VESSELS VESSELS AND NERVESAND NERVESOF THE NECKOF THE NECK

VESSELS VESSELS AND NERVESAND NERVESOF THE NECKOF THE NECK

Main Arteries of the neckMain Arteries of the neckMain Arteries of the neckMain Arteries of the neck

1.1. Common Carotid Artery.Common Carotid Artery.

2.2. External Carotid Artery.External Carotid Artery.

3.3. Internal Carotid Artery.Internal Carotid Artery.

4.4. Subclavian Artery.Subclavian Artery.

1.1. Common Carotid Artery.Common Carotid Artery.

2.2. External Carotid Artery.External Carotid Artery.

3.3. Internal Carotid Artery.Internal Carotid Artery.

4.4. Subclavian Artery.Subclavian Artery.

Main Veins of the neckMain Veins of the neckMain Veins of the neckMain Veins of the neck

1.1. Internal Jugular vein.Internal Jugular vein.

2.2. Subclavian vein.Subclavian vein.

1.1. Internal Jugular vein.Internal Jugular vein.

2.2. Subclavian vein.Subclavian vein.

Main Nerves of the neckMain Nerves of the neckMain Nerves of the neckMain Nerves of the neck

1.1. Vagus nerve.Vagus nerve.2.2. Accessory nerve.Accessory nerve.3.3. Hypoglossal nerve.Hypoglossal nerve.4.4. Cervical part of sympathetic Cervical part of sympathetic

trunk.trunk.5.5. Cervical plexus.Cervical plexus.6.6. Phrenic nerve.Phrenic nerve.

1.1. Vagus nerve.Vagus nerve.2.2. Accessory nerve.Accessory nerve.3.3. Hypoglossal nerve.Hypoglossal nerve.4.4. Cervical part of sympathetic Cervical part of sympathetic

trunk.trunk.5.5. Cervical plexus.Cervical plexus.6.6. Phrenic nerve.Phrenic nerve.

Common Common CarotidCarotid Artery ArteryCommon Common CarotidCarotid Artery Artery BeginningBeginning:: the right from the brachiocephalic the right from the brachiocephalic

trunk behind the sternoclavicular joint. The left trunk behind the sternoclavicular joint. The left arises directly from the arch of aorta in the arises directly from the arch of aorta in the superior mediastinum of thorax.superior mediastinum of thorax.

EndEnd:: at the level of the upper border of thyroid at the level of the upper border of thyroid cartilage (3cartilage (3rdrd cervical vertebra) by dividing into cervical vertebra) by dividing into internal and external carotid arteries.internal and external carotid arteries.

At its end (or beginning of internal carotid) At its end (or beginning of internal carotid) there is a dilatation called there is a dilatation called carotid sinuscarotid sinus which is which is sensitive to blood pressure changes. It has sensitive to blood pressure changes. It has pressoreceptors which are innervated by pressoreceptors which are innervated by glossopharyngeal nerve.glossopharyngeal nerve.

BeginningBeginning:: the right from the brachiocephalic the right from the brachiocephalic trunk behind the sternoclavicular joint. The left trunk behind the sternoclavicular joint. The left arises directly from the arch of aorta in the arises directly from the arch of aorta in the superior mediastinum of thorax.superior mediastinum of thorax.

EndEnd:: at the level of the upper border of thyroid at the level of the upper border of thyroid cartilage (3cartilage (3rdrd cervical vertebra) by dividing into cervical vertebra) by dividing into internal and external carotid arteries.internal and external carotid arteries.

At its end (or beginning of internal carotid) At its end (or beginning of internal carotid) there is a dilatation called there is a dilatation called carotid sinuscarotid sinus which is which is sensitive to blood pressure changes. It has sensitive to blood pressure changes. It has pressoreceptors which are innervated by pressoreceptors which are innervated by glossopharyngeal nerve.glossopharyngeal nerve.

Course and Course and RelationsRelationsCourse and Course and RelationsRelations

It ascends in the neck, enclosed in the carotid It ascends in the neck, enclosed in the carotid sheath with internal jugular vein and vagus nerve.sheath with internal jugular vein and vagus nerve.

