Cervical fascia and lymphatics of head and neck Flashcards Preview

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Flashcards in Cervical fascia and lymphatics of head and neck Deck (9)
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Pathway of lymph

-Lymph-> lymphatic capillaries->afferent vessels-> lymph node-> efferent vessels-> trunk-> right lymphatic or thoracic duct


5 branches of ECA

-From inferior->superior
-Superior thyroid artery
-Facial artery
-Occipital artery (only one branching posterior)
-2 terminal branches: maxillary and superficial temporal
-ICA first branch is opthalmic, and this branch anastomoses w/ the occipital and superficial temporal (branches of ECA) at the scalp
-Branches of opthalmic also anastamose w/ facial artery, sphenopalatine artery, and greater palatine artery (all from ECA)


Infrahyoid muscles

-All innervated by ansa cervicalis (C1-3) except cricothyroid (innervated by external branch of superior laryngeal nerve)
-All suprahyoid muscle innervated by CNs except geniohyoid (innervated by ansa cervicalis C1)


Superficial lymph nodes of neck and head

-Pericervical collar of lymph nodes are found at the junction of the head and neck
-These superficial lymph nodes drain the head
-Superficial lymph nodes that drain the neck (superficial cervical nodes) are found along the course of the external and internal jugular veins
-These drain lymph from superficial tissues of the head and neck
-From pericervical collar nodes, efferent lymph vessels can drain into deep and/or superficial cervical nodes


Deep lymph nodes of the neck

-Deep cervical lymph nodes are found in connective tissue of the carotid sheath, closely associated w/ internal jugular vein
-Receive lymph drainage from both superficial and other deep nodes (drain most of the head and neck)
-Most important is jugulodiagastric: large node on the IJV inferior to the posterior diagastric muscle
-Another important one is jugulo-omohyoid node: lying on the IJV just superior to omohyoid tendon
-Lymph leaving these nodes forms the jugular trunk which drains to the right lymphatic duct on right side and thoracic duct on left side


Cancer and lymphatics

-Cancer of lymph nodes (particularly tongue) may metastasize unilaterally to other superficial/deep nodes on the same side or cross midline and metastasize bilaterally


3 compartments of the neck

-Visceral: anterior part containing GI, respiratory, and endocrine structures
-Skeletal: cervical spine and associated muscles found posteriorly
-Carotid sheath: found laterally btwn the two structures contains the jugulodiagastric node, ansa cervicalis (in the sheath), carotid artery, IJV, and CN X


Deep cervical fascia

-Each compartment is enclosed by a layer of fascia
-Investing layer: surrounds all internal structures (most superficial layer) including trapezius and SCM
-Prevertebral fascia: around spinal cord and deep neck muscles, contains the cervical sympathetic trunk
-Pretracheal fascia: contains viscera like trachea, esophagus, and thyroid gland
-Carotid sheath formed of contributions from adjacent fascia layers
-Retropharyngeal space: empty space btwn the prevertebral and pretracheal fascia


Clinical importance of the retropharyngeal space

-Infections originating adjacent to the pharynx can potentially spread via the retropharyngeal space
-If this occurs, the infection can reach the superior or posterior mediastinum

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