Study guide
Study guide

Internal jugular vein

Glossary

CCA - common carotid artery

CN - cranial nerve(s)

EJV - external jugular vein

ICA - internal carotid artery

IJV - internal jugular vein

LIJ - left internal jugular vein

LN - lymph node

RIJ - right internal jugular vein

SCM - sternocleidomastoid muscle

SCV - subclavian vein

SVC - superior vena cava

Origin and course

  • originates at superior jugular bulb in cranium (confluence of inferior petrosal sinus and sigmoid sinus)
  • exits cranium via jugular foramen with cranial nerves 9-11, posterior to ICA

Anatomical diagram of the IJV, demonstrating its origin and relation to the carotid artery and cranial nerves

  • descends laterally to ICA which is continuous with CCA in the carotid sheath
  • moves anterior and lateral to CCA in anterior triangle of neck
  • descends deep to SCM
  • widens to form inferior jugular bulb posterior to medial clavicle where it joins SCV
    • R) SCV → SVC
    • L) SCV → innominate vein → SVC
  • RIJ usually larger than LIJ
Clinical relevance

You may notice the IJV moves from posterior to anterolateral as you scan inferiorly down the neck when inserting a central line.

Tributaries

  • facial, pharyngeal, lingual, sup/middle thyroid and occipital veins

Anatomical diagram of the course of the IJV

Surface anatomy

The anterior neck triangle is formed by:

  • mandible
  • midline
  • anterior/medial border of SCM

The IJV is 0.5-1cm lateral to the palpable carotid pulse at the apex of this triangle (near the sternum).

Anatomical diagram of anterior neck triangle

Muscles and triangles of neck by Beckie Palmer CC BY, via Anatomy Tool

Relations

Anterior

  • superior neck - skin, subcutaneous tissue
  • inferior neck - SCM

Posterior

  • from superior to inferior:
    • lateral mass of cervical vertebrae, scalene, pleura, sympathetic chain

Medial

  • CCA as described
  • CN 9-12 superiorly
  • thyroid gland, trachea, oesophagus

Lateral

  • SCM
  • thoracic and right lymphatic ducts enter SCV just lateral to insertion of IJV

Inferior

  • pleura (rises 2.5cm above clavicle)

In carotid sheath

  • vagus nerve

Important structures

  • vagus nerve travels between CCA and IJV in the carotid sheath
  • cervical sympathetic plexus is posterior to the carotid sheath
  • EJV is posterior, lateral, and superficial to IJV. It inserts into SCV
  • the deep cervical LNs are in close proximity to IJV

Cross section of the neck

Infrahyoid deep neck spaces CC BY 4.0, via Wikimedia

Anatomical variation

  • duplication (bifurcation, with each limb joining SCV separately)
  • fenestration (bifuration which reunites before joining SCV)
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