Anterolateral relationsAnterolateral relations:: Skin, superficial fascia, Skin, superficial fascia, investing fascia, sternocleidomastoid, investing fascia, sternocleidomastoid, sternohyoid, sternothyroid and superior belly of sternohyoid, sternothyroid and superior belly of omohyoid.omohyoid.

Posterior relationPosterior relation:: Transverse processes of lower 4 Transverse processes of lower 4 cervical vertebra, prevertebral muscles and cervical vertebra, prevertebral muscles and sympathetic trunk.sympathetic trunk.

Medial relationsMedial relations:: larynx, pharynx, thyroid gland, larynx, pharynx, thyroid gland, trachea and esophagus.trachea and esophagus.

Lateral relationLateral relation:: Internal jugular vein and Internal jugular vein and (posterolaterally) vagus nerve(posterolaterally) vagus nerve

It ascends in the neck, enclosed in the carotid It ascends in the neck, enclosed in the carotid sheath with internal jugular vein and vagus nerve.sheath with internal jugular vein and vagus nerve.

Anterolateral relationsAnterolateral relations:: Skin, superficial fascia, Skin, superficial fascia, investing fascia, sternocleidomastoid, investing fascia, sternocleidomastoid, sternohyoid, sternothyroid and superior belly of sternohyoid, sternothyroid and superior belly of omohyoid.omohyoid.

Posterior relationPosterior relation:: Transverse processes of lower 4 Transverse processes of lower 4 cervical vertebra, prevertebral muscles and cervical vertebra, prevertebral muscles and sympathetic trunk.sympathetic trunk.

Medial relationsMedial relations:: larynx, pharynx, thyroid gland, larynx, pharynx, thyroid gland, trachea and esophagus.trachea and esophagus.

Lateral relationLateral relation:: Internal jugular vein and Internal jugular vein and (posterolaterally) vagus nerve(posterolaterally) vagus nerve

External External CarotidCarotid Artery ArteryExternal External CarotidCarotid Artery Artery BeginningBeginning:: One of the two terminal branches One of the two terminal branches

of the common carotid artery. It begins at the of the common carotid artery. It begins at the level of the upper border of thyroid cartilage level of the upper border of thyroid cartilage (3(3rdrd cervical vertebra). cervical vertebra).

EndEnd:: behind the neck of the mandible, within behind the neck of the mandible, within the substance of parotid gland by dividing into the substance of parotid gland by dividing into maxillary and superficial temporal arteries.maxillary and superficial temporal arteries.

At is beginning, the artery lies medial to the At is beginning, the artery lies medial to the internal carotid artery but as it ascends in the internal carotid artery but as it ascends in the neck passes backward and laterally.neck passes backward and laterally.

It is crossed by the posterior belly of digastric It is crossed by the posterior belly of digastric and stylohyoid muscles.and stylohyoid muscles.

BeginningBeginning:: One of the two terminal branches One of the two terminal branches of the common carotid artery. It begins at the of the common carotid artery. It begins at the level of the upper border of thyroid cartilage level of the upper border of thyroid cartilage (3(3rdrd cervical vertebra). cervical vertebra).

EndEnd:: behind the neck of the mandible, within behind the neck of the mandible, within the substance of parotid gland by dividing into the substance of parotid gland by dividing into maxillary and superficial temporal arteries.maxillary and superficial temporal arteries.

At is beginning, the artery lies medial to the At is beginning, the artery lies medial to the internal carotid artery but as it ascends in the internal carotid artery but as it ascends in the neck passes backward and laterally.neck passes backward and laterally.

It is crossed by the posterior belly of digastric It is crossed by the posterior belly of digastric and stylohyoid muscles.and stylohyoid muscles.

