Internal Jugular Vein

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Head & Neck • Anatomy

INTERNAL JUGULAR VEIN

The internal jugular vein is a direct continuation of the sigmoid sinus and joins the subclavian vein to form the brachiocephalic vein.

01

Notes

Internal Jugular Vein

  • It is a direct continuation of the sigmoid sinus.
  • It begins at the jugular foramen.
  • It ends behind the sternal end of the clavicle by joining the subclavian vein to form the brachiocephalic vein.
02

Features

1. Superior Bulb

  • It is a dilatation at the beginning of the internal jugular vein.
  • It lies in the jugular fossa of the temporal bone.

2. Inferior Bulb

  • It is a dilatation near the termination of the internal jugular vein.
  • It lies in the lesser supraclavicular fossa.

3. Larger Right Internal Jugular Vein

  • The right IJV is larger than the left.
  • The right IJV is a direct continuation of the larger right sigmoid sinus (larger superior sagittal sinus).
  • The left IJV is a continuation of the smaller left sigmoid sinus (smaller inferior sagittal sinus).

4. Enclosed within the Carotid Sheath

  • The IJV, carotid arteries and vagus nerve are enclosed within the carotid sheath.
  • The carotid sheath is thinner around the vein.

5. Lymph Nodes

  • The deep cervical nodes lie along the entire course of the IJV.

6. Lymphatic Duct

  • At the jugulo-subclavian angle:
  • On the left → thoracic duct opens.
  • On the right → right lymphatic duct opens.
03

Relations

A. Superficial Relations

  1. Sternocleidomastoid
  2. Posterior belly of digastric
  3. Superior belly of omohyoid
  4. Parotid gland
  5. Styloid process
  6. Internal carotid artery and the following cranial nerves at the base of skull:
  • Glossopharyngeal nerve
  • Vagus nerve
  • Accessory nerve
  • Hypoglossal nerve

B. Posterior Relations

  1. Transverse process of atlas
  2. Cervical plexus
  3. Scalenus anterior
  4. First part of subclavian artery

C. Medial Relations

  1. Internal carotid artery
  2. Common carotid artery
  3. Vagus nerve
04

Beginning and Termination

Beginning

As a continuation of the sigmoid sinus.

Termination

Joins the subclavian vein to form the brachiocephalic vein.

05

Tributaries

  1. Inferior petrosal sinus
  2. Common facial vein
  3. Lingual vein
  4. Pharyngeal veins
  5. Superior thyroid vein
  6. Middle thyroid vein
06

Additional Lymphatic Drainage Shown in the Source

  • Thoracic duct → on the left
  • Right lymphatic duct → on the right
  • Communicating oblique vein

Note

  • In the middle of the neck, the internal jugular vein may communicate with the external jugular vein through the oblique jugular vein.
  • The oblique jugular vein runs across the anterior border of the sternocleidomastoid.
07

Clinical Anatomy

A. Cannulation of IJV

  • Cannulation can be performed through the apex of the lesser supraclavicular triangle.
  • This triangle lies between the two heads of the sternocleidomastoid muscle.
  • The needle should be directed backward and upward to avoid puncture of the cervical pleura.
  • If the cervical pleura is punctured, it will lead to pneumothorax.

B. Thrill

  • Thrill can sometimes be felt at the lesser supraclavicular triangle during atrial systole.
  • It is especially felt in cases of mitral stenosis.

C. Queckenstedt’s Test

  • Compression of the internal jugular veins increases the rate of CSF flow during lumbar puncture.
  • Block in the spinal subarachnoid space results in failure of this increase of CSF flow.

D. Cervical Lymphadenopathy and IJV

  • The IJV is a surgical guide for removal of cervical lymph nodes.
  • In malignant and tubercular lymphadenopathy, the lymph nodes often adhere to the IJV.
  • Resection of such lymph nodes becomes difficult.
  • It may require removal of a segment of IJV.
08

Source Flowchart Information

Internal Jugular Vein

Beginning and Termination

  • Beginning → continuation of sigmoid sinus
  • Termination → joins subclavian vein to form brachiocephalic vein

Tributaries

  • Inferior petrosal sinus
  • Common facial vein
  • Lingual vein
  • Pharyngeal vein
  • Superior thyroid vein
  • Middle thyroid veins
  • Thoracic duct on the left
  • Right lymphatic duct on the right
  • Communicating oblique vein

Clinical Integration

  • Cannulation of IJV
  • Thrill in mitral stenosis
  • Queckenstedt’s test
  • Cervical lymphadenopathy along with IJV

Source Mnemonic

“Medical Schools Let Confident People In”

From inferior to superior:

  1. Middle thyroid
  2. Common facial
  3. Superior thyroid
  4. Pharyngeal
  5. Lingual
  6. Inferior petrosal sinus
INTERNAL JUGULAR VEIN
Anatomy study notes.