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.

Why Is Pee Yellow?

Chloe Effron
Chloe Effron

WHY? is our attempt to answer all the questions every little kid asks. Do you have a question? Send it to why@mentalfloss.com.

Your body is kind of like a house. You bring things into your body by eating, drinking, and breathing. But just like the things we bring home to real houses, we don’t need every part of what we take in. So there are leftovers, or garbage. And if you let garbage sit around in your house or your body for too long, it gets gross and can make you sick. Your body takes out the garbage by peeing and pooping. These two things are part of your body’s excretory system (ECKS-krih-tore-eee SISS-tem), which is just a fancy way of saying “trash removal.” If your body is healthy, when you look in the toilet you should see brown poop and yellow pee.

Clear, light yellow pee is a sign that your excretory system and the rest of your body are working right. If your pee, or urine (YER-inn), is not see-through, that might mean you are sick. Dark yellow urine usually means that you aren’t drinking enough water. On the other hand, really pale or colorless pee can mean you might be drinking too much water! 

Your blood is filtered through two small organs called kidneys (KID-knees). Remember the garbage we talked about earlier? The chemicals called toxins (TOCK-sins) are like garbage in your blood. Your kidneys act like a net, catching the toxins and other leftovers and turning them into pee.

One part of your blood is called hemoglobin (HEE-moh-gloh-bin). This is what makes your blood red. Hemoglobin goes through a lot of changes as it passes through your body. When it reaches your kidneys, it turns yellow thanks to a chemical called urobilin (yer-ah-BY-lin). Urobilin is kind of like food coloring. The more water you add, the lighter it will be. That's why, if you see dark yellow pee in the toilet, it's time to ask your mom or dad for a cup of water. 

To learn more about pee, check out this article from Kids Health. 

12 Facts About Kidney Stones

Illustration by Mental Floss. Images: iStock
Illustration by Mental Floss. Images: iStock

Kidney stones are more common than ever. According to Harvard Medical School, every year more than 3 million people see a doctor for relief from these hard mineral and salt deposits, which form in your kidney when urine becomes too concentrated. Here's what we know about the condition formally called nephrolithiasis.

1. KIDNEY STONES TYPICALLY CAUSE REALLY PAINFUL SYMPTOMS.

At first you may notice your urine is cloudy, bloody, and foul smelling. Your back may begin to ache, and nausea may come over you. Then, as the stone moves from your kidney into your urinary tract or bladder, sometimes becoming trapped, there’s often an intense, stabbing pain that many people say they wouldn’t wish on their worst enemy.

2. MOST PEOPLE DEVELOP ONE TYPE OF STONE …

What kind of kidney stone you get depends on your diet, fluid intake, genetics, hereditary disorders, and even whether you take certain medications, but the vast majority of people get calcium oxalate stones. They're formed from a mix of calcium in urine and the compound oxalate, which is found naturally in food like nuts, chocolate, and some vegetables, including beets and spinach; oxalate is also produced by your liver. There's some evidence that people who take the seizure medicine topiramate can develop these stones in the form of calcium phosphate.

3. … BUT THERE ARE THREE OTHER KINDS TOO.

Struvite stones are fast-growing mineral deposits that typically develop in response to a urinary tract infection, and can grow large enough to block the kidney, ureter, or bladder before you notice any symptoms; they affect women more than men. Uric acid stones turn up in people who eat a lot of red meat, shellfish, and organ meats, which contain hefty doses of an organic compound called purine that can lead to more uric acid than the kidneys can excrete. Cystine stones are caused by a rare hereditary disorder called cistinuria in which your kidneys excrete excessive amounts of the amino acid cystine.

4. THEY'RE EXTREMELY COMMON—ESPECIALLY IN MEN.

There's a solid chance you could end up with a kidney stone. The National Kidney Foundation notes that one in 10 people will develop one during the course of their life. And if you’re male, take note: Your gender alone is considered a kidney stone risk factor. Men are twice as likely as women to develop them. Another factor is age: Although stones are most common from ages 20 through 50, they tend to peak around age 30.

5. IF YOU’VE HAD A KIDNEY STONE, YOU’LL PROBABLY DEVELOP ANOTHER ONE …

Sorry to say, but simply having a kidney stone puts you at risk for a recurrence. If you’ve had one, the U.S. National Library of Medicine notes that there’s a 30 to 50 percent chance more stones will form within five years.

6. … BUT YOU CAN TAKE STEPS TO PREVENT THEM.

Cutting back on sodium (i.e. deli meats, packaged soups, and processed foods) can help, because a stone can form from excessive salt consumption. You should also avoid too much animal protein—it produces urine containing more acid, which is known to increase your risk for kidney stones—and increase your intake of fruits, vegetables, whole grains, and low-fat dairy. And be sure to drink plenty of fluids, especially water—at least 12 glasses a day. (That's good advice for everyone, not just those prone to kidney stones.)