RelationsRelationsRelationsRelations Anterolateral relationsAnterolateral relations:: At its beginning, it is At its beginning, it is

overlapped by sternocleidomastoid. Above, it is overlapped by sternocleidomastoid. Above, it is covered by skin, superficial fascia, investing deep covered by skin, superficial fascia, investing deep fascia. It is crossed by hypoglossal nerve, posterior fascia. It is crossed by hypoglossal nerve, posterior belly of digastric and stylohyoid. Within parotid belly of digastric and stylohyoid. Within parotid gland, it is crossed by facial nerve. Internal jugular gland, it is crossed by facial nerve. Internal jugular vein first lies lateral then posterior to the artery.vein first lies lateral then posterior to the artery.

Medial relationsMedial relations:: pharynx, internal carotid artery. pharynx, internal carotid artery. Structures passing between external and internal Structures passing between external and internal

carotid arteriescarotid arteries:: Styloid process, stylopharyngeus Styloid process, stylopharyngeus muscle, glossopharyngeal nerve, pharyngeal muscle, glossopharyngeal nerve, pharyngeal branch of vagus and parotid gland. branch of vagus and parotid gland.

Anterolateral relationsAnterolateral relations:: At its beginning, it is At its beginning, it is overlapped by sternocleidomastoid. Above, it is overlapped by sternocleidomastoid. Above, it is covered by skin, superficial fascia, investing deep covered by skin, superficial fascia, investing deep fascia. It is crossed by hypoglossal nerve, posterior fascia. It is crossed by hypoglossal nerve, posterior belly of digastric and stylohyoid. Within parotid belly of digastric and stylohyoid. Within parotid gland, it is crossed by facial nerve. Internal jugular gland, it is crossed by facial nerve. Internal jugular vein first lies lateral then posterior to the artery.vein first lies lateral then posterior to the artery.

Medial relationsMedial relations:: pharynx, internal carotid artery. pharynx, internal carotid artery. Structures passing between external and internal Structures passing between external and internal

carotid arteriescarotid arteries:: Styloid process, stylopharyngeus Styloid process, stylopharyngeus muscle, glossopharyngeal nerve, pharyngeal muscle, glossopharyngeal nerve, pharyngeal branch of vagus and parotid gland. branch of vagus and parotid gland.

Branches:Branches:Branches:Branches:1.1. Superior thyroid arterySuperior thyroid artery:: It arises from the It arises from the

anterior aspect and gives muscular branch to anterior aspect and gives muscular branch to the sternocleidomastoid and superior the sternocleidomastoid and superior laryngeal artery, it supplies the thyroid gland.laryngeal artery, it supplies the thyroid gland.

2.2. Ascending pharyngeal arteryAscending pharyngeal artery: : It emerges It emerges from the medial side of the artery. It ascends from the medial side of the artery. It ascends on the wall of the pharynx and supplies it. on the wall of the pharynx and supplies it.

3.3. Lingual arteryLingual artery:: It arises from the anterior It arises from the anterior aspect opposite the tip of greater horn of aspect opposite the tip of greater horn of hyoid bone. It makes a loop which is crossed hyoid bone. It makes a loop which is crossed by the hypoglossal nerve, then it supplies the by the hypoglossal nerve, then it supplies the tongue.tongue.

1.1. Superior thyroid arterySuperior thyroid artery:: It arises from the It arises from the anterior aspect and gives muscular branch to anterior aspect and gives muscular branch to the sternocleidomastoid and superior the sternocleidomastoid and superior laryngeal artery, it supplies the thyroid gland.laryngeal artery, it supplies the thyroid gland.

2.2. Ascending pharyngeal arteryAscending pharyngeal artery: : It emerges It emerges from the medial side of the artery. It ascends from the medial side of the artery. It ascends on the wall of the pharynx and supplies it. on the wall of the pharynx and supplies it.

3.3. Lingual arteryLingual artery:: It arises from the anterior It arises from the anterior aspect opposite the tip of greater horn of aspect opposite the tip of greater horn of hyoid bone. It makes a loop which is crossed hyoid bone. It makes a loop which is crossed by the hypoglossal nerve, then it supplies the by the hypoglossal nerve, then it supplies the tongue.tongue.

