Phlebectasia or enlargement 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 region 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 vein of the cochlear tubule (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. Lingual vein (v. lingualis) steam room, merges from the dorsal and deep veins of the tongue, the hyoid and the vein - the companion of the hyoid nerve. At the large horn of the hyoid bone, they merge into one trunk of the lingual vein.
5. Superior thyroid vein (v. thyroidea superior) steam room, starts 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 1-2 trunks from the isthmus of the thyroid gland. Collects venous blood from the thyroid gland and the venous plexus of the tissue of the neck in the area of spatium suprasternale.
7. Sternocleidomastoid veins (vv. sternocleidomastoideae), 3-4 in number, flow into the internal jugular vein throughout its entire length. Anastomose with 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 confluence 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 region. 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 listed veins 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 wall of the vein is thin and therefore falls off 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 neck lymph nodes. 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. In front, the vein is covered m. sternocleidomastoideus.
Jugular vein(JV) diverts blood from the organs and tissues of the head into the cranial vena cava. It is internal and external.
1. The first of these is located at a fairly close distance from the surface of the body, so it can be seen with the 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 JV. It has valves and other veins flow into it, such as:
a) anterior jugular vein - originates in the chin area, 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 by anastomosis (jugular arch). Thus, the anterior jugular veins, merging, form the vein of the neck.
b) posterior ear 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 JV, and sometimes into the internal one.
d) suprascapular - passes along with the artery and looks like two trunks, connecting 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, runs obliquely down the entire neck under the sternoclavicular muscle, ending in its lateral sections at the base of the neck.
In the case of turning the head to the other side, 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 hard shell, there are systems of venous vessels that flow into the veins and drain blood from the specified organ. All of them connect with each other and form venous ones. 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 into the lingual. They have valves.
c) pharyngeal - originate from the surface of the pharynx, the veins of the vidian canal, palate flow into them, their number can be different, 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. She 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 region of the crown. 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 transition of inflammation to the membranes of the brain, which is a rather dangerous phenomenon.
Thus, the internal jugular vein, connecting with the subclavian, forms the trunk of the superior vena cava.
The jugular vein, located on 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 the regulation of blood flow, being an integral part of the human circulatory system.
Phlebectasia is an anatomical term for the expansion of a vein. With the pathology of the jugular veins, the vessels in the neck expand. Usually this does not bring significant harm to health and is only a cosmetic defect. In a severe form of pathology, the blood supply to the brain is disrupted.
Read in this article
Features of phlebectasia of the jugular vein
This is a congenital anomaly that develops in about 1 in 10,000 children. It begins to appear at the age of 2 - 5 years. When straining, coughing, crying, a bulge is noticeable on his neck. It is caused by the accumulation of blood and stretching of the weakened wall of the jugular vein. Such a weakening is associated with a violation of the development of the vein in the embryonic period.
1- internal; 2- external jugular veins; 3- common carotid artery Distinguish between the pathology 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 with an increase in pressure in the chest cavity, when venous blood normally flows back to the head in a small amount. When a child screams or cries, the neck veins or vessels on the surface of his head may swell. It happens symmetrically.
With congenital weakness of one of the valves, blood enters the affected vein more intensively, and then, with tension, it can be seen that its increase is much greater on one side. This symptom is the main symptom of phlebectasia.
Causes of changes in the right, left, both veins
The cause of phlebectasia is the weakness of the connective tissue of its valves. 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 the processes of structural change under the influence of age-related or hormonal changes. In these cases, jugular phlebectasia may occur with equal probability on either side or even bilateral.
Expansion of both jugular veins- a sign of severe heart disease with insufficient work of his 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 on which side the lesion occurred.:
- 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, revealing all the features of his body.
Symptoms of the disease
In boys, pathology occurs 3 times more often than in girls. Often, along with the expansion of the vein, there is also her.
Pathology outwardly proceeds almost imperceptibly. Patients usually present to the doctor between the ages of 8 and 15 with complaints of bulging on one side of the neck, which is caused by a dilated external jugular vein. At first, it is manifested only by swelling from the side of the sternocleidomastoid muscle of the neck with its tension.
Then, with progression, this formation increases with crying, straining, and other conditions that increase pressure in the chest cavity and impede normal venous blood flow through the subclavian and superior vena cava to the heart.
Violation of the normal outflow of blood from the tissues of the head is accompanied by such clinical symptoms that first appear in childhood:
- episodes;
- sleep disturbance;
- fast fatiguability;
- poor school performance;
- nosebleeds of unknown nature;
- feeling of suffocation, pressure on the neck;
The frequency of occurrence of such symptoms is 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 whole life and not know that he has such a vascular anomaly.
The larger the lumen of the expansion, the more often the patient is worried about something. This is due to the volume of blood reflux and the development of venous congestion in the tissues of the head.
Diagnostic methods
If jugular phlebectasia is suspected, it is necessary to contact a vascular surgeon who will conduct an appropriate angiological examination. To assess the severity of the process caused by a violation of the venous outflow, a consultation of a neurologist and an ophthalmologist (examination of the fundus) is prescribed.
Screening method, that is, rapid preliminary diagnosis -. It allows you to identify such signs:
- the location and structure of education, its size;
- the direction of blood flow, its nature (laminar, that is, linear, or turbulent, that is, swirling);
- the patency of the veins, the condition of their walls and valves.
