5.6 Lymphatics

Question 1

Maxillary sinusitis can result from the spread of infection from what?

Answer 1

posterior maxillary teeth

Question 2

What is an infection of this venous sinus, which may result from the spread of a dental infection?

Answer 2

Cavernous sinus thrombosis

Question 3

What does the occipital scalp drain into?

Answer 3

occipital nodes

Question 4

What does the parietal scalp drain into?

Answer 4

mastoid or superficial parotid nodes

Question 5

What drains the lateral face?

Answer 5

parotid nodes

Question 6

What drains the mid portion of the face?

Answer 6

facial nodes

Question 7

Where are superficial facial nodes located?

Answer 7

along facial vessels

Question 8

Where are the deep facial nodes located?

Answer 8

along maxillary artery in IFT

Question 9

What drains the chin, medial lower lip, lower incisors and gingiva, tip of tongue?

Answer 9

submental nodes

Question 10

What do the submental nodes drain into?

Answer 10

submandibular nodes or deep cervical lymph nodes

Question 11

What drains the lower eyelids, nose, check, maxillary sinus, upper lip, palate, sublingual and submandibular glands, body of tongue, all maxillary teeth except 3rd molars, all mandibular teeth except incisors?

Answer 11

Submandibular nodes

Question 12

What doe submandibular nodes empty into?

Answer 12

deep cervical nodes

Question 13

Where are the anterior superficial cervical nodes (anterior jugular chain) located?

Answer 13

along anterior jugular vein, superficial to infra hyoid mm.

Question 14

What drains the skin and muscles of infra hyoid region of the neck?

Answer 14

Anterior jugular chain

Question 15

What drains the trachea, larynx, and thyroid?

Answer 15

Deep anterior cervical nodes (juxtavisceral)

Question 16

What is one of the pre laryngeal lymph nodes, where enlargement indicated thyroid disease?

Answer 16

Delphian node

Question 17

What nodes are located in the buccopharyngeal fascia posterior to pharynx at the level of the atlas?

Answer 17

retropharyngeal nodes

Question 18

What nodes primarily drain the nasal cavity and paranasal air sinuses, hard and soft palate, nasopharynx, posterior tongue?

Answer 18

Retropharyngeal nodes

Question 19

What nodes are located along the EJV, superficial to SCM?

Answer 19

superficial lateral cervical nodes (cervical chain)

Question 20

What drains the lower ear and parotid region?

Answer 20

superficial lateral cervical nodes (cervical chain)

Question 21

What lymph node group receives all lymph from head and neck?

Answer 21

Internal jugular (deep cervical) chain

Question 22

Where are the superior deep cervical chain nodes located?

Answer 22

surround IJV superior to omohyoid

Question 23

What is the most superior of the superior deep chain cervical nodes?

Answer 23

jugulodigastric (tonsillar) node

Question 24

What do the inferior deep cervical chain nodes drain?

Answer 24

superior deep cervical chain, anterior cervical and transverse cervical nodes

Question 25

Where does most lymph from the tongue drain either directly or indirectly?

Answer 25

jugulo-omohyoid node (part of inferior deep cervical chain)

Question 26

What does the superficial fascia of the head and face surround?

Answer 26

muscles of facial expression and their neurovasuclar supply

Question 27

What are the attachments of the deep fascia of the head and face?

Answer 27

extends from the hyoid bone superiorly to the mandible and zygomatic arch

Question 28

What structures does the deep fascia of the head and face cover?

Answer 28

muscles forming the floor of the mouth and the submandibular gland as a capsule

Question 29

What does the splitting of the deep fascia of the head and face create?

Answer 29

parotid fascia

Question 30

What contains fat, lymph nodes, muscles of facial expression, facial a/v, infraorbital a/v/n, mental a/v/n, and branches of CN VII?

Answer 30

superficial fascial spaces

Question 31

Where is the buccal space located?

Answer 31

between buccinators and skin of the face

Question 32

What is the typical source of infection to the buccal space?

Answer 32

maxillary and mandibular molars and premolars

Question 33

Where does the buccal space communicate to?

Answer 33

canine space, masticator, parapharyngeal spaces

Question 34

What are the typical symptoms of a buccal space infection?