Branches:Branches:Branches:Branches:4.4. Facial arteryFacial artery:: It arises from the anterior aspect It arises from the anterior aspect

just above the lingual artery (may arise in one just above the lingual artery (may arise in one common trunk with lingual) & supplies the common trunk with lingual) & supplies the face.face.

5.5. Occipital arteryOccipital artery: : It emerges from the posterior It emerges from the posterior aspect of the artery. It ascends on the lower aspect of the artery. It ascends on the lower border of the posterior belly of digastric and border of the posterior belly of digastric and accompanies greater occipital nerve to be accompanies greater occipital nerve to be distributed on the back of the scalp. distributed on the back of the scalp.

6.6. Posterior auricular arteryPosterior auricular artery:: It arises from the It arises from the posterior aspect and runs on the upper border posterior aspect and runs on the upper border of posterior belly of digastric and reaches the of posterior belly of digastric and reaches the auricle.auricle.

4.4. Facial arteryFacial artery:: It arises from the anterior aspect It arises from the anterior aspect just above the lingual artery (may arise in one just above the lingual artery (may arise in one common trunk with lingual) & supplies the common trunk with lingual) & supplies the face.face.

5.5. Occipital arteryOccipital artery: : It emerges from the posterior It emerges from the posterior aspect of the artery. It ascends on the lower aspect of the artery. It ascends on the lower border of the posterior belly of digastric and border of the posterior belly of digastric and accompanies greater occipital nerve to be accompanies greater occipital nerve to be distributed on the back of the scalp. distributed on the back of the scalp.

6.6. Posterior auricular arteryPosterior auricular artery:: It arises from the It arises from the posterior aspect and runs on the upper border posterior aspect and runs on the upper border of posterior belly of digastric and reaches the of posterior belly of digastric and reaches the auricle.auricle.

Branches:Branches:Branches:Branches:7.7. Superficial temporal arterySuperficial temporal artery:: One of the One of the

two terminal branches of the ext. car. two terminal branches of the ext. car. artery. It arises within the substances of artery. It arises within the substances of the parotid gland and supplies the the parotid gland and supplies the temporal region and scalp.temporal region and scalp.

8.8. Maxillary arteryMaxillary artery:: The other terminal The other terminal branch of the ext. car. artery. It arises branch of the ext. car. artery. It arises within the substances of the parotid within the substances of the parotid gland and supplies many regions (later).gland and supplies many regions (later).

7.7. Superficial temporal arterySuperficial temporal artery:: One of the One of the two terminal branches of the ext. car. two terminal branches of the ext. car. artery. It arises within the substances of artery. It arises within the substances of the parotid gland and supplies the the parotid gland and supplies the temporal region and scalp.temporal region and scalp.

8.8. Maxillary arteryMaxillary artery:: The other terminal The other terminal branch of the ext. car. artery. It arises branch of the ext. car. artery. It arises within the substances of the parotid within the substances of the parotid gland and supplies many regions (later).gland and supplies many regions (later).

Internal Internal CarotidCarotid Artery ArteryInternal Internal CarotidCarotid Artery Artery BeginningBeginning:: One of the two terminal branches of One of the two terminal branches of

the common carotid artery. It begins at the level the common carotid artery. It begins at the level of the upper border of thyroid cartilage (3of the upper border of thyroid cartilage (3rdrd cervical vertebra).cervical vertebra).

The artery enters the cranial cavity through the The artery enters the cranial cavity through the carotid canal to be distributed to the brain, eye, carotid canal to be distributed to the brain, eye, forehead and part of the nose.forehead and part of the nose.

It ascends in the neck enclosed in the carotid It ascends in the neck enclosed in the carotid sheath with the internal jugular vein and vagus sheath with the internal jugular vein and vagus nerve.nerve.

It is crossed by the posterior belly of digastric It is crossed by the posterior belly of digastric and stylohyoid muscles.and stylohyoid muscles.

It gives off It gives off NO BRANCHESNO BRANCHES in the neck. in the neck.

BeginningBeginning:: One of the two terminal branches of One of the two terminal branches of the common carotid artery. It begins at the level the common carotid artery. It begins at the level of the upper border of thyroid cartilage (3of the upper border of thyroid cartilage (3rdrd cervical vertebra).cervical vertebra).

