The external jugular vein receives the greater part of the blood from the exterior of the

cranium The skull is a bone protective cavity for the brain. The skull is composed of four types of bone i.e., cranial bones, facial bones, ear ossicles and hyoid bone. However two parts are more prominent: the cranium and the mandible. In humans, th ...

and the deep parts of the

face The face is the front of an animal's head that features the eyes, nose and mouth, and through which animals express many of their emotions. The face is crucial for human identity, and damage such as scarring or developmental deformities may aff ...

, being formed by the junction of the posterior division of the retromandibular vein with the

posterior auricular vein The posterior auricular vein is a vein of the head. It begins from a plexus with the occipital vein and the superficial temporal vein, descends behind the auricle, and drains into the external jugular vein. Structure The posterior auricular v ...

Structure

It commences in the substance of the parotid gland, on a level with the angle of the mandible, and runs perpendicularly down the neck, in the direction of a line drawn from the angle of the mandible to the middle of the clavicle superficial to the

sternocleidomastoideus The sternocleidomastoid muscle is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck. The sternocleidomastoid is innervated by the access ...

. In its course it crosses the sternocleidomastoideus obliquely, and in the subclavian triangle perforates the

deep fascia Deep fascia (or investing fascia) is a fascia, a layer of dense connective tissue that can surround individual muscles and groups of muscles to separate into fascial compartments. This fibrous connective tissue interpenetrates and surrounds the ...

, and ends in the

subclavian vein The subclavian vein is a paired large vein, one on either side of the body, that is responsible for draining blood from the upper extremities, allowing this blood to return to the heart. The left subclavian vein plays a key role in the absorptio ...

lateral to or in front of the scalenus anterior, piercing the roof of the posterior triangle. It is separated from the sternocleidomastoideus by the investing layer of the deep cervical fascia, and is covered by the

platysma The platysma muscle is a superficial muscle of the human neck that overlaps the sternocleidomastoid. It covers the anterior surface of the neck superficially. When it contracts, it produces a slight wrinkling of the neck, and a "bowstring" effec ...

, the superficial fascia, and the integument; it crosses the cutaneous cervical nerve, and its upper half runs parallel with the great auricular nerve.

Valves

It is provided with two pairs of valves, the lower pair being placed at its entrance into the subclavian vein, the upper in most cases about 4 cm above the clavicle. The portion of vein between the two sets of valves is often dilated, and is termed the sinus. These valves do not prevent the regurgitation of the blood, or the passage of injection from below upward.

Variation

The external jugular vein varies in size, bearing an inverse proportion to the other veins of the neck, it is occasionally double.

Function

This vein receives the occipital occasionally, the posterior external jugular, and, near its termination, the transverse cervical,

transverse scapular The suprascapular artery is a branch of the thyrocervical trunk on the neck. Structure At first, it passes downward and laterally across the scalenus anterior and phrenic nerve, being covered by the sternocleidomastoid muscle; it then crosse ...

, and anterior jugular veins; in the substance of the parotid, a large branch of communication from the internal jugular joins it. The external jugular vein drains into the subclavian vein lateral to the junction of the subclavian vein and the internal jugular vein.

Clinical significance

The external jugular is a large vein used in prehospital medicine for venous access when the Paramedic is unable to find another peripheral veinhttp://pehsc.org/wp-content/uploads/2015/08/EMS-Provider-Scope-of-Practice-08-28-15.pdf It is commonly used in cardiac arrest or other situations where the patient is unresponsive due to the pain associated with the procedure. In a

cardiac arrest Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possi ...

using this vein has the advantage that the paramedic can stay at the head and intubate the patient as well. Although many EMTs and paramedics use this vein, the

American Heart Association The American Heart Association (AHA) is a nonprofit organization in the United States that funds cardiovascular medical research, educates consumers on healthy living and fosters appropriate cardiac care in an effort to reduce disability and deat ...

still recommends the use of the cephalic vein.

Additional images

File:2132 Thoracic Abdominal Veins.jpg, Veins of the thoracic and abdominal regions File:Gray378.png, Muscles of the head, face, and neck. File:Gray384.png, Section of the neck at about the level of the sixth cervical vertebra. File:Gray577.png, The venæ cavæ and azygos veins, with their tributaries.

References

External links

* () {{Authority control Veins of the head and neck