The Major Arteries of the Neck

The neck contains several critical blood vessels that supply oxygenated blood to the brain, face, and scalp. The largest and most important of these are the carotid arteries and the vertebral arteries.

Carotid Arteries

There are two common carotid arteries, one on each side of the neck. Each divides into an internal and an external branch. The internal carotid artery carries blood to the brain, while the external carotid artery supplies blood to the face and neck tissues. The carotid arteries are palpable and are often checked for a pulse in emergency situations.

Vertebral Arteries

Running along the back of the neck, the vertebral arteries travel through the cervical spine and join together to form the basilar artery. These vessels supply the posterior part of the brain, including the cerebellum and brainstem.

The Major Veins of the Neck

Veins in the neck return deoxygenated blood from the head and neck back to the heart. The most prominent are the internal jugular veins and the external jugular veins.

Internal Jugular Vein

The internal jugular vein is a large vessel that drains blood from the brain, face, and superficial parts of the neck. It runs deep within the neck, alongside the carotid artery, and eventually joins the subclavian vein to form the brachiocephalic vein.

External Jugular Vein

The external jugular vein is more superficial and drains blood from the outer parts of the face and scalp. It crosses the surface of the sternocleidomastoid muscle and empties into the subclavian vein.

Clinical Significance

Blood vessels in the neck are vulnerable to a variety of conditions. Carotid artery narrowing, known as carotid stenosis, can reduce blood flow to the brain and increase the risk of stroke. A carotid bruit, an abnormal sound heard with a stethoscope, may indicate turbulent blood flow in a narrowed artery.

Deep vein thrombosis in the neck is uncommon but can occur, particularly in the internal jugular vein, often related to central venous catheters or intravenous drug use. Dissection of the carotid or vertebral arteries, a tear in the vessel wall, is a serious cause of stroke in younger adults.

Because these vessels are close to the surface, they can be injured during trauma. Proper knowledge of their anatomy is essential for surgeons performing procedures in the neck region, such as carotid endarterectomy or placement of central venous lines.

Common Diagnostic Tests

• Carotid ultrasound – uses sound waves to image the carotid arteries and measure blood flow.
• CT angiography – provides detailed imaging of the neck blood vessels.
• MR angiography – uses magnetic resonance to visualise the arteries and veins.
• Venography – an X-ray examination of the veins after injection of a contrast agent.