Venous Drainage of the Head and Neck

Jugular Veins

There are three main jugular veins – external, internal and anterior. They are ultimately responsible for the venous drainage of the whole head and neck.

External Jugular Vein

The external jugular vein and its tributaries supply the majority of the external face. It is formed by the union of two veins:

• Posterior auricular vein – drains the area of scalp superior and posterior to the outer ear.
• Retromandibular vein (posterior branch) – itself formed by the maxillary and superficial temporal veins, which drain the face.

These two veins combine immediately posterior to the angle of mandible, and inferior to the outer ear, forming the external jugular vein.

After formation, the external jugular vein descends down the neck within the superficial fascia. It runs anteriorly to the sternocleidomastoid muscle, crossing it in an oblique, posterior and inferior direction.

In the root of the neck, the vein passes underneath the clavicle, and terminates by draining into the subclavian vein. Along its route down the neck, the external jugular vein receives tributaries – posterior external jugular, transverse cervical and suprascapular veins.

By TeachMeSeries Ltd (2026)

Fig 1
Major tributaries of the external jugular vein, draining the external face and scalp. The facial and internal jugular veins are labelled for completeness

Anterior Jugular Veins

The anterior jugular veins vary from person to person. They are paired veins, which drain the anterior aspect of the neck. Often they will communicate via a jugular venous arch. The anterior jugular veins descend down the midline of the neck, emptying into the subclavian vein.

By TeachMeSeries Ltd (2026)

Fig 2
Anterior view of the neck, showing the jugular veins

Internal Jugular Vein

The internal jugular vein (IJV) begins in the cranial cavity as a continuation of the sigmoid sinus. The initial part of the internal jugular vein is dilated and is known as the superior bulb. It exits the skull via the jugular foramen.

In the neck, the internal jugular vein descends within the carotid sheath, deep to the sternocleidomastoid muscle and lateral to the common carotid artery. At the base of the neck, posteriorly to the sternal end of the clavicle, the IJV combines with the subclavian vein to form the brachiocephalic vein. Immediately prior to this, the inferior end of internal jugular vein dilates to form the inferior bulb. It has a valve that stops back-flow of blood.

During its descent down the neck, the internal jugular vein receives blood from the facial, lingual, occipital, superior and middle thyroid veins. These veins drain blood from the anterior face, trachea, thyroid, oesophagus, larynx, and muscles of the neck.

By TeachMeSeries Ltd (2026)

Fig 3
The internal jugular vein and the formation of the brachiocephalic vein

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Dural Venous Sinuses

The dural venous sinuses are spaces between the periosteal and meningeal layers of dura mater, which are lined by endothelial cells. They collect venous blood from the veins that drain the brain and bony skull, and ultimately drain into the internal jugular vein.

Clinical Relevance

Cavernous Sinus

The cavernous sinuses are a clinically important pair of dural sinuses. They are located next to the lateral aspect of the body of the sphenoid bone. This sinus receives blood from the superior and inferior ophthalmic veins, the middle superficial cerebral veins, and from another dural venous sinus; the sphenoparietal sinus.

Located within the cavernous sinus is the internal carotid artery, which crosses the sinus. This allows for cooling of the arterial blood before it reaches the brain. Along with the internal carotid artery, the abducens (VI) nerve crosses the sinus. Several nerves are located within the lateral wall of each sinus; oculomotor (III), trochlear (IV), ophthalmic (V1) and maxillary (V2) nerves.

If the cavernous sinus becomes infected, these nerves are at risk of damage. The facial vein is connected to cavernous sinus via the superior ophthalmic vein. The facial vein is valveless – blood can reverse direction and flow from the facial vein to the cavernous sinus. This provides a potential pathway by which infection of the face can spread to the venous sinuses.

By TeachMeSeries Ltd (2026)

Fig 4
Coronal section demonstrating the contents of the right cavernous sinus.