Internal jugular vein

At a glance

English

Internal jugular vein

Latin (TA2)

Vena jugularis interna

System

Vein

Region

Neck

Side

Paired, left and right

About the internal jugular vein

The internal jugular vein is the main channel draining the brain, and it also takes blood from the face and neck. It begins at the jugular foramen in the base of the skull as the continuation of the sigmoid sinus, in the hind part of the foramen. Its first stretch is widened into the superior bulb. It then runs straight down the neck at its side and, behind the sternal end of the clavicle, meets the subclavian vein, and the two make the brachiocephalic vein. Just before that junction it widens again into the inferior bulb, which holds a pair of valves.

Throughout the neck it lies in the carotid sheath. Above, it is behind the internal carotid artery, resting on rectus capitis lateralis, with the last four cranial nerves leaving the skull between the two vessels. Lower down it lies lateral to the internal and then the common carotid artery, with the vagus nerve between and behind them in the sheath. The glossopharyngeal and hypoglossal nerves pass forwards between vein and artery, and the accessory nerve crosses the vein, usually in front of it. Low in the neck the right vein lies a little away from the common carotid, over the first part of the right subclavian artery, whereas the left usually overlaps its artery and is generally the smaller.

Its tributaries include the inferior petrosal sinus, the pharyngeal veins, the common facial vein, the lingual vein, the superior and middle thyroid veins and sometimes the occipital vein. Its average width is about a centimetre, but it varies greatly, and in some people it is small or barely present.

Since only the right atrium and its valves stand between the heart and this vein, the column of blood in the right internal jugular reflects right atrial pressure. With the patient reclined at about 45 degrees, its pulsation, the jugular venous pressure, can be seen but not felt; it is raised in right heart failure, tricuspid valve disease and cardiac tamponade, and pressing on the liver can make it rise. The vein is a favoured site for central venous catheters, guided by ultrasound to avoid the carotid artery, the lung apex and the vagus nerve. Injury to it can cause rapid, heavy bleeding.

Course and drainage

Begins at

Begins at the jugular foramen as the continuation of the sigmoid sinus, with a widened superior bulb.

Drains into

Unites with the subclavian vein behind the sternal end of the clavicle, creating the brachiocephalic vein.

Drains

Drains the brain and the inside of the skull, and much of the face, tongue, pharynx, thyroid and neck.