11 Striking Facts About the Jugular

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The human body is an amazing thing. For each one of us, it's the most intimate object we know. And yet most of us don't know enough about it: its features, functions, quirks, and mysteries. Our series The Body explores human anatomy, part by part. Think of it as a mini digital encyclopedia with a dose of wow.

Jugular veins are popular in horror flicks for their gushing at the mouths of vampires, werewolves, and knife-wielding assassins. While that's unlikely to happen to most of us, this crucial vein does give up copious blood. Jugular veins are big—much larger than the veins you typically offer to your doctor for a blood test and those you find spidering off the side of your legs. Jugular veins are also key players in the circulation and drainage systems to the brain, face, and neck. To learn more, Mental Floss spoke with William W. Ashley, a cerebral-vascular neurosurgeon at Sandra and Malcolm Berman Brain & Spine Institute at LifeBridge Health Hospital, in Baltimore, Maryland. Here are 11 things you might not have known about this crucial body part.

1. IT'S A REAL BRAIN DRAIN.

"The jugular vein is an important body part because it drains deoxygenated blood from the head and the neck," Ashley tells Mental Floss. "Most important is to drain the brain. If you block the jugular veins, the pressure in the brain goes up."

2. YOU ACTUALLY HAVE FOUR JUGULAR VEINS.

There's an internal and an external jugular vein on each side of the neck. The internal jugular vein (really a pair of veins) largely drains the cerebral veins—those coming from the brain—while the external jugular vein (also a pair) drains those structures more on the surface of the head, such as the scalp, sinuses, and other portions of the face. The left vein is usually smaller than the one on the right, but both possess valves that help transport blood. At two points in the vein it looks wider, and these parts are called the superior bulb and the inferior bulb.

3. THESE ARE THE VEINS THAT STAND OUT ON EITHER SIDE OF YOUR NECK.

Your jugular veins run alongside the thyroid gland down to just above your collarbone, and close to your trachea, or windpipe. When you're picking up a heavy box, or clenching your jaw, your jugular veins might bulge slightly. "They respond to changes in pressure, so you can see them get big and small," Ashley says.

4. SOME PEOPLE HAVE MORE THAN THEIR SHARE OF THESE VEINS …

According to the Indian Journal of Plastic Surgery, during a surgery to treat a 65-year-old woman's cancer of the tongue, surgeons discovered a surprise: She had two right internal jugular veins, "a rare congenital abnormality," the authors write. While unusual, it didn't appear to cause any other health problems.

5. … WHILE OTHERS MAKE DO WITH FEWER.

Ashley had a patient with the opposite issue: "I've seen an absence of one [right vein] where everything drained on the left side. We found it incidentally. If she injured her one jugular vein, she'd be in bad shape. We were doing an angiogram to see if she had a brain aneurism." Her dearth of jugulars hadn't caused any health problems, however, he said, because "the body had adopted a different pattern [of drainage]."

6. A BULGING JUGULAR VEIN CAN BE A CAUSE FOR ALARM.

A bulging or "distended" jugular vein can be a sign of emergency. Unless you're The Hulk, that distended vein is a sign that the jugular is carrying more blood than the heart has the ability to pump back out. The conditions that can cause this include tension pneumothorax—where air has leaked from the lungs into the chest cavity and can't get back out without being released by a needle—or cardiac tamponade, a condition where fluid leaks from the heart into the pericardium, the sac that surrounds the heart. In this case, pericardiocentesis is required—drawing the fluid out through a needle. Lastly, constrictive pericarditis, an infection of the pericardium, can also cause this condition, which may require surgery and antibiotics to treat.

7. IN RARE CASES, IVF IS LINKED TO DANGEROUS INTERNAL JUGULAR VEIN BLOOD CLOTS.

A blood clot in the internal jugular veins (IJV), known as a thrombosis, is a very serious condition that can prove fatal if not caught and treated quickly. Clots in the IJV are rare compared to those that occur in legs and lungs, but they can happen. Most commonly they are the result of an infection or a tumor. In a very small number of cases, in vitro fertilization (IVF) treatments, in which a woman receives hormones and drugs to stimulate ovulation to increase chances of pregnancy, can cause a thrombosis of the IJV. This seems to be related to ovarian hyper stimulation syndrome (which can occur in an IVF cycle), where swelling and inflammation of the ovaries also causes blood leaving the ovaries to become hypercoagulated, or extra thick. This thickened blood can then form a clot in the IJV. Any thrombosis is treated with anticoagulation medicines, and if infection is present, antibiotics.

8. THESE VEINS DON'T DO WELL UNDER PRESSURE …

"One interesting thing about them is that they can cause a variety of brain problems, such as elevated pressure in the brain," says Ashley. One is a condition known as Eagle syndrome, which he calls "pretty cool" (as only a cerebral-vascular neurosurgeon could). In this syndrome, "a congenital bony prominence at the base of skull pushes on the jugular vein and causes the brain to swell up and become engorged with blood," Ashley describes. As the pressure builds in the brain, it has to be surgically released or it will cause serious damage. "We can do that by putting in a shunt [in the brain] to drain off fluid," he says. Occasionally, doctors can also surgically remove the piece of the bone that's causing the problem.

9. … OR WITH TRAUMA, WHICH IS THE MOST COMMON CAUSE OF CONSTRICTION.

Other than congenital issues—those you're born with—the most common causes of constriction in the jugular veins are from traumas, such as car accidents and other traumatic brain or neck injuries. "Blood clots and trauma can constrict the jugular vein," Ashley says, as can "congenital narrowing of the vein."

