Notes
Veins of the Head and Neck
Sections
Notes
Tributaries of the Brachiocephalic vein:
Subclavian vein
Internal jugular vein
Subclavian vein
- Internal thoracic vein, which travels with the internal thoracic artery within the thoracic cage
- External jugular vein
- Posterior auricular vein
- Retromandibular vein drains Superficial temporal vein and Maxillary vein
- Transverse cervical vein, which drains blood from the upper back
- Suprascapular vein, which drains the posterior shoulder region
- Anterior jugular vein, which is a superficial vein that drains superficial tissues of the anterior neck.
Internal jugular vein
- Descends within neck with internal carotid artery
- Exits skull via jugular foramen
Receives blood from: - Common facial vein
- Supra-orbital vein
- Supratrochlear vein
- Angular vein
- Facial vein
- Lingual vein
- Superior and middle thyroid veins
- Internal jugular vein often receives blood from the posterior scalp via the occipital vein, although this is highly variable.
- Retromandibular vein.
- Retromandibular vein drains into both the external and the internal jugular veins.
Additional information
Where the internal jugular vein meets the subclavian vein, they form the venous angle.
It is at this junction that lymphatic vessels drain lymph to the systemic blood supply.
On the left side, the venous angle receives lymph via the thoracic duct, and, on the right side, from the right lymphatic duct.
Clinical correlation
- Clinicians 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 failure of the right side of the heart.
- Vascular networks, especially venous networks, are highly variable.
Full-Length Text
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.
Show a tree of the major veins that drain the head and neck.
Indicate that the brachiocephalic vein drains the subclavian vein, and, the internal jugular vein.
Denote that the subclavian vein drains the external jugular vein, which receives blood from the posterior auricular vein and, the retromandibular vein.
Denote that the internal jugular vein receives blood from the common facial vein, and, the retromandibular vein.
Notice that the retromandibular vein will drain into both the external and the internal jugular veins.
Now, in order to understand the important anatomical landmarks, let's draw the bony features of the head in lateral view.
Draw the cranium, and outline the anterior face: the nasal bones and the maxilla, the zygomatic arch and bone, and, the eye orbit.
Draw the mastoid process (of the temporal bone), and, just anterior to it, the show the external auditory meatus.
Draw the neck and body of the mandible.
Indicate the infratemporal fossa, which is an irregularly shaped area inferior to the zygomatic arch and deep to the mandible.
Now we'll redraw the right side of the skull with the veins.
Again, draw the cranium and bones of the face.
Show the zygomatic arch and bone, the mastoid process, and, the external auditory meatus.
Draw the mandible.
Next, add the 7 cervical vertebrae.
Anteriorly, in the neck, draw the trachea and larynx.
Show that the thyroid gland lies superficial to the trachea and larynx.
Now we'll draw the veins.
First, show the internal jugular vein as it descends through the neck (specifically, with the internal carotid artery within the carotid sheath). Though not visible here, the internal jugular vein, which receives blood from the brain, exits the skull through the jugular foramen on the inferior surface of the skull.
Next, draw the veins that drain into the internal jugular vein:
The common facial vein, which receives blood from several smaller veins, including, from superior to inferior, the: Supra-orbital vein, Supratrochlear vein, angular, facial, and lingual veins.
Show that the internal jugular 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 that the external jugular vein, which remains external to the skull, drains the posterior auricular and retromandibular veins.
First, draw the posterior auricular vein as it descends behind the external auditory meatus.
Then, show that, together, the superficial temporal vein and the maxillary vein drain into the retromandibular vein.
The superficial temporal vein drains blood from the scalp; the maxillary vein drains blood from the infratemporal fossa.
Next, show that the retromandibular vein has an anterior branch, which drains into common facial vein, and, a
posterior branch, which drains into the external jugular vein.
Inferiorly, show that the external jugular vein drains into the subclavian vein (which drains 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.
Finally, write that clinicians 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 failure of the right side of the heart.
Also, remember that vascular networks, especially venous networks, are highly variable.
END OF ESSENTIAL/START OF ADVANCED
Now, list some of the tributaries that have been omitted in our diagram:
Indicate that:
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
- 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.
Write that the internal thoracic vein, which travels with the internal thoracic artery within the thoracic cage, drains into the subclavian vein.
The brachiocephalic vein receives blood from the inferior thyroid vein (as opposed to the superior and middle thyroid veins, which drained into the internal jugular vein).
Finally, in our diagram, indicate that where the internal jugular vein meets the subclavian vein, they form the venous angle. It is at this junction that lymphatic vessels drain lymph to the systemic blood supply. Write that, on the left side, the venous angle receives lymph via the thoracic duct, and, on the right side, from the right lymphatic duct.