, flowing 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 through a common trunk with the suprascapular vein.

5. Anterior jugular vein, V. jugularis anterior, is formed from the cutaneous veins of the mental region, goes down near the midline, lying first on the outer surface of the mylohyoid 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 to the subclavian vein. There are internal, external and anterior jugular veins, the internal one being the widest. These paired vessels are classified as the superior system.

The internal jugular vein (IJV, vena jugularis interna) is the widest vessel that carries out 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 under tension. There are valves in its lumen.

The IJV begins 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 to form the superior bulb, then descends to the level of the junction of the sternum and clavicle, located posterior to the muscle attached to the sternum, clavicle and mastoid process.

Being on the surface of the neck, the IJV is placed outside and behind the internal carotid artery, then moves 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 IJV goes from the outside of the nerve, and the carotid artery from the inside.

Before uniting with the subclavian vein behind the junction of the sternum and clavicle, the IJV once again increases its diameter (inferior bulb), and then unites with the subclavian vein, where the brachiocephalic vein begins. In the zone of inferior expansion and at the point of its confluence with the subclavian vein, the internal jugular vein contains valves.

The internal jugular vein receives blood from intra- 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;
• Orbital and auditory.

The tributaries coming from the outside of the skull carry blood from the soft tissues of the head, the skin of the outer surface of the skull, and the face. The intra- and extracranial tributaries of the jugular vein are connected through emissaries that penetrate through the bony cranial foramina.

From the external tissues of the skull, temporal zone, and neck organs, blood enters the IJV through the facial and retromandibular veins, as well as vessels from the pharynx, tongue, larynx, and thyroid gland. The deep and external tributaries of the IJV are combined into a dense multi-tiered network of the head, guaranteeing good venous outflow, but, at the same time, these branches can serve as routes 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 from the face, outer parts of the head and neck and is easily visible when straining (coughing, singing).

The external jugular vein begins behind the ear, or more precisely, behind the mandibular angle, then runs downward along the outer part of the sternocleidomastoid muscle, then crosses it below and behind, and above the clavicle flows together with the anterior jugular branch into the subclavian vein. The external jugular vein in 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 considered to be veins coming from the back of the head, ear and suprascapular areas.

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 front of the mylohyoid muscle, just below - 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 unite 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 drain blood from the tissues of the head and brain. The external branch is visible subcutaneously on the neck and is accessible for palpation, so it is often used for medical procedures - for example.

In healthy people and small children, you can observe swelling of the jugular veins when screaming, straining, or 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 lines are also possible, which become noticeable in early childhood.

Among the changes in the jugular veins are described:

1. Thrombosis;
2. Dilatation (dilatation of jugular veins, ectasia);
3. Inflammatory changes (phlebitis);
4. Congenital defects.

Jugular vein ectasia

Jugular vein ectasia is a dilation 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 vein valves are insufficient, which provokes an excessive amount of blood, or diseases of other organs and systems.

jugular vein ectasia

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

It is almost impossible to see ectasia of the internal jugular vein due to its deep location, and the external branch is clearly visible under the skin of the anterolateral part of the neck. This phenomenon does not pose a danger to life; rather, it is a cosmetic defect, which may be a reason to consult a doctor.

Symptoms of phlebectasia The jugular vein is usually scanty. It may not exist at all, and the most that worries its owner is the aesthetic moment. With large ectasia, a feeling of discomfort in the neck may appear, which intensifies with tension and screaming. With significant expansion of the internal jugular vein, voice disturbances, pain in the neck and even difficulty breathing are possible.

Without posing a threat to life, phlebectasis of the cervical vessels does not require treatment. In order to eliminate a cosmetic defect, unilateral ligation of the vessel can be performed without subsequent disruption 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 a vessel with a blood clot that completely or partially disrupts the flow of blood. Thrombosis is usually associated with the venous vessels of the lower extremities, but it is also possible in the jugular veins.

The causes of jugular vein thrombosis can be:

• Disturbance of the blood coagulation system with hypercoagulation;
• Medical manipulations;
• Tumors;
• Prolonged immobilization after injuries, operations, due to severe disorders of the nervous system and musculoskeletal system;
• Injection of narcotic drugs into the jugular veins;
• Taking medications (hormonal contraceptives);
• Pathology of internal organs, infectious processes (sepsis, severe heart failure, thrombocytosis and polycythemia, systemic connective tissue diseases), inflammatory processes of the ENT organs (otitis media, sinusitis).

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

When the external jugular vein is blocked, you can palpate the area of ​​compaction on the neck corresponding to its course; thrombosis of the internal jugular vein will be indicated by swelling, pain, and an increased venous pattern on the affected side, but it is impossible to palpate 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 becomes denser and slightly decreases in size.

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

The danger of damage to nearby structures, nerves, arteries forces one to refuse 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 performed using minimally invasive methods - endovascular thrombectomy, thrombolysis.

Drug elimination of neck vein thrombosis consists of prescribing analgesics, drugs that normalize the rheological properties of blood, thrombolytic and anti-inflammatory drugs, antispasmodics (papaverine), broad-spectrum antibiotics if there is a 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 the pathology (heparin, fraxiparin) are indicated.

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 inserting venous catheters, and drug addiction. Thrombophlebitis is more dangerous than thrombosis due to the risk of spread of the infectious process to the sinuses of the brain; sepsis is also possible.

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

Inflammatory changes – phlebitis and thrombophlebitis

thrombophlebitis of the jugular vein

Most common localization thrombophlebitis or phlebitis The jugular vein is considered to be its bulb, and the most likely cause is purulent inflammation of the middle ear and mastoid tissue (mastoiditis). Infection of a blood clot can be complicated by the penetration of its fragments through the bloodstream into other internal organs with the development of a generalized septic process.

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

For thrombophlebitis, surgical interventions are performed aimed at removing the infected and inflamed vein wall along with thrombotic applications; for purulent otitis, the affected vessel is ligated.

Jugular vein aneurysm

An extremely rare pathology is considered true jugular vein aneurysm, which can be detected 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 2-7 years old. It is assumed that the reason for this is a violation of the development of the connective tissue base of the vein during intrauterine development. Clinically, an aneurysm may not manifest itself in any way, but in almost all children you can feel a rounded expansion in the area of ​​the jugular vein, which becomes especially noticeable to the eye when crying, laughing or screaming.

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

In addition to purely venous ones, malformations of a mixed structure may appear, consisting of arteries and veins at the same time. Their common cause is trauma when a communication occurs between the carotid arteries and the IJV. Venous congestion, swelling of facial tissues, and exophthalmos that progress with such aneurysms 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 Resection of the malformation is performed with the imposition of an anastomosis that discharges venous blood and vascular prosthetics. For traumatic aneurysms, observation is possible if surgery poses a greater risk than watchful waiting.