The artery enters the cranial cavity through the The artery enters the cranial cavity through the carotid canal to be distributed to the brain, eye, carotid canal to be distributed to the brain, eye, forehead and part of the nose.forehead and part of the nose.

It ascends in the neck enclosed in the carotid It ascends in the neck enclosed in the carotid sheath with the internal jugular vein and vagus sheath with the internal jugular vein and vagus nerve.nerve.

It is crossed by the posterior belly of digastric It is crossed by the posterior belly of digastric and stylohyoid muscles.and stylohyoid muscles.

It gives off It gives off NO BRANCHESNO BRANCHES in the neck. in the neck.

RelationsRelationsRelationsRelations Anterolateral relationsAnterolateral relations:: A.A. Below the digastric muscle: At its beginning, it is Below the digastric muscle: At its beginning, it is

overlapped by sternocleidomastoid. Above, it is covered overlapped by sternocleidomastoid. Above, it is covered by skin, superficial fascia, investing deep fascia. It is by skin, superficial fascia, investing deep fascia. It is crossed by hypoglossal nerve, crossed by hypoglossal nerve,

B.B. Above the digastric: stylohyoid, stylopharyngeus Above the digastric: stylohyoid, stylopharyngeus muscle, glossopharyngeal nerve, pharyngeal branch of muscle, glossopharyngeal nerve, pharyngeal branch of vagus, parotid gland and external carotid artery.vagus, parotid gland and external carotid artery.

Posterior relationsPosterior relations:: Sympathetic trunk, longus capitis Sympathetic trunk, longus capitis and transverse processes of the upper 3 cervical and transverse processes of the upper 3 cervical vertebrae.vertebrae.

Medial relationsMedial relations:: pharynx and superior laryngeal nerve. pharynx and superior laryngeal nerve. Structures passing between external and internal Structures passing between external and internal

carotid arteriescarotid arteries:: Styloid process, stylopharyngeus Styloid process, stylopharyngeus muscle, glossopharyngeal nerve, pharyngeal branch of muscle, glossopharyngeal nerve, pharyngeal branch of vagus and parotid gland. vagus and parotid gland.

Anterolateral relationsAnterolateral relations:: A.A. Below the digastric muscle: At its beginning, it is Below the digastric muscle: At its beginning, it is

overlapped by sternocleidomastoid. Above, it is covered overlapped by sternocleidomastoid. Above, it is covered by skin, superficial fascia, investing deep fascia. It is by skin, superficial fascia, investing deep fascia. It is crossed by hypoglossal nerve, crossed by hypoglossal nerve,

B.B. Above the digastric: stylohyoid, stylopharyngeus Above the digastric: stylohyoid, stylopharyngeus muscle, glossopharyngeal nerve, pharyngeal branch of muscle, glossopharyngeal nerve, pharyngeal branch of vagus, parotid gland and external carotid artery.vagus, parotid gland and external carotid artery.

Posterior relationsPosterior relations:: Sympathetic trunk, longus capitis Sympathetic trunk, longus capitis and transverse processes of the upper 3 cervical and transverse processes of the upper 3 cervical vertebrae.vertebrae.

Medial relationsMedial relations:: pharynx and superior laryngeal nerve. pharynx and superior laryngeal nerve. Structures passing between external and internal Structures passing between external and internal

carotid arteriescarotid arteries:: Styloid process, stylopharyngeus Styloid process, stylopharyngeus muscle, glossopharyngeal nerve, pharyngeal branch of muscle, glossopharyngeal nerve, pharyngeal branch of vagus and parotid gland. vagus and parotid gland.

Subclavian arterySubclavian arterySubclavian arterySubclavian artery BeginningBeginning:: the right from the the right from the

brachiocephalic trunk behind the brachiocephalic trunk behind the sternoclavicular joint. The left arises sternoclavicular joint. The left arises directly from the arch of aorta in the directly from the arch of aorta in the superior mediastinum of thorax.superior mediastinum of thorax.

