Jugular Vein

What are the jugular veins?

The jugular veins are major blood vessels that stretch from your head to your upper chest. Typically, there are three pairs of jugular veins — six in total — each of which directs blood from different areas of your head toward your heart.

What do these veins do?

The jugular veins are very important because your head — especially your brain — has an enormous need for oxygen. Though the average human brain weighs about 3 lbs., your brain gets about 15% to 20% of the blood your heart pumps out. Your face, scalp, ears and other parts of your head also need plenty of blood flow for a wide range of reasons.

Once the blood delivers the oxygen to the brain and other parts of your head, it needs to return to the heart to make way for incoming blood. It does that by traveling through the jugular veins. Those veins ensure that blood flows smoothly and continuously to and from your brain.

Where are the jugular veins?

The two sets of jugular veins are the interior and exterior jugular veins.

• Exterior jugular veins: These veins provide blood flow return from areas outside your skull. They start at the occipital (ox-ip-it-al) veins at the back of your head. From there, they run downward on either side of your spine. They get the "external" part of their name because of how they run between your major neck muscle groups and your skin, keeping them closer to the skin's surface.
• Interior jugular veins: These are larger than the external veins and allow blood from your brain to return to your chest. They start inside your skull and pass downward on either side of your spine, similar to the external jugular veins. The key difference is that these veins are underneath the major muscles of your neck, so they're deeper inside your body. The right interior jugular vein is slightly larger than the left, so it's used more often for intravenous (IV) lines.
• Anterior jugular veins: These are the smallest of the jugular veins. Both are on the front of your neck, found just on either side of your windpipe.

Once the jugular veins pass through your neck, they connect to other major veins as follows:

• External: The external jugular veins connect to the subclavian (sub-clay-vee-an) vein. The subclavian vein’s name means “under the clavicle.” The clavicles are also known as your collarbones.
• Internal: The internal jugular veins lead into the subclavian veins under your collarbones. Once they do, they become the brachiocephalic (bray-key-oh-sef-al-ick) veins, whose name means “related to the arms and head.”
• Anterior: These lead into the exterior jugular veins.

The brachiocephalic veins merge just below where your neck meets your chest. The connected veins form a larger vein, the superior vena cava (vee-nah cay-vah). The superior vena cava is the largest vein in your body. It’s the vein that carries all the blood that’s returning from your body into your heart.

What are the common conditions and disorders that affect this body system or organ?

• Aneurysm: This is when a blood vessel wall has a weakness that causes part of the vessel to balloon outward. If that section of the vessel tears or breaks, it can lead to severe or even life-threatening bleeding.
• Diabetes: While diabetes doesn’t usually affect the jugular veins directly, the internal jugular vein is a common spot for placing intravenous lines or a cannula (an entry port). This is especially likely when a person needs dialysis.
• Stenosis: This is the narrowing of a blood vessel. It can happen because of injuries or scarring, various diseases, and more.
• Thrombosis: This is when a blood clot forms inside a vein or gets stuck there for another reason. If the clot is big enough, it can block blood flow through the vein. Clots that happen because of infections, known as Lemierre’s syndrome, can happen after surgery or infections in your throat or neck. This is especially dangerous because the infection can cause sepsis, a life-threatening overreaction of your immune system when an infection spreads.

What are some common signs or symptoms of conditions that affect the jugular veins?

The signs and symptoms that affect your jugular veins can happen around them or in areas connected to them, especially in your head.

• Distension: This is when higher pressure inside a vein causes it to bulge outward. This bulging, which is often visible, is a potential symptom of serious heart problems like heart failure, cardiac tamponade or coronary artery disease.
• Ear problems: Increased pressure from vein problems can also affect your ears, causing dizziness, tinnitus (pronounced “tin-EYE-tus” or “TIN-it-us”) or hearing loss. A specific example of this is pulsatile tinnitus, when you can hear your heartbeat in your ears. Those who have it often describe it as a throbbing, thumping or whooshing sound.
• Eye problems: The increased pressure from limited blood flow through the jugular can cause blurred vision, double vision or swollen eyes.
• Pain: This can be pain or discomfort in your neck or headaches.
• Problems sleeping: Changes in how blood flows out of your brain can affect your sleep.

Common tests to check the health of the body organ?

The most common tests on the jugular vein involve either a physical examination or imaging tests.

• Physical examination: This test involves sitting with your upper body at a specific angle. A healthcare provider will look for signs of swelling or pressure changes in the jugular veins. This might involve turning your head to the side, breathing in and out, or the provider pressing on your upper chest or belly in certain areas to change the pressure in your jugular vein.
• Vascular ultrasound: This test involves using ultra-high-frequency sound waves to “see” your jugular veins, similar to how bats use sonar to fly without hitting obstacles.
• Computerized tomography (CT) scan and angiography: Computerized tomography uses X-rays and computer processing to create a 3D picture of the inside of your body. A CT angiogram uses contrast, a liquid that providers can inject into your bloodstream. The contrast is very visible on CT, which can help show areas of the vein where blood isn't flowing as it should.
• Magnetic resonance imaging (MRI): This test uses a very powerful magnet and computer processing to create images of the inside of your body. It’s especially useful for making extremely detailed images that can tell the difference between muscle, blood vessels, nerves, bones
  and more.

What treatments can use or affect the jugular veins?

Some of the more common treatments for jugular vein conditions, or that use the jugular veins as an access point to treat other conditions, include:

• Antibiotics: These are likely when you have infections that affect the jugular veins.
• Blood thinners: These are most common when you have clot-based problems like thrombosis.
• IV lines: Examples include central and peripherally inserted central catheter (PICC)
• Surgery: This can help with problems involving narrowed or damaged jugular veins. In some cases, a surgeon may remove a jugular vein, which they’ll use to create a bypass for a blocked blood vessel in your heart. Depending on the specific jugular vein, it’s possible to live with no long-term effects after having one removed or closed off.
• Vena cava filters: These are filters a healthcare provider inserts into a jugular vein and then down toward your superior vena cava. Once there, it catches blood clots before they can enter your heart and lungs. This helps prevent life-threatening conditions like pulmonary embolism.

How can I ensure my jugular veins stay healthy?

Some of the best ways to care for and maintain your jugular veins’ health include:

• Watch out for your heart health. Circulatory conditions that affect your heart are also very likely to affect major blood vessels, including your jugular veins. Reaching and maintaining a healthy weight, eating healthy and staying physically active are all important parts of this.
• Protect your neck. Your jugular veins, especially the exterior jugular veins, are prone to injuries and damage. Use caution and wear proper protective gear during sports activities (especially sports like ice hockey) or while working with power tools or equipment.
• Pay attention to your body. If you start having symptoms like neck pain or swelling, or if you have any symptoms related to your eyesight and brain, talk to a healthcare provider. This is especially true when those symptoms start to affect your routine or interfere with your usual activities.
• Keep it clean. If your jugular vein is an IV access point, keep the area around the IV line or port clean. It's also very important that you follow healthcare provider instructions on how you should and shouldn't move your neck or turn your head.

A note from Cleveland Clinic

The jugular veins are a major part of your circulatory system, especially because they affect blood flow in your brain. While there aren't many conditions and diseases that affect them directly, the jugular veins commonly play a role in diagnosing and treating other conditions. If you have questions about potential jugular vein issues, talk to a healthcare provider. They can answer your questions or help you find a specialist who can assist you further.