19 - Lymphatics of the head and neck Flashcards

1
Q

What is the function of the lymphatic system?

A
  • drainage of surplus tissue fluid
  • removal of debris from cell breakdown or immune response
  • important to indicate infection
  • facilitates malignancy spread
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2
Q

Describe the general lymphatic drainage of the head and neck.

A
  • nodes within the face drain into superior deep cervical nodes
  • deep cervical nodes and occipital nodes drain into inferior deep cervical nodes
  • all nodes drain into left or right subclavian vein
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3
Q

Which nodes drain into the superior deep cervical nodes?

A
  • facial nodes
  • anterior and posterior auricular nodes
  • superficial parotid nodes
  • deep parotid nodes
  • retropharyngeal nodes
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4
Q

Where is the thoracic duct located?

A

Left subclavian vein

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5
Q

What does the thoracic duct drain?

A

All lymph from body except upper right quadrant

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6
Q

Where is the right lymphatic duct located?

A

Right subclavian vein

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7
Q

What does the right lymphatic duct drain?

A

Upper right quadrant

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8
Q

What are the superficial nodes of the head?

A
  • facial
  • superficial parotid
  • posterior auricular
  • anterior auricular
  • occipital
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9
Q

How many superficial parotid nodes are there?

A

10

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10
Q

How many posterior auricular nodes are there?

A

1-3

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11
Q

How many anterior auricular nodes are there?

A

1-3

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12
Q

How many occipital nodes are there?

A

1-3

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13
Q

What do the superficial parotid and posterior and anterior auricular nodes drain?

A
  • area of external ear
  • lacrimal glands
  • adjacent skin of scalp and face
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14
Q

How many facial nodes are there?

A

12

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15
Q

Where are the facial nodes located?

A

Along facial vein

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16
Q

Where are the superficial parotid nodes located?

A

Superficial to the parotid gland

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17
Q

Where are the anterior auricular nodes located?

A

Anterior to the external acoustic meatus

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18
Q

Where are the posterior auricular nodes located?

A

Posterior to the external acoustic meatus

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19
Q

Where are the occipital nodes located?

A

Over the occipital region of the head

20
Q

What are the subdivisions of the facial nodes?

A
  • infraorbital
  • nasolabial
  • buccal
  • mandibular
21
Q

What do the facial nodes drain?

A

Skin and mucosa in the area, superior to inferior

22
Q

What are the deep lymph nodes of the head?

A
  • deep parotid
  • retropharyngeal
23
Q

How many deep parotid nodes are there?

A

10

24
Q

How many retropharyngeal nodes are there?

A

0, usually disappear by ages 4-5

25
Q

What do the deep parotid nodes drain?

A
  • middle ear
  • auditory tube
  • parotid gland
26
Q

What do the retropharyngeal nodes drain?

A
  • palate
  • pharynx
  • paranasal sinuses
  • oral cavity
27
Q

What are the superficial cervical nodes?

A
  • submandibular
  • submental
  • anterior jugular
  • external jugular
28
Q

How many submandibular nodes are there?

A

3-6

29
Q

How many submental nodes are there?

A

2-3

30
Q

Where are the submandibular nodes located?

A

in the region of the angle of the mandible

31
Q

Where are the submental nodes located?

A

Under the chin

32
Q

Where are the anterior jugular nodes located?

A

Along the anterior jugular vein

33
Q

Where are the external jugular nodes located?

A

Along the external jugular vein

34
Q

What do the submandibular nodes drain?

A
  • cheek
  • upper lip
  • body of tongue
  • anterior hard palate
  • majority of teeth, PDLs and gingiva (except lower incisors and upper 8s)
35
Q

What do the sublingual nodes drain?

A
  • drain tissue bilaterally
  • lower lip
  • chin
  • floor of mouth
  • apex of tongue
  • mandibular incisors, PDLs and gingiva
36
Q

What are the deep cervical nodes?

A
  • jugulodigastric
  • jugulo-omohyoid
  • accessory
  • supraclavicular
37
Q

How many deep cervical nodes are there?

A

15-30 along each IJV

38
Q

What do the jugulodigastric nodes drain?

A
  • palate
  • tonsils
39
Q

What do the jugulo-omohyoid nodes drain?

A
  • tongue
  • submental triangle
40
Q

What do the accessory and supraclavicular nodes drain?

A

Lateral triangles of the head

41
Q

How are the deep cervical nodes separated into superior and inferior?

A

Where the omohyoid crosses the IJV

42
Q

What do the superior deep cervical nodes drain?

A
  • posterior nasal cavity
  • posterior hard palate and soft palate
  • base of tongue (bilateral)
  • maxillary 8s
  • TMJ
  • oesophagus
  • trachea
  • thyroid gland
43
Q

What do the inferior deep cervical nodes drain?

A
  • posterior scalp and neck
  • superior pectoral region
  • part of the arm
44
Q

How does infection and inflammation in the lymph node present?

A

Swollen and tender lymph nodes

45
Q

How does malignancy present in lymph nodes?

A

Hard and painless lumps

46
Q

What does swelling in the submandibular lymph nodes indicate?

A

Disease or malignancy in the oral cavity, face, nasal cavity or maxillary sinus

47
Q

What does swelling in the supraclavicular lymph nodes indicate?

A

Disease or malignancy in the thorax or abdomen