Answer 34

large, tender swelling of cheek, may extend from phylum of lip to parotid region and superiorly to eye and eyelids

Question 35

What is the typical source of infection to the canine space?

Answer 35

maxillary canine

Question 36

Where does the canine space communicate to?

Answer 36

buccal space, cavernous sinus

Question 37

What is the typical symptoms of infection to the canine space?

Answer 37

firm or fluctuant mass along lateral border of nose (obliteration of nasolabial fold) may extend up to medial angle of eye and periorbital area

Question 38

Odontogenic infection is the most common pathologic condition to affect what space?

Answer 38

masticator space

Question 39

What are the contents of the masticator space? (7)

Answer 39

mandibular ramus, TMJ, muscles of mastication, CN V3 and br., maxillary a. and br., pterygoid venous plexus, chorda tympani n.

Question 40

What separates the masticator space posteriorly from the parotid region?

Answer 40

stylomandibular ligament

Question 41

What are the typical sources of infection to the masticator space?

Answer 41

mandibular 3rd molars, followed in frequency by more anterior molars and bicuspids

Question 42

What are the typical symptoms of a masticator space infection?

Answer 42

facial swelling, pain, muscle trismus

Question 43

Infection from the masticator space can spread to the parapharyngeal space to invoke the ....

Answer 43

lateral oropharynx leading to airway compromise

Question 44

Osteomyelitis of the mandible has been described as both a precursor to and a result of soft tissue infection in what space?

Answer 44

masticator

Question 45

What are the contents of the sublingual space? (6)

Answer 45

sublingual gland, submandibular duct, deep portion of submandibular gland, lingual a/n/v, hypoglossal n., submandibular ganglion,

Question 46

What is the typical source of infection of the sublingual space?

Answer 46

apices of 1st mandibular molars or premolars

Question 47

What are the typical communications with the sublingual space?

Answer 47

submandibular, masticator, and parapharyngeal

Question 48

What are the typical symptoms of a sublingual space infection?

Answer 48

elevated tongue with decreased mobility, swollen floor of the mouth, dysphagia

Question 49

What are the contents of the submandibular space? (6)

Answer 49

submandibular gland, lymph nodes, hypoglossal n., n. to mylohyoid, facial a/v, ant. belly digastric m.

Question 50

What is the typical source of infection to the submandibular space?

Answer 50

apices of 2nd and 3rd mandibular molars

Question 51

What spaces are the major communications to the submandibular space?

Answer 51

sublingual and parapharyngeal

Question 52

What are the symptoms of a submandibular space infection?

Answer 52

firm, painful swelling in submandibular region, dysphagia

Question 53

What are the typical sources of infection to the submental space?

Answer 53

mandibular anteriors (incisors)

Question 54

What are the typical communications to the submental spaces?

Answer 54

submandibular spaces on either side

Question 55

What are the typical symptoms of a submental space infection?

Answer 55

hard midline swelling under chin

Question 56

Ludwig's Angina is typically the result of infections from what teeth?

Answer 56

2nd and 3rd mandibular molars

Question 57

What are the 4 criteria of Ludwigs Angina?

Answer 57

(1) involves both the sublingual and submandibular spaces (2) presence of gangrene or seroganguinous phlegm, but no pus (3) Involves CT, muscle, and fascia but spares glandular tissue (4) spread by contiguity of spaces not lymphatics

Question 58

What are the typical sources of infection to the parapharyngeal space?

Answer 58

maxillary and mandibular molars

Question 59

What are the typical symptoms of a parapharyngeal space infection?

Answer 59

pain and muscle truisms, swollen soft palate with deviated uvula, dysphagia, inability to palpate angle of mandible

Question 60

The parapharyngeal space is the most frequently infected secondary space from what 5 primary areas?

Answer 60

masticator space, teeth, tongue, salivary glands, and tonsillar region

Question 61

Where do infections from the parapharyngeal space spread?

Answer 61

retropharyngeal space --> mediastinum

Question 62

What is the primary route of infection from head and neck into "danger space" and subsequently into the mediastinum?

Answer 62

retropharyngeal space