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.

‘Water’ in Kansas City Woman’s Ear Turned Out to Be a Venomous Brown Recluse Spider

N-sky/iStock via Getty Images
N-sky/iStock via Getty Images

Susie Torres, a resident of Kansas City, Missouri, woke up on Tuesday morning with the distinct feeling that water was lodged in her left ear. She likened it to the swooshing sensation that can often happen after swimming, WDAF-TV reports.

Instead of waiting for the problem to resolve itself, Torres went to the doctor—a decision that might have saved her from some serious pain. The medical assistant was the first to realize something was alarmingly amiss, and immediately called for backup.

“She ran out and said ‘I’m going to get a couple more people,’” Torres told 41 Action News. “She then said, ‘I think you have an insect in there.’” For many people, the thought of having any live insect stuck in an ear would be enough to cue a small- or large-scale freak-out, but Torres stayed calm.

The doctors “had a few tools and worked their magic and got it out,” Torres said. The “it” in question turned out to be a spider—and not just any harmless house spider (which you shouldn’t kill, by the way). It was a venomous brown recluse spider.

“Gross,” Torres told WDAF-TV. “Why, where, what, and how.”

Miraculously, the spider didn’t bite Torres. If it had, she would’ve ended up visiting the doctor with more than general ear discomfort: Brown recluse bites can cause pain, burning, fever, nausea, and purple or blue discoloration of the surrounding skin, according to Healthline.

Torres may have remained admirably level-headed throughout the ordeal, but that doesn’t mean she’s taking it lightly. “I went and put some cotton balls in my ears last night,” she told WDAF-TV. “I’m shaking off my clothes, and I don’t put my purse on the floor. I’m a little more cautious.”

Is this the first time an insect has posted up in the ear of an unsuspecting, innocent human? Absolutely not—here are six more horror stories, featuring a cockroach, a bed bug, and more.

[h/t WDAF-TV]

12 Fantastic Facts About the Immune System

monkeybusinessimages/iStock via Getty Images
monkeybusinessimages/iStock via Getty Images

If it weren't for our immune system, none of us would live very long. Not only does the immune system protect us from external pathogens like viruses, bacteria, and parasites, but it also battles cells that have mutated due to illnesses, like cancer, within the body. Here are 12 fascinating facts about the immune system.

1. The immune system saves lives.

The immune system is a complex network of tissues and organs that spreads throughout the entire body. In a nutshell, it works like this: A series of "sensors" within the system detects an intruding pathogen, like bacteria or a virus. Then the sensors signal other parts of the system to kill the pathogen and eliminate the infection.

"The immune system is being bombarded by all sorts of microbes all the time," Russell Vance, professor of immunology at University of California, Berkeley and an investigator for the Howard Hughes Medical Institute, tells Mental Floss. "Yet, even though we're not aware of it, it's saving our lives every day, and doing a remarkably good job of it."

2. Before scientists understood the immune system, illness was chalked up to unbalanced humors.

Long before physicians realized how invisible pathogens interacted with the body's system for fighting them off, doctors diagnosed all ills of the body and the mind according to the balance of "four humors": melancholic, phlegmatic, choleric, or sanguine. These criteria, devised by the Greek philosopher Hippocrates, were divided between the four elements, which were linked to bodily fluids (a.k.a. humors): earth (black bile), air (blood), water (phlegm) and fire (yellow bile), which also carried properties of cold, hot, moist, or dry. Through a combination of guesswork and observation, physicians would diagnose patients' humors and prescribe treatment that most likely did little to support the immune system's ability to resist infection.

3. Two men who unraveled the immune system's functions were bitter rivals.

Two scientists who discovered key functions of the immune system, Louis Pasteur and Robert Koch, should have been able to see their work as complementary, but they wound up rivals. Pasteur, a French microbiologist, was famous for his experiments demonstrating the mechanism of vaccines using weakened versions of the microbes. Koch, a German physician, established four essential conditions under which pathogenic bacteria can infect hosts, and used them to identify the Mycobacterium tuberculosis bacterium that causes tuberculosis. Though both helped establish the germ theory of disease—one of the foundations of modern medicine today—Pasteur and Koch's feud may have been aggravated by nationalism, a language barrier, criticisms of each other's work, and possibly a hint of jealousy.

4. Specialized blood cells are the immune system's greatest weapon.

The most powerful weapons in your immune system's arsenal are white blood cells, divided into two main types: lymphocytes, which create antigens for specific pathogens and kill them or escort them out of the body; and phagocytes, which ingest harmful bacteria. White blood cells not only attack foreign pathogens, but recognize these interlopers the next time they meet them and respond more quickly. Many of these immune cells are produced in your bone marrow but also in the spleen, lymph nodes, and thymus, and are stored in some of these tissues and other areas of the body. In the lymph nodes, which are located throughout your body but most noticeably in your armpits, throat, and groin, lymphatic fluid containing white blood cells flows through vein-like tubules to escort foreign invaders out.

5. The spleen helps your immune system work.

Though you can live without the spleen, an organ that lies between stomach and diaphragm, it's better to hang onto it for your immune function. According to Adriana Medina, a doctor who specializes in hematology and oncology at the Alvin and Lois Lapidus Cancer Institute at Sinai Hospital in Baltimore, your spleen is "one big lymph node" that makes new white blood cells and cleans out old blood cells from the body.