Then the patient is assigned such methods of research:
- blood tests, urine,;
- x-ray examination of the chest and cervicothoracic spine;
- ultrasonic triplex scanning in B-mode;
- Dopplerographic determination of the linear and volumetric velocity of blood flow through the veins;
- radiopaque phlebography (filling the lumen of the vein with a substance that does not transmit x-rays);
- computer and magnetic resonance tomoangiography to accurately determine all the characteristics of the lesion.
According to phlebography, 4 types of the disease are distinguished:
- limited circular expansion in combination with tortuosity of the vein;
- limited circular expansion;
- diffuse circular expansion;
- side extension, or .
Depending on the data obtained, the surgeon plans the type of operation.
Treatment of phlebectasia of the jugular vein
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 the operation performed 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;
- expansion resection with vessel plasty.
All these types of intervention are equally effective and allow you to finally restore normal blood flow. The operation is performed under general anesthesia and takes 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 develop stenosis or thrombosis of the vessel. Doctors are good at managing these complications. The use of modern medicines can reduce the frequency of complications to a minimum.
No complications were noted in the late postoperative period.
If an operation is necessary, then refusing it will lead to adverse consequences.:
- prolonged headaches;
- the impossibility of intense physical activity;
- poor school performance;
- increased severity of other symptoms;
- the growth of a cosmetic defect in the neck.
A rare but most dangerous complication is trauma or rupture of an enlarged venous vessel. In this case, intense bleeding occurs, requiring emergency medical attention. This condition occurs with large (up to 10 cm or more) extensions.
Even the smallest phlebectasias serve as a source of improper blood flow, so they can thrombose over time. This is dangerous if a blood clot enters the heart, and through its right ventricle - into the pulmonary circulatory system. The result is a serious and often fatal condition such as pulmonary embolism.
Is it possible to give birth with moderate phlebectasia
During childbirth, pressure in the chest cavity increases, which creates an additional load on the dilated vein. Therefore, the question of the conduct of 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 straining period, anesthesia can be carried out.
With particularly severe phlebectasia and other concomitant diseases, a caesarean section is indicated.
The question of the tactics of childbirth is decided for each woman individually. If she underwent surgery for this disease in childhood, there are no restrictions for normal childbirth.
Development prevention
Primary prevention of 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 - a healthy diet, good rest, taking multivitamins for pregnant women.
If a child has an operation for this disease, in the future he is carried out annually to ensure the normal course of recovery.
If the surgical intervention was not performed, if the defect is small, it may further decrease or disappear on its own. To do this, it is necessary to strengthen the muscles of the neck: massage and physiotherapy exercises are shown. Situations that increase intra-abdominal and intrathoracic pressure should be avoided.:
- strong prolonged cough;
- persistent constipation;
- weight lifting;
- intense physical activity.
Jugular vein
| Jugular vein | |
Jugular veins. The internal jugular vein (large) is clearly visible on the left half of the figure. The external jugular vein is shown on the right (goes superficially). The anterior jugular veins descend vertically on the sides of the midline of the neck. |
|
| Latin name | |
|---|---|
| Falls into | |
| Catalogs | |
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 that carries blood from the cranial cavity. It is a continuation of the sigmoid sinus of the dura mater and starts from the jugular foramen of the skull with a bulbous extension (superior bulb of the jugular vein, bulbus jugularis superior). Further, 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 (here there is a lower 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, goes along the front 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, collects blood from superficial formations of the head, face and neck; sometimes used for catheterization and drug administration. Below, it perforates its own fascia and flows into the subclavian vein.
- Anterior jugular vein ( v. jugularis anterior) - small, formed from the saphenous veins of the chin, descends at some distance from the midline of the neck. In the lower neck, the right and left anterior jugular veins form an anastomosis, called the jugular venous arch ( arcus venosus juguli). Then the artery goes under the sternocleidomastoid muscle and flows, as a rule, into the external jugular vein.
The following veins drain into the external jugular vein:
- Posterior ear vein ( v. auricularis posterior), collects venous blood from the superficial plexus located behind the auricle. She is related to 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 flows into the external jugular vein below the posterior auricular. 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 that connect and form one trunk that flows into the terminal section of the external jugular vein or into the subclavian vein.
Anterior jugular vein ( v. jugularis anterior) is formed from the skin veins of the mental region, from where it goes down near the midline, lying first 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, forming the median vein of the neck.
Links
Wikimedia Foundation. 2010 .
See what the "Jugular Vein" is in other dictionaries:
Neck vein. The internal jugular vein (internal jugular) 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 sternum clavicular joint merges ... ... medical terms
The external jugular vein, g. 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 (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 its own 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 ear vein, g. auricularis posterior, collects venous blood from the superficial plexus located behind the auricle. She is related to 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 flows into the external jugular vein below the posterior auricular. 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 that flows into the terminal section of the external jugular vein or into the subclavian vein.
- Anterior jugular vein, v. jugularis anterior, is formed from the skin veins of the mental region, from where it goes down near the midline, lying first on the outer surface of m. mylohyoideus, and then on the front 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, forming the median vein of the neck.
