The jugular lymphatic trunks (right and left) carry all the lymph from the head and neck. Each is formed by efferent vessels from the inferior deep cervical lymph nodes along the internal jugular vein. The left trunk usually joins the thoracic duct, and the right trunk joins the right lymphatic duct or opens directly into the junction of the internal jugular and subclavian veins.
| Origin | Efferent vessels of the inferior deep cervical lymph nodes |
|---|---|
| Course | Descends along the internal jugular vein to the root of the neck, ending in the thoracic duct on the left and in the right lymphatic duct or venous angle on the right |
| Branches |
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The jugular trunks lie at the root of the neck near the venous angle, so they can be injured during neck dissection for head and neck cancer, causing a lymph or chyle leak, especially on the left. Because lymph from the head and neck passes through the deep cervical nodes into these trunks, the nodes along the internal jugular vein are a key site for staging and removing cancer. Leaks are managed with drainage, dietary fat restriction and occasionally reoperation.
Injury to the jugular trunk or the thoracic duct at the left venous angle causes milky or clear fluid in the neck drain after surgery, managed with pressure dressings, diet changes and sometimes surgical repair.
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