It's also a place where immune cells congregate. "Because the immune cells are spread out through the body," Vance says, "eventually they need to communicate with each other." They do so in both the spleen and lymph nodes.

6. You have immune cells in all of your tissues.

While immune cells may congregate more in lymph nodes than elsewhere, "every tissue in your body has immune cells stationed in it or circulating through it, constantly roving for signs of attack," Vance explains. These cells also circulate through the blood. The reason for their widespread presence is that there are thousands of different pathogens that might infect us, from bacteria to viruses to parasites. "To eliminate each of those different kinds of threats requires specialized detectors," he says.

7. How friendly you're feeling could be linked to your immune system.

From an evolutionary perspective, humans' high sociability may have less to do with our bigger brains, and more to do with our immune system's exposure to a greater number of bacteria and other pathogens.

Researchers at the University of Virginia School of Medicine have theorized that interferon gamma (IG), a substance that helps the immune system fight invaders, was linked to social behavior, which is one of the ways we become exposed to pathogens.

In mice, they found IG acted as a kind of brake to the brain's prefrontal cortex, essentially stopping aberrant hyperactivity that can cause negative changes in social behavior. When they blocked the IG molecule, the mice's prefrontal cortexes became hyperactive, resulting in less sociability. When they restored the function, the mice's brains returned to normal, as did their social behavior.

8. Your immune system might recruit unlikely organs, like the appendix, into service.

The appendix gets a bad rap as a vestigial organ that does nothing but occasionally go septic and create a need for immediate surgery. But the appendix may help keep your gut in good shape. According to Gabrielle Belz, professor of molecular immunology at the Walter and Eliza Hall Institute of Medical Research in Melbourne, Australia, research by Duke University's Randal Bollinger and Bill Parker suggests the appendix houses symbiotic bacteria that are important for overall gut health—especially after infections wipe out the gut's good microbes. Special immune cells known as innate lymphoid cells (ILCs) in the appendix may help to repopulate the gut with healthy bacteria and put the gut back on track to recovery.

9. Gut bacteria has been shown to boost immune systems in mice.

Researchers at the University of Chicago noticed that one group of mice in their lab had a stronger response to a cancer treatment than other mice. They eventually traced the reason to a strain of bacteria—Bifidobacterium—in the mice's guts that boosted the animals' immune system to such a degree they could compare it to anti-cancer drugs called checkpoint inhibitors, which keep the immune system from overreacting.

To test their theory, they transferred fecal matter from the robust mice to the stomachs of less immune-strengthened mice, with positive results: The treated mice mounted stronger immune responses and tumor growth slowed. When they compared the bacterial transfer effects with the effects of a checkpoint inhibitor drug, they found that the bacteria treatment was just as effective. The researchers believe that, with further study, the same effect could be seen in human cancer patients.

10. Scientists are trying to harness the immune system's "Pac-Man" cells to treat cancer.

Aggressive pediatric tumors are difficult to treat due to the toxicity of chemotherapy, but some researchers are hoping to develop effective treatments without the harmful side effects. Stanford researchers designed a study around a recently discovered molecule known as CD47, a protein expressed on the surface of all cells, and how it interacts with macrophages, white blood cells that kill abnormal cells. "Think of the macrophages as the Pac-Man of the immune system," Samuel Cheshier, lead study author and assistant professor of neurosurgery at Stanford Medicine, tells Mental Floss.

CD47 sends the immune system's macrophages a "don't eat me" signal. Cancer cells fool the immune system into not destroying them by secreting high amounts of CD47. When Cheshier and his team blocked the CD47 signals on cancer cells, the macrophages could identify the cancer cells and eat them, without toxic side effects to healthy cells. The treatment successfully shrank all five of the common pediatric tumors, without the nasty side effects of chemotherapy.

11. A new therapy for type 1 diabetes tricks the immune system.

In those with type 1 diabetes, the body attacks its own pancreatic cells, interrupting its normal ability to produce insulin in response to glucose. In a 2016 paper, researchers at MIT, in collaboration with Boston's Children's Hospital, successfully designed a new material that allows them to encapsulate and transplant healthy pancreatic "islet" cells into diabetic mice without triggering an immune response. Made from seaweed, the substance is benign enough that the body doesn't react to it, and porous enough to allow the islet cells to be placed in the abdomen of mice, where they restore the pancreatic function. Senior author Daniel Anderson, an associate professor at MIT, said in a statement that this approach "has the potential to provide [human] diabetics with a new pancreas that is protected from the immune system, which would allow them to control their blood sugar without taking drugs. That's the dream."

12. Immunotherapy is on the cutting edge of immune system research.

Over the last few years, research in the field of immunology has focused on developing cancer treatments using immunotherapy. This method engineers the patient's own normal cells to attack the cancer cells. Vance says the technique could be used for many more conditions. "I feel like that could be just the tip of the iceberg," he says. "If we can understand better what the cancer and immunotherapy is showing, maybe we can go in there and manipulate the immune responses and get good outcomes for other diseases, too."

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