Phlebectasia or dilatation of the jugular vein in the neck. Internal jugular vein (v
The internal jugular vein (v. jugularis interna) is a paired large vessel that begins in the area of the jugular foramen of the skull. It collects blood from the organs of the head and neck, taking the following branches.
1. Sigmoid sinus (sinus sigmoideus) of the dura mater.
2. The cochlear canaliculus vein (v. canaliculi cochleae) begins in the cochlea and flows into the beginning of the jugular vein.
3. Pharyngeal veins (vv. pharyngeae) originate from the pharyngeal plexus. The veins of the auditory tube, soft palate, and dura mater of the posterior cranial fossa flow into this plexus.
4. The lingual vein (v. lingualis) is a pair, merges from the dorsal and deep veins of the tongue, the sublingual vein and the vein that is a companion to the hypoglossal nerve. At the large horn of the hyoid bone they merge into one trunk of the lingual vein.
5. The superior thyroid vein (v. thyroidea superior) is steamy, begins with 2-3 trunks from the upper part of the thyroid gland. The superior thyroid veins anastomose with the veins of the larynx and sternocleidomastoid muscle.
6. The middle thyroid vein (v. thyroidea media) begins with 1-2 trunks from the isthmus of the thyroid gland. Collects venous blood from the thyroid gland and the venous plexus of the neck tissue in the area of the spatium suprasternale.
7. The sternocleidomastoid veins (vv. sternocleidomastoideae), numbering 3-4, flow into the internal jugular vein along its entire length. Anastomose with the branches of the external jugular vein.
8. The superior laryngeal vein (v. laryngea superior) exits through the membrana thyrohyoidea. Often anastomoses with the superior thyroid and sternocleidomastoid veins.
9. The facial vein (v. facialis) accompanies the facial artery. The vein is formed by the fusion of the angular vein, suprafrontal and supraorbital veins. These veins anastomose with the superior and inferior ophthalmic veins. The facial vein also collects blood from the upper and lower eyelids, nose, upper and lower lips, parotid gland, chin and deep facial area. Below the angle of the lower jaw it connects with v. retromandibularis, and then flows into v. jugularis interna.
10. The mandibular vein (v. retromandibularis) is formed from the superficial and middle temporal veins, the deep temporal vein, the pterygoid plexus, the veins of the parotid gland and the temporomandibular joint.
The veins listed are tributaries of the internal jugular vein (v. jugularis interna), having a diameter of 12-20 mm, which expands near the jugular foramen and at the junction with the subclavian vein. The vein wall is thin and therefore collapses easily; there are one or two valves in the lumen. The vein lies lateral to a. carotis interna, a. carotis communis and the vagus nerve, surrounded by deep lymph nodes of the neck. At the level of the sternoclavicular joint, it forms a venous angle (angulus venosus) with the subclavian vein. The ductus thoracicus flows into the left venous angle, and the ductus lymphaticus dexter into the right. The vein is covered in front by m. sternocleidomastoideus.
Jugular vein(JV) drains blood from the organs and tissues of the head into the cranial vena cava. It can be internal and external.
1. The first of these is located at a sufficiently close distance from the surface of the body, so it can be seen with appropriate muscle tension. It is located in the jugular groove, and conducts blood from the back of the head, skin of the neck and chin, and then flows into the internal jugular groove. It has valves and other veins flow into it, such as:
a) anterior jugular vein - originates in the chin area and goes down to the surface of the sternohyoid muscle. There are two of them, on both sides they descend into the suprasternal space, where they are connected through an anastomosis (jugular arch). Thus, the anterior jugular veins merge to form the vein of the neck.
b) posterior auricular vein - conducts blood coming from the plexus, which is located behind. It is located behind the ear.
c) occipital - conducts blood from the venous plexus in the occipital part of the head, it flows into the external venous vein, and sometimes into the internal one.
d) suprascapular - runs along with the artery and has the form of two trunks, joining into one in the final section of the subclavian vein.
The jugular vein (external) contains valves.
2. The internal jugular vein plays a special role. It originates at the site of the jugular foramen, which is located at the base of the skull, passes obliquely along the entire neck down under the sternoclavicular muscle, ending in its lateral sections at the base of the neck.
If the head turns in the other direction, it goes along the junction of the auricle and the sternoclavicular joint, is located in the carotid sac and the lateral nerve.
It should also be noted that in the brain, namely in its dura mater, there are systems of venous vessels that flow into veins and drain blood from this organ. They all connect to each other and form venous sinuses. Thus, blood is concentrated in two sigmoid sinuses, passing through certain openings in the skull. In this way, the right and left internal jugular veins are formed.
a) facial - originates from the lower jaw, at the confluence of two veins (anterior facial and posterior), goes down, then back. It has no valves.
b) thyroid veins - accompany the arteries and flow into the facial vein or the lingual vein. They have valves.
c) pharyngeal - originate from the surface of the pharynx, the veins of the Vidian canal and palate flow into them. Their number may vary, they do not have valves.
d) lingual vein - located near the artery, leaving it, it lies on the surface of the lingual muscle and runs parallel to the hypoglossal nerve. It has valves.