EndEnd:: At the outer border of the first rib At the outer border of the first rib where it continues as the axillary artery.where it continues as the axillary artery.

The scalenus anterior muscle when The scalenus anterior muscle when passing in front of the artery divides it passing in front of the artery divides it into 3 parts; 1into 3 parts; 1stst, 2, 2ndnd and 3 and 3rdrd..

BeginningBeginning:: the right from the the right from the brachiocephalic trunk behind the brachiocephalic trunk behind the sternoclavicular joint. The left arises sternoclavicular joint. The left arises directly from the arch of aorta in the directly from the arch of aorta in the superior mediastinum of thorax.superior mediastinum of thorax.

EndEnd:: At the outer border of the first rib At the outer border of the first rib where it continues as the axillary artery.where it continues as the axillary artery.

The scalenus anterior muscle when The scalenus anterior muscle when passing in front of the artery divides it passing in front of the artery divides it into 3 parts; 1into 3 parts; 1stst, 2, 2ndnd and 3 and 3rdrd..

First part of Subclavian First part of Subclavian arteryarteryFirst part of Subclavian First part of Subclavian arteryartery RelationsRelations:: Anterior: common carotid artery, Anterior: common carotid artery,

vagus nerve and internal jugular vein.vagus nerve and internal jugular vein. Posterior: Dome of pleura, apex of the Posterior: Dome of pleura, apex of the

lung and on right the right recurrent lung and on right the right recurrent laryngeal n.laryngeal n.

BranchesBranches::1.1. Vertebral artery.Vertebral artery.2.2. Thyrocervical trunk.Thyrocervical trunk.3.3. Internal thoracic artery.Internal thoracic artery.

RelationsRelations:: Anterior: common carotid artery, Anterior: common carotid artery,

vagus nerve and internal jugular vein.vagus nerve and internal jugular vein. Posterior: Dome of pleura, apex of the Posterior: Dome of pleura, apex of the

lung and on right the right recurrent lung and on right the right recurrent laryngeal n.laryngeal n.

BranchesBranches::1.1. Vertebral artery.Vertebral artery.2.2. Thyrocervical trunk.Thyrocervical trunk.3.3. Internal thoracic artery.Internal thoracic artery.

Second part of Subclavian Second part of Subclavian arteryarterySecond part of Subclavian Second part of Subclavian arteryartery RelationsRelations:: Anterior: scalenus anterior muscle.Anterior: scalenus anterior muscle. Posterior: Dome of pleura, apex of Posterior: Dome of pleura, apex of

the lung.the lung. BranchesBranches:: Costocervical trunk, which givesCostocervical trunk, which gives

1.1. Superior intercostal artery.Superior intercostal artery.2.2. Deep cervical arteryDeep cervical artery

RelationsRelations:: Anterior: scalenus anterior muscle.Anterior: scalenus anterior muscle. Posterior: Dome of pleura, apex of Posterior: Dome of pleura, apex of

the lung.the lung. BranchesBranches:: Costocervical trunk, which givesCostocervical trunk, which gives

1.1. Superior intercostal artery.Superior intercostal artery.2.2. Deep cervical arteryDeep cervical artery

Third Part of Subclavian Third Part of Subclavian ArteryArtery CourseCourse: : enters the anteroinferior enters the anteroinferior

angle of posterior triangle and angle of posterior triangle and disappears behind the middle of disappears behind the middle of the clavicle. Together with the the clavicle. Together with the brachial plexus, it is surrounded brachial plexus, it is surrounded by extension from prevertebral by extension from prevertebral fascia called axillary sheath.fascia called axillary sheath.

BranchesBranches:: No branches, but No branches, but sometimes the transverse cervical sometimes the transverse cervical artery arises from it.artery arises from it.

CourseCourse: : enters the anteroinferior enters the anteroinferior angle of posterior triangle and angle of posterior triangle and disappears behind the middle of disappears behind the middle of the clavicle. Together with the the clavicle. Together with the brachial plexus, it is surrounded brachial plexus, it is surrounded by extension from prevertebral by extension from prevertebral fascia called axillary sheath.fascia called axillary sheath.

