External Jugular Vein

vena jugularis externa

The external jugular vein forms at the angle of the mandible by the union of the posterior division of the retromandibular vein and the posterior auricular vein. It descends obliquely across the sternocleidomastoid muscle, pierces the deep fascia superior to the clavicle, and drains into the subclavian vein. It receives the transverse cervical, suprascapular, and anterior jugular veins.

Region: Neck

Clinical Relevance

Clinical Notes

The external jugular vein is one of the most visible superficial veins and is used for emergency venous access when peripheral veins are collapsed or inaccessible. Its distension at rest or with the patient at 45 degrees is a sign of elevated jugular venous pressure from right heart failure, cardiac tamponade, or superior vena cava obstruction. It is at risk during lateral neck dissection and parotidectomy. Persistent external jugular vein distension is a key physical sign in assessing volume status and right heart function.

Pathology

Common Injuries & Conditions

Elevated JVP

Distension of the external jugular vein above the level of the clavicle with the patient at 45 degrees indicates elevated central venous pressure from right heart failure, tricuspid regurgitation, cardiac tamponade, or SVC obstruction, assessed alongside other signs of right heart failure such as peripheral oedema.

EJV Injury in Neck Surgery

The external jugular vein may be divided during selective neck dissection or parotidectomy, requiring ligation; inadvertent uncontrolled division causes venous haemorrhage and the potential for air embolism if the torn end retracts beneath the deep fascia.