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Veins of the Head and Neck

Venae capitis et colli

For medical students2 min readUpdated 2026-10-10

The primary collecting vessel for venous blood from the head and neck is the internal jugular vein. The venous drainage system of this region is unique due to the dural venous sinuses—rigid, valveless channels that do not collapse, ensuring a steady outflow of blood from the brain.

Main collectorInternal jugular vein (v. jugularis interna)

SinusesSpecialized valveless venous channels of the brain

Brachiocephalic veinFormed by the merger of the internal jugular and subclavian veins

Emissary veinsConnect intracranial sinuses with extracranial veins

Jugular Vein System

All venous blood from the head and neck organs drains into the jugular vein system. The largest of these is the internal jugular vein (v. jugularis interna). It originates at the jugular foramen of the skull, forming the superior bulb (bulbus superior). In the neck, it lies within the carotid sheath alongside the common carotid artery and vagus nerve, and before uniting with the subclavian vein, it forms the inferior bulb (bulbus inferior).

Supportive roles are played by:

External jugular vein (v. jugularis externa) — descends subcutaneously across the superficial surface of the sternocleidomastoid muscle. It is formed behind the angle of the mandible.
Anterior jugular vein (v. jugularis anterior) — runs close to the midline of the neck. Above the sternum, the veins of both sides communicate in the interfascial space to form the jugular venous arch (arcus venosus jugularis).

Dural Venous Sinuses

Blood from the cranial cavity drains into the dural venous sinuses (sinus durae matris). Unlike typical veins, their walls are formed by dense fibrous connective tissue containing elastic fibers. They lack valves and remain patent when cut, ensuring unhindered blood flow regardless of intracranial pressure.

Major sinuses:

Superior and inferior sagittal sinuses — run along the margins of the falx cerebri.
Straight sinus (sinus rectus) — merges with the superior sagittal sinus to form the confluence of sinuses (confluens sinuum).
Transverse sinus (sinus transversus) — drains blood from the confluence of sinuses, continuing as the sigmoid sinus.
Sigmoid sinus (sinus sigmoideus) — empties directly into the superior bulb of the internal jugular vein.

Veins of the Face and Scalp

Superficial drainage of the face is carried out by the facial vein (v. facialis). It begins at the medial angle of the eye as the angular vein (v. angularis), descending obliquely downward while receiving tributaries from the nose, eyelids, and lips.

Deep regions of the face are drained via:

Retromandibular vein (v. retromandibularis), which passes through the parotid gland.
Pterygoid plexus (plexus pterygoideus) — a deep venous plexus.
Emissary veins (vv. emissariae) — parietal, occipital, mastoid, and condylar. They pierce the cranial bones and connect intracranial sinuses with the superficial veins of the head.

Mnemonic

Topography of the carotid sheath contents (from medial to lateral): Artery (common carotid) is medial, Vein (internal jugular) is lateral, and Nerve (vagus) is between them and posterior.

Frequently asked questions

From the union of which veins is the external jugular vein formed?

The external jugular vein is formed at the level of the mandibular angle below the auricle by the union of two venous trunks. Its formation involves:

Anastomosis with the retromandibular vein
Posterior auricular vein (v. auricularis posterior) — collects blood posterior to the auricle.

What tributaries does the facial vein receive along its course?

Along its course, the facial vein receives several tributaries that collect blood from various facial structures. These include:

Angular vein (v. angularis) — initial segment at the root of the nose.
Supratrochlear vein (v. supratrochlearis) — descends from the forehead.
Supraorbital vein (v. supraorbitalis).
Nasofrontal vein (v. nasofrontalis).
Superior and inferior palpebral veins (vv. palpebrales superiores et inferiores).
External nasal veins (vv. nasales externae).
Superior and inferior labial veins (vv. labiales superiores et inferiores).
Transverse facial vein (v. transversa faciei) — drains laterally.
Deep facial vein (v. profunda faciei).

Which veins drain into the pterygoid venous plexus?

Sources explicitly indicate that draining into the pterygoid venous plexus are:

Deep temporal veins.

Additionally, the pterygoid venous plexus communicates with:

Maxillary vein (v. maxillaris)
Middle meningeal vein (v. meningea media)

It features anastomoses with:

Facial vein
Cavernous sinus via emissary veins.

What extracranial tributaries does the internal jugular vein receive?

The extracranial tributaries of the internal jugular vein collect blood from the soft tissues of the head and neck organs. These include:

Pharyngeal veins (vv. pharyngeae)
Lingual vein (v. lingualis)
Superior thyroid vein (v. thyroidea superior)
Middle thyroid veins (vv. thyroideae mediae)
Facial vein (v. facialis)

Additionally, the occipital vein (v. occipitalis) may occasionally drain into the internal jugular vein.

How do dural venous sinuses differ from regular veins?

The walls of the sinuses are formed by dense dura mater tissue, they do not collapse when cut, and they lack valves, unlike most veins.

Where does the internal jugular vein drain?

Behind the sternoclavicular joint, it merges with the subclavian vein to form the brachiocephalic vein.

What is the confluence of sinuses?

The confluence of sinuses (confluens sinuum) is the junction point of the sagittal, straight, transverse, and occipital sinuses on the internal surface of the occipital bone.

Go deeper

Internal thoracic veins and their anastomoses with epigastric veins
Anatomy of the cavernous sinus (sinus cavernosus)
Tributaries of the external jugular vein (occipital, suprascapular, transverse cervical veins)
Topography of vertebral and deep cervical veins
Ophthalmic veins and their connections with sinuses and the facial vein