BranchesBranches:: No branches, but No branches, but sometimes the transverse cervical sometimes the transverse cervical artery arises from it.artery arises from it.

Third Part of Subclavian Third Part of Subclavian ArteryArteryRelations:Relations: AnteriorlyAnteriorly: : Skin, superficial fascia, Skin, superficial fascia,

external jugular vein and investing external jugular vein and investing deep cervical fascia. At its beginning it deep cervical fascia. At its beginning it is partially covered by sternomastoid, is partially covered by sternomastoid, and at its end it is covered by clavicle.and at its end it is covered by clavicle.

PosteriorlyPosteriorly: : Lower trunk of brachial Lower trunk of brachial plexus and scalenus medius.plexus and scalenus medius.

SuperiorlySuperiorly: : Upper and middle trunks of Upper and middle trunks of brachial plexus.brachial plexus.

InferiorlyInferiorly: : Upper surface of the first rib.Upper surface of the first rib.

Relations:Relations: AnteriorlyAnteriorly: : Skin, superficial fascia, Skin, superficial fascia,

external jugular vein and investing external jugular vein and investing deep cervical fascia. At its beginning it deep cervical fascia. At its beginning it is partially covered by sternomastoid, is partially covered by sternomastoid, and at its end it is covered by clavicle.and at its end it is covered by clavicle.

PosteriorlyPosteriorly: : Lower trunk of brachial Lower trunk of brachial plexus and scalenus medius.plexus and scalenus medius.

SuperiorlySuperiorly: : Upper and middle trunks of Upper and middle trunks of brachial plexus.brachial plexus.

InferiorlyInferiorly: : Upper surface of the first rib.Upper surface of the first rib.

Internal jugular veinInternal jugular veinInternal jugular veinInternal jugular vein BeginningBeginning:: at the jugular foramen as a at the jugular foramen as a

continuation of the sigmoid sinus.continuation of the sigmoid sinus. EndEnd:: by uniting with the subclavian by uniting with the subclavian

vein behind the medial end of clavicle vein behind the medial end of clavicle to form the brachiocephalic vein.to form the brachiocephalic vein.

The vein has two dilatation; at its The vein has two dilatation; at its beginning (superior bulb) and at its beginning (superior bulb) and at its end (inferior bulb).end (inferior bulb).

It descends in the neck within the It descends in the neck within the carotid sheath.carotid sheath.

BeginningBeginning:: at the jugular foramen as a at the jugular foramen as a continuation of the sigmoid sinus.continuation of the sigmoid sinus.

EndEnd:: by uniting with the subclavian by uniting with the subclavian vein behind the medial end of clavicle vein behind the medial end of clavicle to form the brachiocephalic vein.to form the brachiocephalic vein.

The vein has two dilatation; at its The vein has two dilatation; at its beginning (superior bulb) and at its beginning (superior bulb) and at its end (inferior bulb).end (inferior bulb).

It descends in the neck within the It descends in the neck within the carotid sheath.carotid sheath.

Tributaries of Internal jugular Tributaries of Internal jugular veinveinTributaries of Internal jugular Tributaries of Internal jugular veinvein

1.1. Inferior petrosal sinus.Inferior petrosal sinus.

2.2. Facial vein.Facial vein.

3.3. Pharyngeal veins.Pharyngeal veins.

4.4. Lingual vein.Lingual vein.

5.5. Superior thyroid vein.Superior thyroid vein.

6.6. Middle thyroid vein.Middle thyroid vein.

7.7. Occipital vein (occasionally).Occipital vein (occasionally).

1.1. Inferior petrosal sinus.Inferior petrosal sinus.

2.2. Facial vein.Facial vein.

3.3. Pharyngeal veins.Pharyngeal veins.

4.4. Lingual vein.Lingual vein.

5.5. Superior thyroid vein.Superior thyroid vein.

6.6. Middle thyroid vein.Middle thyroid vein.

7.7. Occipital vein (occasionally).Occipital vein (occasionally).