It should be noted that all veins of the head have anastomoses with venous sinuses through the bones of the skull. So, they are located on the inner corner of the eyes, behind the auricle, in the crown area. These anastomoses make it possible to regulate the pressure in the cranium. Also, in the event of inflammation in the tissues, they serve as a pathway for the inflammation to transfer to the membranes of the brain, which is a rather dangerous phenomenon.
Thus, the internal jugular vein, connecting with the subclavian vein, forms the trunk of the superior vena cava.
The jugular vein, located in the neck, produces an outflow of blood from the tissues and organs of the head, and is part of it. It consists of two pairs (external and internal), which perform important functions in regulating blood flow, being an integral part of the human circulatory system.
Phlebectasia is an anatomical term for the dilation of a vein. With pathology of the jugular veins, the vessels in the neck dilate. Usually this does not cause significant harm to health and is only a cosmetic defect. In severe cases of pathology, the blood supply to the brain is disrupted.
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Features of phlebectasis of the jugular vein
This is a congenital malformation that develops in approximately 1 in 10 thousand children. It begins to appear at the age of 2 - 5 years. When straining, coughing, or crying, there is a noticeable bulge in his neck. It is caused by the accumulation of blood and stretching of the weakened wall of the jugular vein. This weakening is associated with impaired development of the vein in the embryonic period.
1- internal; 2- external jugular veins; 3- common carotid artery There are pathologies of the internal and external jugular (jugular) veins. Internal - a wide vessel that collects blood from the internal parts of the skull. The outer one is thinner; venous vessels flow into it from the outer surface of the head. There is also an anterior vein, which is a collector for venous blood from the neck and sublingual region. All these vessels are paired; they flow into the subclavian veins.
All veins are equipped with developed valves that prevent blood from flowing in the opposite direction. This is possible when the pressure in the chest cavity increases, when venous blood normally flows back to the head in small quantities. When a child screams or cries, the neck veins or vessels on the surface of his head may swell. This happens symmetrically.
With congenital weakness of one of the valves, blood flows into the affected vein more intensely, and then with tension it is clear that its increase is much greater on one side. This symptom is the main sign of phlebectasia.
Reasons for changes in the right, left, and both veins
The cause of phlebectasia is the weakness of the connective tissue of its valves. The pathology can manifest itself in a child, but quite often it occurs in women during menopause and in the elderly. This is due to the intensification of structural changes under the influence of age-related or hormonal changes. In these cases, jugular phlebectasia may occur with equal probability on either side or even bilaterally.
Dilatation of both jugular veins- a sign of severe heart disease with insufficient functioning of the left ventricle. This can be observed in chronic lung diseases or severe heart defects, for example.
In addition to the anatomical weakness of the venous valves, the cause of the disease can be a tumor that compresses the overlying part of the vessel. In this case, it matters which side the lesion occurs on.:
- right-sided jugular phlebectasia can be observed with a significant increase in the cervical lymph nodes on the right or soft tissue tumors in this area;
- Accordingly, damage to the left jugular vein should alert doctors to any pathology of the lymphatic vessels on the left.
There is no list of diseases that cause phlebectasia. In each case, the doctor examines the patient individually, identifying all the features of his body.
Symptoms of the disease
The pathology occurs 3 times more often in boys than in girls. Often, simultaneously with the expansion of the vein, it is also present.
Outwardly, the pathology proceeds almost unnoticeably. Typically, patients consult a doctor between the ages of 8 and 15 years with complaints of a bulge on one side of the neck, which is caused by dilation of the external jugular vein. Initially, it manifests itself only as swelling on the side of the sternocleidomastoid muscle of the neck when it is tense.
Then, as it progresses, this formation increases with crying, straining and other conditions that increase pressure in the chest cavity and impede the normal venous flow of blood through the subclavian and superior vena cava to the heart.
Disruption of the normal outflow of blood from the tissues of the head is accompanied by the following clinical symptoms that first appear in childhood:
- episodes;
- sleep disturbance;
- fatigue;
- poor performance at school;
- nosebleeds of unknown origin;
- feeling of suffocation, pressure on the neck;
The incidence of such symptoms ranges from 10 to 40% and forces the patient to consult a doctor. In other cases, if the disease is asymptomatic, a person may live his entire life and not know that he has such a vascular anomaly.
The larger the lumen of the expansion, the more often the patient is bothered by something. This is due to the volume of blood return and the development of venous stagnation in the tissues of the head.