10. WE CAN NOW TREAT JUGULAR-DERIVED BRAIN PRESSURE BETTER.

In the past five to 10 years, surgeons have begun to use stents, metal tubes inserted directly into the vein, to open it up. "A shunt is a tube that goes into the brain that helps drain off spinal pressure. The stent goes into the vein, that's a little more elegant a solution," Ashley says.

11. AS EVERY HORROR MOVIE SUGGESTS, BE CAREFUL WITH SHARP OBJECTS AROUND YOUR JUGULAR.

If your jugular is punctured, Ashley warns, "you can rapidly lose blood." A needle is less likely to cause problems than a knife, but blood is likely to flow out of your jugular "more rapidly than out of a vein in wrist or arm," making a puncture a serious problem.

10 Facts About Your Tonsils

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iStock/Neustockimages

Most of us only become aware of our tonsils if they become swollen or infected. But these masses of lymphatic tissue in the mouth and throat are important immunological gatekeepers at the start of the airways and digestive tract, grabbing pathogens and warding off diseases before they reach the rest of your body. Here are some essential answers about these often-overlooked tissues—like what to do when your tonsils are swollen, and whether you should get your tonsils removed.

1. People actually have four kinds of tonsils.

The term tonsils usually refers to your palatine tonsils, the ones that can be seen at the back of your throat. But tonsillar tissue also includes the lingual tonsil (located in the base of the tongue), tubal tonsils, and the adenoid tonsil (often just called adenoids). "Collectively, these are referred to as Waldeyer's ring," says Raja Seethala, the director of head and neck pathology at the University of Pittsburgh Medical Center and a member of the College of American Pathologists Cancer Committee.

2. Tonsils are one of the body's first responders to pathogens.

The tonsils are a key barrier to inhaled or ingested pathogens that can cause infection or other harm, Seethala tells Mental Floss. "These pathogens bind to specialized immune cells in the lining—epithelium—to elicit an immune response in the lymphoid T and B cells of the tonsil," he says. Essentially, they help jumpstart your immune response.

3. Adenoid tonsils can obstruct breathing and cause facial deformities.

If the adenoid tonsils are swollen, they can block breathing and clog up your sinus drainage, which can cause sinus and ear infections. If adenoids are too big, it forces a person to breathe through their mouth. In children, frequent mouth breathing has the potential to cause facial deformities by stressing developing facial bones. "If the tonsils are too large and cause airway obstruction, snoring, or obstructive sleep apnea, then removal is important," says Donald Levine, an ear, nose, and throat specialist in Nyack, New York. Fortunately, the adenoids tend to get smaller naturally in adulthood.

4. As many of us know, sometimes tonsils are removed.

Even though your tonsils are part of your immune system, Levine tells Mental Floss, "when they become obstructive or chronically infected, then they need to be removed." The rest of your immune system steps in to handle further attacks by pathogens. Another reason to remove tonsils besides size, Levine says, is "chronic tonsillitis due to the failure of the immune system to remove residual bacteria from the tonsils, despite multiple antibiotic therapies."

5. Tonsillectomies have been performed for thousands of years ...

Tonsil removal is believed to have been a phenomenon for three millennia. The procedure is found in ancient Ayurvedic texts, says Seethala, "making it one of the older documented surgical procedures." But though the scientific understanding of the surgery has changed dramatically since then, "the benefits versus harm of tonsillectomy have been continually debated over the centuries," he says.

6. ... and they were probably quite painful.

The first known reported case of tonsillectomy surgery, according to a 2006 paper in Otorhinolaryngology, is by Cornélio Celsus, a Roman "encylopaediest" and dabbler in medicine, who authored a medical encyclopedia titled Of Medicine in the 1st century BCE. Thanks to his work, we can surmise that a tonsillectomy probably was an agonizing procedure for the patient: "Celsus applied a mixture of vinegar and milk in the surgical specimen to hemostasis [stanch bleeding] and also described his difficulty doing that due to lack of proper anesthesia."

7. Tonsil removal was performed for unlikely reasons.

The same paper reveals that among some of the more outlandish reasons for removing tonsils were conditions like "night enuresis (bed-wetting), convulsions, laryngeal stridor, hoarseness, chronic bronchitis, and asthma."

8. An early treatment for swollen tonsils included frog fat.

As early practitioners struggled to perfect techniques for removing tonsils effectively, another early physician, Aetius de Amida, recommended "ointment, oils, and corrosive formulas with frog fat to treat infections."

9. Modern tonsillectomy is much more sophisticated.

A common technique today for removing the tonsils, according to Levine, is a far cry from the painful early attempts. Under brief general anesthesia, Levine uses a process called coblation. "[It's] a kind of cold cautery, so there is almost no bleeding, less post operative pain, and quicker healing. You can return to normal activities 10 days later," Levine says.

10. Sexually-transmitted HPV can cause tonsil cancer.

The incidence of tonsillar cancers is increasing, according to Seethala. "Unlike other head and neck cancers, which are commonly associated with smoking and alcohol, tonsillar cancers are driven by high-risk human papillomavirus (HPV)," he says. "HPV-related tonsillar cancer can be considered sexually transmitted."

26 Amazing Facts About the Human Body

Mental Floss via YouTube
Mental Floss via YouTube

At some point in your life, you've probably wondered: What is belly button lint, anyway? The answer, according to Mental Floss editor-in-chief Erin McCarthy, is that it's "fibers that rub off of clothing over time." And hairy people are more prone to getting it for a very specific (and kind of gross-sounding) reason. A group of scientists who formed the Belly Button Biodiversity Project in 2011 have also discovered that there's a whole lot of bacteria going on in there.

In this week's all-new edition of The List Show, Erin is sharing 26 amazing facts about the human body, from your philtrum (the dent under your nose) to your feet. You can watch the full episode below.

For more episodes like this one, be sure to subscribe here.

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