Veins - Head & Neck

Here we will learn the veins of the head and neck, with a focus on the tributaries of the external and internal jugular veins. The venous drainage of the brain and meninges are discussed elsewhere. The brachiocephalic vein receives blood from the subclavian and internal jugular veins. The subclavian vein drains the external jugular vein, which receives blood from the posterior auricular and retromandibular veins. The internal jugular vein receives blood from the common facial vein, which receives blood from the retromandibular and facial veins. The internal jugular vein also commonly receives blood from the lingual vein. We show the internal jugular vein as it descends through the neck; note that the internal jugular vein travels with the internal carotid artery in the carotid sheath. We can't see it in lateral view, but the internal jugular vein exits the skull via the jugular foramen after receiving blood from the brain. Veins that drain into the internal jugular vein: The common facial vein, which receives blood from the retromandibular and facial veins. The facial vein drains the angular vein, which receives blood from the supra-orbital and supratrochlear veins. Inferior to the common facial vein, the lingual vein drains into the internal jugular vein. The internal jugular vein also receives blood from the superior and middle thyroid veins, which drain the thyroid gland (the inferior thyroid vein does not drain into the internal jugular vein). Now we'll show the external jugular vein and its tributaries. The posterior auricular vein descends behind the external auditory meatus and drains into the external jugular vein. The superficial temporal and maxillary veins drain into the retromandibular vein. The superficial temporal vein drains blood from the scalp; the maxillary vein drains blood from the infratemporal fossa. The retromandibular vein has an anterior branch and posterior branch. The anterior branch drains into the common facial vein; the posterior branch drains into the external jugular vein. The external jugular vein drains into the subclavian vein (which also receives blood from the upper extremity). Together, the subclavian and internal jugular veins drain into the brachiocephalic vein, which returns blood from the head and neck to the right atrium via the superior vena cava. We can measure jugular venous pulse, typically of the right internal jugular vein, to assess the functioning of the right side of the heart. Elevation of the jugular venous pulse may indicate right heart failure. Also, remember that vascular networks, especially venous networks, are highly variable. The external jugular vein receives blood from the: Transverse cervical vein, which drains blood from the upper back; The suprascapular vein, which drains the posterior shoulder region; And, the anterior jugular vein, which is a superficial vein that drains superficial tissues of the anterior neck. The internal jugular vein often receives blood from the posterior scalp via the occipital vein, although this is highly variable. The subclavian vein receives blood from the internal thoracic vein, which travels with the internal thoracic artery within the thoracic cage. The brachiocephalic vein receives blood from the inferior thyroid vein (recall that the superior and middle thyroid veins drained into the internal jugular vein). The venous angle is formed where the internal jugular vein meets the subclavian vein; this is the junction where lymphatic vessels drain lymph to the systemic blood supply. On the left side, the venous angle receives lymph from the thoracic duct, and, on the right side, from the right lymphatic duct.