Venous Drainage of the Head and Neck
The veins of the head and neck collect deoxygenated blood and return it to the heart. Anatomically, the venous drainage can be divided into three parts:
Venous drainage of the brain and meninges: Supplied by the dural venous sinuses.
Venous drainage of the scalp and face: Drained by veins synonymous with the arteries of the face and scalp. These empty into the internal and external jugular veins.
Venous drainage of the neck: Carried out by the anterior jugular veins.
In this article, we shall look at the veins mentioned above, their anatomical course, and any clinical correlations.
Jugular Veins
There are three main jugular veins – external, internal and anterior. They are ultimately responsible for the venous drainage of the whole head and neck.
External Jugular Vein
The external jugular vein and its tributaries supply the majority of the external face. It is formed by the union of two veins:
Posterior auricular vein – drains the area of scalp superior and posterior to the outer ear.
Retromandibular vein (posterior branch) – itself formed by the maxillary and superficial temporal veins, which drain the face.
These two veins combine immediately posterior to the angle of mandible, and inferior to the outer ear, forming the external jugular vein.
After formation, the external jugular vein descends down the neck within the superficial fascia. It runs anteriorly to the sternocleidomastoid muscle, crossing it in an
oblique, posterior and inferior direction.
In the root of the neck, the vein passes underneath the clavicle, and terminates by draining into the subclavian vein. Along its route down the neck, the EJV receives
tributary veins – posterior external jugular, transverse cervical and suprascapular veins.
Fig 1 – Major tributaries of the external jugular vein, draining the external face and scalp. The facial and internal jugular veins are labelled for completeness
+Clinical Relevance: Severance of the External Jugular Vein
The external jugular vein has a relatively superficial course down the neck, leaving it vulnerable to damage.
If it is severed, in an injury such as a knife slash, its lumen is held open – this is due to the thick layer of investing fascia (for more information see Fascial Layers of
the Neck). Air will be drawn into the vein, producing cyanosis, and can stop blood flow through the right atrium. This is a medical emergency, managed by the
application of pressure to the wound – stopping the bleeding, and the entry of air.
Anterior Jugular Veins
The anterior jugular veins vary from person to person. They are paired veins, which drain the anterior aspect of the neck. Often they will communicate via a jugular venous
arch. The anterior jugular veins descend down the midline of the neck, emptying into the subclavian vein.
The veins of the head and neck collect deoxygenated blood and return it to the heart. Anatomically, the venous drainage can be divided into three parts:
Venous drainage of the brain and meninges: Supplied by the dural venous sinuses.
Venous drainage of the scalp and face: Drained by veins synonymous with the arteries of the face and scalp. These empty into the internal and external jugular veins.
Venous drainage of the neck: Carried out by the anterior jugular veins.
In this article, we shall look at the veins mentioned above, their anatomical course, and any clinical correlations.
Jugular Veins
There are three main jugular veins – external, internal and anterior. They are ultimately responsible for the venous drainage of the whole head and neck.
External Jugular Vein
The external jugular vein and its tributaries supply the majority of the external face. It is formed by the union of two veins:
Posterior auricular vein – drains the area of scalp superior and posterior to the outer ear.
Retromandibular vein (posterior branch) – itself formed by the maxillary and superficial temporal veins, which drain the face.
These two veins combine immediately posterior to the angle of mandible, and inferior to the outer ear, forming the external jugular vein.
After formation, the external jugular vein descends down the neck within the superficial fascia. It runs anteriorly to the sternocleidomastoid muscle, crossing it in an
oblique, posterior and inferior direction.
In the root of the neck, the vein passes underneath the clavicle, and terminates by draining into the subclavian vein. Along its route down the neck, the EJV receives
tributary veins – posterior external jugular, transverse cervical and suprascapular veins.
Fig 1 – Major tributaries of the external jugular vein, draining the external face and scalp. The facial and internal jugular veins are labelled for completeness
+Clinical Relevance: Severance of the External Jugular Vein
The external jugular vein has a relatively superficial course down the neck, leaving it vulnerable to damage.
If it is severed, in an injury such as a knife slash, its lumen is held open – this is due to the thick layer of investing fascia (for more information see Fascial Layers of
the Neck). Air will be drawn into the vein, producing cyanosis, and can stop blood flow through the right atrium. This is a medical emergency, managed by the
application of pressure to the wound – stopping the bleeding, and the entry of air.
Anterior Jugular Veins
The anterior jugular veins vary from person to person. They are paired veins, which drain the anterior aspect of the neck. Often they will communicate via a jugular venous
arch. The anterior jugular veins descend down the midline of the neck, emptying into the subclavian vein.
