no THE HEAD AND NECK 



The vein wall is very adherent to the margins of the opening 

 in the deep fascia through which it passes, and at this point, 

 therefore,, the vein cannot collapse. If the vessel is cut in this 

 region there is danger lest air be drawn in by the suction of the 

 chest in inspiration, and on this account the finger should 

 immediately be applied over such a wound. In its upper half 

 the external jugular vein is commonly accompanied by the great 

 auricular nerve, and throughout its whole course it is closely 

 related to the superficial cervical lymph glands. 



Owing to its superficial position, the external jugular vein 

 may be opened to relieve the venous congestion which sometimes 

 occurs during the administration of an anaesthetic from disten- 

 tion of the right side of the heart. 



The Anterior Jugular Vein arises just below the chin and 

 runs downwards near the anterior median line of the neck (p. 164). 

 It turns laterally deep to the sterno-mastoid, just above the 

 clavicle, and joins the external jugular vein close to its termina- 

 tion. Occasionally the anterior jugular is joined by the common 

 facial vein. The two anterior jugular veins are connected by a 

 transverse branch (Fig. 51) which lies in the suprasternal space 

 (of Burns) (p. in). 



The superficial veins of the neck vary considerably in size, 

 and the increase of one is balanced by the decrease of another. 



The Superficial Cervical Lymph Glands lie in the superficial 

 fascia of the neck. They consist of three groups, (A) Occipital, 

 (B) Mastoid, and (C) a chain of glands accompanying the external 

 jugular vein. 



A. The Occipital lymph glands lie at the apex of the posterior 

 triangle. They receive afferents from the posterior part of the 

 scalp, and are commonly enlarged in pediculosis or impetigo 

 of the area which they drain. Their efferents pass partly to 

 group (C), and partly to the upper posterior group of the deep 

 cervical lymph glands (p. 132). 



B. The Mastoid lymph glands lie on the upper part of the 

 sterno-mastoid. They drain the adjoining area of the scalp 

 and the deep surface of the pinna, and their efferents take the 

 same course as the efferents of the occipital glands. 



C. This group receives afferents from the Occipital and 

 Mastoid lymph glands, which are the usual sources of infection. 

 They are not liable to tuberculous disease, and therefore, when 

 they become enlarged, there is very little periadenitis, so that 

 they can easily be felt to slip about beneath the platysma. 



