Jugular venous system
All venous blood from the head and neck organs is directed into the jugular venous system. The largest of these is the internal jugular vein (v. jugularis interna). It originates at the jugular foramen of the skull, forming the superior bulb (bulbus superior). In the neck, it is located in the carotid triangle along with the common carotid artery and vagus nerve, and before joining the subclavian vein, it forms the inferior bulb (bulbus inferior).
An auxiliary role is played by:
- External jugular vein (v. jugularis externa) — descends subcutaneously along the outer surface of the sternocleidomastoid muscle. It is formed behind the angle of the mandible.
- Anterior jugular vein (v. jugularis anterior) — runs close to the midline of the neck. Above the sternum, the veins of both sides connect in the interfascial space, forming the jugular venous arch (arcus venosus jugularis).
Dural venous sinuses
Blood from the cranial cavity is drained into the dural venous sinuses (sinus durae matris). Unlike ordinary veins, their walls are formed by dense fibrous connective tissue with elastic fibers. They lack valves and remain patent when cut, which ensures unobstructed blood outflow regardless of intracranial pressure.
Main sinuses:
- Superior and inferior sagittal — run along the margins of the falx cerebri.
- Straight sinus (sinus rectus) — merges with the superior sagittal sinus, forming the confluence of sinuses (confluens sinuum).
- Transverse sinus (sinus transversus) — drains blood from the confluence of sinuses, continuing as the sigmoid sinus.
- Sigmoid sinus (sinus sigmoideus) — drains blood directly into the superior bulb of the internal jugular vein.
Veins of the face and cranial vault
Superficial blood drainage from the face is carried out by the facial vein (v. facialis). It begins at the medial angle of the eye as the angular vein (v. angularis), descending obliquely downwards and receiving veins from the nose, eyelids, and lips.
Deep parts of the face are drained through:
- Retromandibular vein (v. retromandibularis), which passes through the parotid gland.
- Pterygoid plexus (plexus pterygoideus) — a deep venous plexus.
Of particular importance are the emissary veins (vv. emissariae) — parietal, occipital, mastoid, and condylar. They perforate the cranial bones and connect intracranial sinuses with the superficial veins of the head.
Briefly: answers to topical questions
The external jugular vein is formed by the union of which veins?
The external jugular vein is formed at the level of the mandibular angle below the auricle by the confluence of two venous trunks. Its formation involves:
- Anastomosis with the retromandibular vein
- Posterior auricular vein (v. auricularis posterior) — collects blood behind the auricle.
What tributaries does the facial vein receive along its course?
Along its course, the facial vein receives a number of tributaries that collect blood from various facial structures. These include:
- Angular vein (v. angularis) — the initial segment at the root of the nose.
- Supratrochlear vein (v. supratrochlearis) — descends from the forehead.
- Supraorbital vein (v. supraorbitalis).
- Nasofrontal vein (v. nasofrontalis).
- Superior and inferior palpebral veins (vv. palpebrales superiores et inferiores).
- External nasal veins (vv. nasales externae).
- Superior and inferior labial veins (vv. labiales superiores et inferiores).
- Transverse facial vein (v. transversa faciei) — drains laterally.
- Deep facial vein (v. profunda faciei).
Which veins drain into the pterygoid venous plexus?
Sources explicitly indicate that the following drain into the pterygoid venous plexus:
- Deep temporal veins.
Also, the pterygoid venous plexus is connected with:
- Maxillary vein (v. maxillaris)
- Middle meningeal vein (v. meningea media)
It has anastomoses with:
- Facial vein
- Cavernous sinus via emissary veins.
What extracranial tributaries does the internal jugular vein have?
The extracranial tributaries of the internal jugular vein collect blood from the soft tissues of the head and neck organs. These include:
- Pharyngeal veins (vv. pharyngeae)
- Lingual vein (v. lingualis)
- Superior thyroid vein (v. thyroidea superior)
- Middle thyroid veins (vv. thyroideae mediae)
- Facial vein (v. facialis)
Additionally, the occipital vein (v. occipitalis) may sometimes drain into the internal jugular vein.
Topography of the neurovascular bundle of the neck (from center to periphery): Artery (common carotid) — medially, Vein (internal jugular) — laterally, and Nerve (vagus) — between them and posteriorly.
Class and exam questions
How do venous sinuses differ from ordinary veins?
The walls of the sinuses are formed by the dense tissue of the dura mater; they do not collapse when cut and have no valves, unlike most veins.
Where does the internal jugular vein drain?
Behind the sternoclavicular joint, it joins the subclavian vein to form the brachiocephalic vein.
What is the confluence of sinuses?
The confluence of sinuses (confluens sinuum) is the junction point of the sagittal, straight, transverse, and occipital sinuses on the inner surface of the occipital bone.
What else to study on this topic
- Internal thoracic veins and their anastomoses with epigastric veins
- Anatomy of the cavernous sinus (sinus cavernosus)
- Tributaries of the external jugular vein (occipital vein, suprascapular vein, transverse cervical veins)
- Topography of the vertebral and deep cervical veins
- Ophthalmic veins and their connections with the sinuses and facial vein
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