course tributaries clinicals

1. IJV - Course
• It begins as the Direct Continuation Of The
Sigmoid Sinus at the base of the skull below
the jugular foramen
• Descends vertically downwards to end behind
the sternal end of the clavicle by joining the
Subclavian Vein to form the
Brachiocephalic Vein
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2. IJV - Course
• The Right Internal Jugular Vein is usually
Larger Than the Left
▫ because it drains the blood from the Larger
Superior Sagittal Sinus
▫ Left Internal Jugular Vein drains blood from the
Smaller Inferior Sagittal Sinus.
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3. Internal Jugular Vein
• The Internal Jugular Vein is usually the Largest
Vein In The Neck
• The Internal Jugular Vein Drains from Brain
and Most of the Tissues of the Head and
Neck.

4. Two Dilatations
▫ First:-at its commencement,
Lies In The Jugular Fossa
Of The Temporal Bone.
 It is known as Superior Bulb
and is Related to
the Floor of the Middle Ear.
▫ Second:-close to its
termination, which Lies In
The Lesser
Supraclavicular Fossa
between the sternal and
clavicular heads of
sternocleidomastoid.
 It is known as Inferior Bulb
and is Guarded by a
Bicuspid Valves.
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5. Carotid sheath
IJV is lateral to the Internal and Common
Carotid Arteries, Enclosed with them and the
Vagus Nerve in Carotid Sheath
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6. Cervical lymph
node
The Deep Cervical Lymph Nodes Lie
Along Its Entire Course.
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7. Surface marking
Constant in Position
Marked on the surface by
a vertical line extending
from midpoint between
the Tip of the Mastoid
Process and the Angle of
the Mandible, to the
Sternoclavicular Joint
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8. Superficial (Anterolateral) Relations
• 1. Crossed by two muscles
▫ (a) Posterior belly of Digastric Muscle in the upper part.
▫ (b) Inferior belly of Omohyoid in the lower part.
• 2. Crossed by two arteries
▫ (a) Occipital Artery.
▫ (b) Posterior Auricular Artery.
• 3. Crossed by one vein
▫ Anterior Jugular Vein
• 4. Crossed by two nerves
▫ (a) Spinal Accessory Nerve.
▫ (b) Inferior Root of Ansa cervicalis (Descendens cervicalis).
• 5. At the base of skull the internal carotid artery lies in Front of
the Internal Jugular Vein and the Last Four Cranial Nerves
Intervene Between the Vein and the Artery.
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9. Deep (Posterior) Relations
• 1. Rectus capitis lateralis.
• 2. Transverse process of atlas.
• 3. Levator scapulae.
• 4. Scalenus medius and Cervical plexus.
• 5. Scalenus anterior and Phrenic Nerve.
• 6. Thyrocervical trunk and first part of Vertebral
Artery.
• 7. First part of the Subclavian Artery.
• 8. Thoracic Duct on the left side.
• 9. The Sternocleidomastoid overlaps the upper part
and covers the lower part of the vein.
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10. Medial Relations
1. Internal Carotid Artery
2.9th, 10th, 11th, and 12th Cranial Nerves in the
upper part
3. Common Carotid Artery
4. Vagus Nerve in the lower part.
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11. Tributaries
• 1. Inferior Petrosal sinus —is usually the First
Tributary and joins the Internal Jugular Vein
immediately below the Jugular Foramen.
• 2. Pharyngeal Veins—from Pharyngeal Plexus.
• 3. Facial Vein.
• 4. Lingual Vein.
• 5. Superior Thyroid Vein.
• 6. Middle Thyroid Vein.
• 7. Occipital Vein (only sometimes)
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12. Tributaries
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13. Subclavian vein
Continuation of axillary vein at the outer
border of the 1st rib
join IJV to form Brachiocephalic vein
receiving EJV
left side : receive thoracic duct
right side: receive lymphatic duct
RELATIONS
Ant : clavicle
Post : scal.ANT and Phrenic nerve
Inf: upper surface of the 1st rib

14. Clinical Correlation
• The Internal Jugular Vein acts as a Guide for
Surgeons during removal of Deep
Cervical Lymph Nodes.
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15. Deep (Posterior) Relations
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16. Superficial (Anterolateral) Relations
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