Diagnostic methods
If you suspect jugular phlebectasia, you should contact a vascular surgeon who will conduct an appropriate angiological examination. To assess the severity of the process caused by impaired venous outflow, a consultation with a neurologist and ophthalmologist (fundus examination) is scheduled.
The screening method, that is, rapid preliminary diagnosis, is. It allows you to identify such signs:
- location and structure of the formation, its size;
- direction of blood flow, its nature (laminar, that is, linear, or turbulent, that is, swirling);
- patency of veins, condition of their walls and valves.
Then the patient is prescribed the following research methods:
- blood tests, urine tests;
- X-ray examination of the chest and cervicothoracic spine;
- Ultrasound triplex scanning in B-mode;
- Dopplerographic determination of linear and volumetric blood flow velocity through the veins;
- X-ray contrast venography (filling the lumen of the vein with a substance that does not transmit x-rays);
- computer and magnetic resonance imaging to accurately determine all characteristics of the lesion.
According to phlebography, 4 types of disease are distinguished:
- limited circular expansion in combination with tortuosity of the vein;
- limited circular expansion;
- diffuse circular expansion;
- lateral expansion, or .
Depending on the data obtained, the surgeon plans the type of operation.
Treatment of jugular vein phlebectasis
Phlebectasia is not only a cosmetic defect. It leads to disruption of the blood supply to the brain and disrupts its functions. In the future, this condition may progress. Therefore, it is best to have surgery at 7–10 years of age.
Types of surgical interventions:
- circular resection (removal) of the extension;
- longitudinal resection;
- casing (strengthening the walls of the vessel) with a polymer mesh;
- resection of the extension with vessel plasty.
All these types of interventions are equally effective and allow you to finally restore normal blood flow. The operation is performed under general anesthesia and lasts about 2 hours. The recovery period is short. These tissues are well supplied with blood and heal quickly.
Possible complications
After surgery on the jugular veins, in the near future, 8 - 9% of patients experience stenosis or thrombosis of the vessel. Doctors are good at managing these complications. The use of modern medications can reduce the incidence of complications to a minimum.
There were no complications noted in the long-term postoperative period.
If surgery is necessary, refusing it will lead to adverse consequences.:
- prolonged headaches;
- inability to engage in intense physical activity;
- poor performance at school;
- increased severity of other symptoms;
- increase in cosmetic defect in the neck area.
A rare, but most dangerous complication is injury or rupture of a dilated venous vessel. In this case, intense bleeding occurs, requiring emergency medical attention. This condition occurs with large (up to 10 cm or more) dilations.
Even the smallest phlebectasias serve as a source of improper blood flow, so over time they can thrombose. This is dangerous because a blood clot enters the heart, and through its right ventricle into the pulmonary circulatory system. The result is such a serious and often fatal condition as pulmonary embolism.
Is it possible to give birth with moderate phlebectasia?
During childbirth, the pressure in the chest cavity increases, which creates additional stress on the dilated vein. Therefore, the question of managing the birth process depends on the severity of phlebectasia.
A pregnant woman should consult a vascular surgeon. 
You can give birth with this disease in any case. Depending on the severity of the pathology, natural childbirth, exclusion of the period of pushing, and anesthesia can be performed.
In case of particularly severe phlebectasis and other concomitant diseases, a cesarean section is indicated.
The issue of childbirth tactics is decided for each woman individually. If she underwent surgery for this disease in childhood, there are no restrictions for normal childbirth.
Prevention of development
Primary prevention for this disease has not been developed since it is congenital and its cause has not been established. Only general advice on bearing a child is given - healthy eating, proper rest, taking multivitamins for pregnant women.
If a child has had surgery for this disease, he or she will undergo annual surgery thereafter to ensure normal recovery.
If no surgical intervention was performed, if the size of the defect is small, it may subsequently shrink or disappear on its own. To do this, it is necessary to strengthen the neck muscles: massage and physical therapy are indicated. Situations that increase intra-abdominal and intrathoracic pressure should be avoided:
- severe prolonged cough;
- constant constipation;
- lifting weights;
- intense physical activity.
Jugular vein
| Jugular vein | |
Jugular veins. The internal jugular vein (large) is clearly visible on the left half of the picture. The external jugular vein is shown on the right (runs superficially). The anterior jugular veins descend vertically on each side of the midline of the neck. |
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Jugular veins (venae jugulares) - several paired veins located on the neck and carrying blood away from the neck and head; belong to the superior vena cava system.