Don't drink much apple or cranberry juice as both contain oxalates and are linked to an increased risk of developing calcium oxalate stones. High doses of Vitamin C may boost the concentration of oxalate in urine; the Cleveland Clinic recommends a daily maximum of 500 milligrams.

7. IT'S A MYTH THAT CALCIUM CREATES SOME KIDNEY STONES.

Despite the fact that the word calcium is part of the most common kind of kidney stone, you don’t need to treat calcium as the enemy. In fact, having too little calcium can actually increase the odds you’ll get these types of stones. According to the Cleveland Clinic, eating about two or three servings of calcium-rich foods daily reduces oxalate absorption, helping to keep calcium oxalate stones away. So get out the cheese.

8. IF YOU PASS A STONE, CONGRATULATIONS! NOW TAKE IT TO A DOCTOR.

Ninety percent of kidney stones are passed through urination. Getting one out this way may hurt a lot, but once the stone has finished causing you agony, it could provide clues that could help you avoid developing another one. If you’re able to retrieve the stone, bring it to your doctor, who can order an analysis. Identifying its components can reveal the kind of stone it is and potentially point to a treatment or prevention plan.

9. IF YOU CAN’T PASS A STONE, TREATMENTS ARE AVAILABLE …

In an attempt to exit the body, a stone travels from the kidney to the bladder through a narrow tube called the ureter. If the stone is larger than a quarter-inch, it's simply too big to pass through the ureter, and will get trapped there. (If it can make it through to your bladder, it's small enough to pass out out of your body through the urethra.) This causes intense pain, blocked urine flow, and possible bleeding from urinary tract walls. That's when it's time for treatment.

There are several methods for getting rid of a kidney stone, all of which aim to break the stone into smaller pieces so they can leave the body. In an extracorporeal shock wave lithotripsy (from the Greek for "crushed stone"), high-frequency sound waves are applied externally to break stones up, allowing them to pass when you pee. Laser lithotripsy takes a similar approach: Stones in the ureter are broken up with a laser and also leave the body naturally. More invasive is percutaneous ultrasonic lithotripsy, which involves passing narrow instruments (including a fiberoptic camera) through your back to your kidney; ultrasound breaks the stones up, and then fragments are removed by an instrument. Finally, a ureteroscopy is a treatment option in which a small scope is inserted in the ureter towards the bladder to determine the stone's location. Then it's broken up for natural passage or removed altogether. Luckily, you're unconscious under general anesthesia during the last procedure.

10. … AND THEY'RE FAR SUPERIOR TO THOSE USED IN THE PAST.

Kidney stones are nothing new—mentions of the painful formations go back more than 5000 years, to Mesopotamian medical texts—and medical interventions have occurred for just as long. Stones made it into the Hippocratic Oath, in which physicians swore they would "not use the knife, not even on sufferers from stone," leaving the procedure to "such men as are engaged in this work" [PDF]. Surgeons in ancient Greece and India were attempting stone removal as far back as the 7th century BCE.

The 16th to 18th centuries were a heyday for stone surgeons, who were largely self-taught. The most notorious of them was Frere Jacques Beaulieu. He pioneered the lateral perineal lithotomy—which involved making an incision in the perineum, inserting a terrifying cutting instrument into the bladder, cutting up the stone, and then extracting the pieces with the instrument or his fingers—in the late 17th century. Unfortunately for his patients, he had no technical training, and his method was often deadly; in 1698, after 25 of his 60 patients died, he was banned from doing the procedure—but he didn't stop. He's thought to have performed more than 5000 lithotomies. (And no, the song doesn't seem to be about him.)

11. IF ALL ELSE FAILS, TRY RIDING A ROLLER COASTER.

If you’re a thrill seeker who happens to have kidney stones (and some vacation time), you may be in luck. After a "notable number" of patients reported that riding the Big Thunder Mountain roller coaster at Walt Disney World in Orlando helped them to pass their kidney stones, Michigan State University urologist David Wartinger decided to investigate. He created a kidney replica—complete with kidney stones—put it in a backpack, and let it ride the roller coaster 60 times. It worked—but passing the stones depended on where the backpack was placed in the coaster. Rides in the last car were the most effective, with the stones passing 64 percent of the time, while the front few cars yielded only a 16 percent success rate.

Big Thunder Mountain was the only ride in the theme park that was effective. Neither Space Mountain nor Aerosmith's Rock 'n' Roller Coaster did the trick, likely because they were too fast, with a G-force that pinned the stones in place. Of course, while this is an interesting finding, if you suspect you have kidney stones, speak to your doctor before you high-tail it to Walt Disney World.

12. A KIDNEY STONE THE SIZE OF A MOUSE WAS REMOVED FROM A MAN IN 2004.

The stone measured 5.11 inches at its widest point—a world record. Five years later, a whopping 2.5-pound stone was surgically removed from a man in Hungary in 2009. Perhaps seeing a bunch of kidney stones in one place other than originating from your own body will put you at ease. If that’s the case, check out the International Museum of Surgical Science in Chicago, where a collection of stones is on display in glass jars.

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