Internal jugular vein
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| Vein: Internal jugular vein | |
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| The fascia and middle thyroid veins. (Internal jugular visible at center left.) | |
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| Veins of the tongue. The hypoglossal nerve has been displaced downward in this preparation. (Internal jugular visible at bottom left.) | |
| Latin | vena jugularis interna |
| Gray's | subject #168 648 |
| Source | anterior facial |
| Drains to | brachiocephalic |
| Artery | internal carotid, common carotid |
| MeSH | Jugular+Veins |
| Dorlands / Elsevier | v_05/12850757 |
| Cardiology Network |
 Discuss Internal jugular vein further in the WikiDoc Cardiology Network |
| Adult Congenital |
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Overview
The internal jugular vein collects the blood from the brain, from the superficial parts of the face, and from the neck.
Path
It is directly continuous with the sigmoid sinus, and begins in the posterior compartment of the jugular foramen, at the base of the skull.
At its origin it is somewhat dilated, and this dilatation is called the superior bulb.
It runs down the side of the neck in a vertical direction, lying at first lateral to the internal carotid artery, and then lateral to the common carotid, and at the root of the neck unites with the subclavian vein to form the brachiocephalic vein (innominate vein); a little above its termination is a second dilatation, the inferior bulb.
Above, it lies upon the Rectus capitis lateralis, behind the internal carotid artery and the nerves passing through the jugular foramen; lower down, the vein and artery lie upon the same plane, the glossopharyngeal and hypoglossal nerves passing forward between them; the vagus descends between and behind the vein and the artery in the same sheath (the carotid sheath), and the accessory runs obliquely backward, superficial or deep to the vein.
At the root of the neck the right internal jugular vein is placed at a little distance from the common carotid artery, and crosses the first part of the subclavian artery, while the left internal jugular vein usually overlaps the common carotid artery.
The left vein is generally smaller than the right, and each contains a pair of valves, which are placed about 2.5 cm. above the termination of the vessel.
Clinical Relevance
The jugular veins are relatively superficial and not protected by tissues such as bone or cartilage. This makes it susceptible to damage. Due to the large volumes of blood that flow though the jugular veins, damage to the jugulars can quickly cause significant blood loss which can lead to hypovolæmic shock and then death if not treated.
JVP
As there are no valves between the right atrium of the heart and the internal jugular, blood can flow back into the internal jugular when the pressure in the atrium is sufficiently high. This can be seen from the outside, and allows one to estimate the pressure in the atrium. The pulsation seen is called the jugular venous pressure, or JVP. This is normally viewed with the patient at 45 degrees turning their head slightly away from the observer. The JVP can be raised in a number of conditions:[1]
- right ventricular failure (heart failure),
- tricuspid stenosis
- tricuspid regurgitation
- cardiac tamponade
The JVP can also be artificially raised by applying pressure to the liver (the hepatojugular reflux). This method is used to locate the JVP and distinguish it from the carotid pulse. Unlike the carotid pulse, the JVP is impalpable.
Catheterization
As the internal jugular is large, central and relatively superficial, it is often used to place venous lines. Such a line may be inserted for several reasons, such as to accurately measure the central venous pressure or to administer fluids when a line in a peripheral vein would be unsuitable (such as during resuscitation when peripheral veins are hard to locate).
Because the internal jugular rarely varies in its location, it is easier to find than other veins. However sometimes when a line is inserted the jugular is missed and other structures such as the carotid artery or the vagus nerve (CN X) are punctured, causing damage to those structures.
Additional images
 Section of the neck at about the level of the sixth cervical vertebra. |
 Diagram showing completion of development of the parietal veins. |
 Superficial dissection of the right side of the neck, showing the carotid and subclavian arteries. |
 The veins of the neck, viewed from in front. |
 The vertebral vein. |
 The venæ cavæ and azygos veins, with their tributaries. |
 Scheme showing relative positions of primary lymph sacs. |
 The thoracic and right lymphatic ducts. |
 Alveolar branches of superior maxillary nerve and sphenopalatine ganglion. |
 Course and distribution of the glossopharyngeal, vagus, and accessory nerves. |
 Hypoglossal nerve, cervical plexus, and their branches. |
 Muscles of the pharynx, viewed from behind, together with the associated vessels and nerves. |
 The position and relation of the esophagus in the cervical region and in the posterior mediastinum. Seen from behind. |
 The thyroid gland and its relations. |
 The thymus of a full-term fetus, exposed in situ. |
See also
References
This article was originally based on an entry from a public domain edition of Gray's Anatomy. As such, some of the information contained herein may be outdated. Please edit the article if this is the case, and feel free to remove this notice when it is no longer relevant.
