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FIG. 90558 The veins of the neck, viewed from in front. (Spalteholz.) |
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The posterior external jugular vein (v. jugularis posterior) begins in the occipital region and returns the blood from the skin and superficial muscles in the upper and back part of the neck, lying between the Splenius and Trapezius. It runs down the back part of the neck, and opens into the external jugular vein just below the middle of its course. |
The anterior jugular vein (v. jugularis anterior) begins near the hyoid bone by the confluence of several superficial veins from the submaxillary region. It descends between the median line and the anterior border of the Sternocleidomastoideus, and, at the lower part of the neck, passes beneath that muscle to open into the termination of the external jugular, or, in some instances, into the subclavian vein (Figs. 90557, 90558). It varies considerably in size, bearing usually an inverse proportion
to the external jugular; most frequently there are two anterior jugulars, a right and left; but sometimes only one. Its tributaries are some laryngeal veins, and occasionally a small thyroid vein. Just above the sternum the two anterior jugular veins communicate by a transverse trunk, the venous jugular arch, which receive tributaries from the inferior thyroid veins; each also communicates with the internal jugular. There are no valves in this vein. |
The internal jugular vein (v. jugularis interna) collects the blood from the brain, from the superficial parts of the face, and from the neck. It is directly continuous with the transverse 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 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, 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. |
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FIG. 90559 Veins of the tongue. The hypoglossal nerve has been displaced downward in this preparation. (Testut after Hirschfeld.) |
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Tributaries.This vein receives in its course the inferior petrosal sinus, the common facial, lingual, pharyngeal, superior and middle thyroid veins, and sometimes the occipital. The thoracic duct on the left side and the right lymphatic duct on the right side open into the angle of union of the internal jugular and subclavian veins. |
The Inferior Petrosal Sinus (sinus petrosus inferior) leaves the skull through the anterior part of the jugular foramen, and joins the superior bulb of the internal jugular vein. |
The Lingual Veins (vv. linguales) begin on the dorsum, sides, and under surface of the tongue, and, passing backward along the course of the lingual artery, end in the internal jugular vein. The vena comitans of the hypoglossal nerve (ranine
vein), a branch of considerable size, begins below the tip of the tongue, and may join the lingual; generally, however, it passes backward on the Hyoglossus, and joins the common facial. |
The Pharyngeal Veins (vv. pharyngeæ) begin in the pharyngeal plexus on the outer surface of the pharynx, and, after receiving some posterior meningeal veins and the vein of the pterygoid canal, end in the internal jugular. They occasionally open into the facial, lingual, or superior thyroid vein. |
The Superior Thyroid Vein (v. thyreoidea superioris) (Fig. 90560) begins in the substance and on the surface of the thyroid gland, by tributaries corresponding with the branches of the superior thyroid artery, and ends in the upper part of the internal jugular vein. It receives the superior laryngeal and cricothyroid veins. |
The Middle Thyroid Vein (Figs. 90561, 90562) collects the blood from the lower part of the thyroid gland, and after being joined by some veins from the larynx and trachea, ends in the lower part of the internal jugular vein. |
The common facial and occipital veins have been described. |
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FIG. 90560 The veins of the thyroid gland. |
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The vertebral vein (v. vertebralis) is formed in the suboccipital triangle, from numerous small tributaries which spring from the internal vertebral venous plexuses and issue from the vertebral canal above the posterior arch of the atlas. They unite with small veins from the deep muscles at the upper part of the back of the neck, and form a vessel which enters the foramen in the transverse process of the atlas, and descends, forming a dense plexus around the vertebral artery, in the canal formed by the foramina transversaria of the cervical vertebræ. This plexus ends in a single trunk, which emerges from the foramen transversarium of the sixth cervical vertebra, and opens at the root of the neck into the back part of the innominate vein near its origin, its mouth being guarded by a pair of valves. On the right side, it crosses the first part of the subclavian artery. |
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Tributaries.The vertebral vein communicates with the transverse sinus by a vein which passes through the condyloid canal, when that canal exists. It receives branches from the occipital vein and from the prevertebral muscles, from the internal and external vertebral venous plexuses, from the anterior vertebral and the deep cervical veins; close to its termination it is sometimes joined by the first intercostal vein. |
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FIG. 90561 Diagram showing common arrangement of thyroid veins. (Kocher.) |
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FIG. 90562 The fascia and middle thyroid veins. The veins here designated the inferior thyroid are called by Kocher the thyroidea ima. (Poirier and Charpy.) |
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The Anterior Vertebral Vein commences in a plexus around the transverse processes of the upper cervical vertebræ, descends in company with the ascending cervical artery between the Scalenus anterior and Longus capitis muscles, and opens into the terminal part of the vertebral vein. |
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FIG. 90563 The vertebral vein. (Poirier and Charpy.) |
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The Deep Cervical Vein (v. cervicalis profunda; posterior vertebral or posterior deep cervical vein) accompanies its artery between the Semispinales capitis and colli. It begins in the suboccipital region by communicating branches from the occipital vein and by small veins from the deep muscles at the back of the neck. It receives tributaries from the plexuses around the spinous processes of the cervical vertebræ, and terminates in the lower part of the vertebral vein. |