Anatomy - Implantation of a tunneled, double-lumen atrial catheter in the right internal jugular vein for hemodialysis

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Venous System of the Neck

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The venous drainage of the head and neck occurs through a superficial and deep venous system. Both systems converge in the so-called venous angle (Angulus venosus) to form the brachiocephalic vein and empty into the superior vena cava.
Superficial Neck Veins
V. jugularis externa
- runs in the lateral cervical triangle covered by the platysma
- passes through the superficial lamina of the cervical fascia
- empties into the venous angle or previously into the V. jugularis interna and then into the V. cava superior
V. jugularis anterior
- usually runs on the M. sternocleidomastoideus
- empties into the venous angle or into the V. jugularis externa

Deep Neck Veins

Origin	originates intracranially through the confluence of the sigmoid sinus and inferior petrosal sinus begins as the so-called superior jugular bulb and passes through the skull base in the jugular foramen
Course	runs together with the common carotid artery within the carotid sheath forms the brachiocephalic vein in the venous angle together with the subclavian vein and others
Tributaries cranial → caudal	Superior ophthalmic vein Facial vein Retromandibular vein Pterygoid plexus Pharyngeal veins Lingual vein Superior and middle thyroid veins Sternocleidomastoid vein
Drainage area	entire brain Face Thyroid gland

Continuation of the axillary vein
runs anterior to the anterior scalene muscle
joins with the internal jugular vein at the venous angle and forms the brachiocephalic vein, which empties into the superior vena cava

Origin	arises from the confluence of the subclavian vein and internal and external jugular veins
Location	ventral to the anterior scalene muscle dorsal to the sternoclavicular joint at the level of the superior thoracic aperture
Tributaries cranial → caudal	Subclavian vein External jugular vein Internal jugular vein left venous angle: Thoracic duct right venous angle: Right lymphatic duct
Drainage area	all structures of the head-neck region