Veins of the torso | |
|---|---|
| Coronary | coronary sinus (great cardiac, left marginal, small cardiac, middle cardiac, posterior of the left ventricle, oblique of the left atrium) • anterior cardiac (right marginal) • pulmonary |
| Thorax/ SVC | brachiocephalic: internal thoracic (anterior intercostal, superior epigastric) - left superior intercostal - supreme - vertebral - subclavian (axillary: lateral thoracic, thoracoepigastric, dorsal scapular) - pericardiacophrenic azygos: right superior intercostal - bronchial - intercostal/posterior intercostal 5-11 - accessory hemiazygos/hemiazygos - superior phrenic |
| Vertebral column | vertebral venous plexuses (external, internal) • spinal (posterior, anterior) • basivertebral • intervertebral |
| Abdomen/ IVC | to IVC (some to renal vein on left): inferior phrenic - hepatic - suprarenal - renal - gonadal (ovarian ♀/testicular ♂, pampiniform plexus ♂) - lumbar - common iliac to azygos system: ascending lumbar (subcostal) |
| Pelvis/common iliac | median sacral vein
external iliac: inferior epigastric - deep circumflex iliac vein internal iliac - posterior: iliolumbar - superior gluteal - lateral sacral internal iliac - anterior: inferior gluteal - obturator - uterine ♀ (uterine plexus ♀) - vesical (vesical plexus, prostatic plexus ♂, deep of penis ♂/clitoris ♀, posterior scrotal ♂/labial ♀) - vaginal plexus/vein ♀ - middle rectal - internal pudendal (inferior rectal, bulb of penis ♂/vestibule ♀) - rectal plexus |
| Portal system/ portal vein | splenic: short gastric - left gastroepiploic - pancreatic - inferior mesenteric (superior rectal, left colic)
superior mesenteric: right gastroepiploic - pancreaticoduodenal - jejunal - ileal - middle colic - right colic - ileocolic (appendicular) direct (cystic, left gastric/esophageal, right gastric, paraumbilical) |
| fetal | ductus venosus • umbilical |
WikiDoc Research Resources for Internal jugular vein | |
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| Articles on Internal jugular vein | Most recent articles on Internal jugular vein • Most cited articles on Internal jugular vein • Review articles on Internal jugular vein • Articles on Internal jugular vein in N Eng J Med, Lancet, BMJ |
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| Evidence Based Medicine Regarding Internal jugular vein | Cochrane Collaboration on Internal jugular vein • Bandolier on Internal jugular vein • TRIP on Internal jugular vein |
| Cost Effectiveness of Internal jugular vein | Cost Effectiveness of Internal jugular vein |
| Clinical Trials Involving Internal jugular vein | Ongoing Trials on Internal jugular vein at Clinical Trials.gov • Trial results on Internal jugular vein • Clinical Trials on Internal jugular vein at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Internal jugular vein | US National Guidelines Clearinghouse on Internal jugular vein • NICE Guidance on Internal jugular vein • NHS PRODIGY Guidance • FDA on Internal jugular vein • CDC on Internal jugular vein |
| Textbook Information on Internal jugular vein | Books and Textbook Information on Internal jugular vein |
| Pharmacology Resources on Internal jugular vein | Dosing of Internal jugular vein • Drug interactions with Internal jugular vein • Side effects of Internal jugular vein • Allergic reactions to Internal jugular vein • Overdose information on Internal jugular vein • Carcinogenicity information on Internal jugular vein • Internal jugular vein in pregnancy • Pharmacokinetics of Internal jugular vein • |
| Genetics, Pharmacogenomics, and Proteinomics of Internal jugular vein | Genetics of Internal jugular vein • Pharmacogenomics of Internal jugular vein • Proteomics of Internal jugular vein |
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| Patient Resources on Internal jugular vein | Patient resources on Internal jugular vein • Discussion groups on Internal jugular vein • Patient Handouts on Internal jugular vein • Directions to Hospitals Treating Internal jugular vein • Risk calculators and risk factors for Internal jugular vein |
| Healthcare Provider Resources on Internal jugular vein | Symptoms of Internal jugular vein • Causes & Risk Factors for Internal jugular vein • Diagnostic studies for Internal jugular vein • Treatment of Internal jugular vein |
| Continuing Medical Education (CME) Programs on Internal jugular vein | CME Programs on Internal jugular vein |
| International Resources on Internal jugular vein | Internal jugular vein en Espanol • Internal jugular vein en Francais |
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| Informatics Resources on Internal jugular vein | List of terms related to Internal jugular vein |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