Anatomy
There are three pairs of jugular veins:
- Internal jugular vein ( v. jugularis interna) - the largest, is the main vessel carrying blood from the cranial cavity. It is a continuation of the sigmoid sinus of the dura mater and begins from the jugular foramen of the skull with a bulbous extension (superior bulb of the jugular vein, bulbus jugularis superior). Then it descends towards the sternoclavicular joint, being covered in front by the sternocleidomastoid muscle. In the lower parts of the neck, the vein is located in the common connective tissue sheath along with the common carotid artery and vagus nerve, while the vein is located somewhat more superficially and lateral to the artery. Behind the sternoclavicular joint, the internal jugular vein merges with the subclavian vein (there is an inferior bulb of the jugular vein, bulbus jugularis inferior), forming the brachiocephalic vein.
- External jugular vein ( v. jugularis externa) - smaller in caliber, located in the subcutaneous tissue, runs along the anterior surface of the neck, deviating laterally in the lower sections (crossing the posterior edge of the sternocleidomastoid muscle approximately at the level of its middle). This vein is well contoured when singing, screaming or coughing, collecting blood from the superficial formations of the head, face and neck; sometimes used for catheterization and drug administration. Below it pierces its own fascia and flows into the subclavian vein.
- Anterior jugular vein ( v. jugularis anterior) - small, formed from the saphenous veins of the chin, descending down at some distance from the midline of the neck. In the lower parts of the neck, the right and left anterior jugular veins form an anastomosis called the jugular venous arch ( arcus venosus juguli). The artery then goes under the sternocleidomastoid muscle and usually flows into the external jugular vein.
The following veins drain into the external jugular vein:
- Posterior auricular vein ( v. auricularis posterior), collects venous blood from the superficial plexus located behind the auricle. She has a connection with v. emissaria mastoidea.
- Occipital vein, v. occipitalis, collects venous blood from the venous plexus of the occipital region of the head, which is supplied by the artery of the same name. It drains into the external jugular vein below the posterior auricular vein. Sometimes, accompanying the occipital artery, the occipital vein flows into the internal jugular vein.
- Suprascapular vein ( v. suprascapularis), accompanies the artery of the same name in the form of two trunks, which connect and form one trunk, flowing into the terminal section of the external jugular vein or into the subclavian vein.
Anterior jugular vein ( v. jugularis anterior) is formed from the cutaneous veins of the mental region, from where it is directed downward near the midline, initially lying on the outer surface m. mylohyoideus, and then on the front surface m. sternohyoideus. Above the jugular notch of the sternum, the anterior jugular veins of both sides enter the interfascial suprasternal space, where they are connected to each other through a well-developed anastomosis called the jugular venous arch ( arcus venosus juguli). Then the jugular vein deviates outward and, passing behind m. sternocleidomastoideus, flows into the external jugular vein before it flows into the subclavian vein, less often - into the latter. Alternatively, it can be noted that the anterior jugular veins of both sides sometimes merge to form the median vein of the neck.
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See what “Jugular vein” is in other dictionaries:
Cervical vein. The internal jugular vein is a very large paired vein that runs vertically down the side of the neck next to the carotid artery. Collects blood from the head and neck. Behind the sternoclavicular joint it merges... ... Medical terms
The external jugular vein, 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 (see below). The external jugular vein from the place of its formation descends vertically down the outer surface of m. sternocleido-mastoideus, lying directly under the platysma. Approximately in the middle of the length m. sternocleidomastoideus, the external jugular vein reaches its posterior edge and follows it; before reaching the collarbone, it penetrates through the fascia of the neck and flows either into the subclavian vein, v. subclavia, or into the internal jugular vein, and sometimes into the venous angle - the confluence of v. jugularis interna with v. subclavia. The external jugular vein contains valves. The following veins drain into the external jugular vein.
- The posterior auricular vein, auricularis posterior, collects venous blood from the superficial plexus located behind the auricle. She has a connection with v. emissaria mastoidea.
- Occipital vein, v. occipitalis, collects venous blood from the venous plexus of the occipital region of the head, which is supplied by the artery of the same name. It drains into the external jugular vein below the posterior auricular vein. Sometimes, accompanying the occipital artery, the occipital vein flows into the internal jugular vein.
- The suprascapular vein, g. suprascapularis, accompanies the artery of the same name in the form of two trunks, which connect and form one trunk, flowing into the terminal section of the external jugular vein or into the subclavian vein.
- Anterior jugular vein, v. jugularis anterior, is formed from the cutaneous veins of the mental region, from where it goes down near the midline, initially lying on the outer surface of m. mylohyoideus, and then on the anterior surface of m. sternohyoideus. Above the jugular notch of the sternum, the anterior jugular veins of both sides enter the interfascial suprasternal space, where they are connected to each other through a well-developed anastomosis called the jugular venous arch, arcus venosus juguli. Then the jugular vein deviates outward and, passing behind m. sternocleidomastoideus, flows into the external jugular vein before it flows into the subclavian vein, less often into the latter. Alternatively, it can be noted that the anterior jugular veins of both sides sometimes merge to form the median vein of the neck.
