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Head and Neck Anatomy > H&N lymphatics > Flashcards

H&N lymphatics Flashcards

1
Q

directions of lymph flow

A
  • superior to inferior
  • superficial to deep
  • anterior to posterior
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2
Q

superficial lymph nodes

A 
1 retroauricular
2 occipital 
3 superficial parotid 
4 mastoid 
5 anterior superficial cervical
6 lateral superficial cervical
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3
Q

retroauricular lymph nodes

A
  • drains posterolateral scalp

* located posterior to auricle

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4
Q

occipital lymph nodes

A
  • drains occipital scalp
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5
Q

superficial parotid lymph nodes

A
  • drains lateral face, scalp, EAM, buccal mucosa

* located on top of fascia covering parotid gland

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6
Q

mastoid lymph nodes

A
  • drains posterolateral scalp and posterior ear

* located on top of mastoid process

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7
Q

anterior superficial cervical lymph nodes

A
  • drains anterior neck

* located anterior SCM

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8
Q

lateral superficial cervical lymph nodes

A
  • drains posterolateral neck

* located posterior-ish SCM

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9
Q

deep parotid nodes are DEEP

A
  • drains EAM, auditory tube, middle ear

* embedded IN or deep to parotid tissue

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10
Q

name the 6 cervical node quadrants

A

1) submental and submandibular -SF
2) jugulodigastric -deep
3) juxtavisceral -deep
4) jugulo-omohyoid -deep
5) posterior triangle nodes -SF
6) anterior jugular (cervical) nodes -SF

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11
Q

1) submental and submandibular

A

submental= chin, anterior gingiva, tip of tongue, anterior floor of mouth, medial lower lip and MD INCISORS

submandibular= uppier lip, lateral lower lip,cheeck, teeth, sublingual and submandibular glands… BULK of oral cavity except MD incisors

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12
Q

submental nodes drain into?

A

submandibular nodes before they drain into jugulodigastric

maybe deep anterior jugular (cervical) nodes

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13
Q

5) posterior triangle nodes

A

within posterior triangle

*posterior neck

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14
Q

6) anterior jugular (cervical) nodes

A

skin and muscles of the anterior infrahyoid region

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15
Q

2) jugulodigastric -deep

A
  • *all of head
  • junction of jugulars along posterior line of digastric
  • upper deep cervical nodes, all oral cavity/pharynx, tonsils, all superior superficial nodes
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16
Q

3) juxtavisceral -deep

A
  • unique to viscera, collects from 2

* esophagus, larynx, trachea, thyroid gland

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17
Q

4) jugulo-omohyoid -deep

A

head and neck above this level

  • most inferior
  • no new drainage
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18
Q

what are the internal nodes?

A

tonsils!

1) pharyngeal tonsil
2) tubal tonsil
3) palatine tonsil
4) lingual tonsil

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19
Q

what is waldeyers lymphatic rings?

A

simply refers to internal ring of tonsils that are collecting all of the lymph from deep within

20
Q

what are tonsils?

A

mounds od lymph tissue that eventually drain into jugular chain of nodes OR directly into retropharengeal or jugular digastirc nodes

21
Q

outer and inner ring or ‘waldeyer’s lymphatic rings’?

A

Inner

1) pharyngeal tonsil
2) tubal tonsil
3) palatine tonsil
4) lingual tonsil

Outer

1) retropharyngeal node -deep
2) jugulodigastric node- deep
3) jugular chain of nodes -deep
4) submandibular nodes
5) submental nodes

22
Q

jugulofacial venous juntion

A

where common facial and jugular vein meet

23
Q

the internal jugular and subclavian v meet to form?

A

the venous angle and brachiocehalic vein

24
Q

jugulosubclavian venous junction

A

thoracic duct on left
lymphatic duct on right
***where lymph drainage meets venous angle

25
Q

drainage of the ear

  • anterior
  • posterior
  • inferior
A
  • anterior (ear canal)= to parotid, superficial
  • posterior= drains into mastoid nodes
  • inferior (lobule)= drains directly into jugulo-digastirc deep nodes
26
Q

MD incisors drain into?

A

submental nodes in submental triangle (and apex of tongue)

27
Q

all teeth except MD incisors drain into?

A

submandibular nodes

28
Q

3rd molars can drain directly into?

A

deep cervical nodes

*so can spread infections faster and deeper; biggest prob

29
Q

apex of tongue (anterior part) drains into?

A

submental

30
Q

rest of tongue (exlcusing apex and root) drain into?

A

submandibular

31
Q

root of tongue drains in?

A

deep cervical nodes (upper group) and jugulodigastric nodes

32
Q

drainage order of tongue

A

submental > submandibular >deep cervical nodes > jugulofacial venous junctions > jugular nodes

33
Q

why is extensive metastasis of cancer/lesions of tongue a big deal?

A

both ipsilateral AND contralateral drainage! easy to spread due to large overlap

34
Q

venous angle is the junction of?

A

internal jugular and subclavian

35
Q

Right lymphatic duct empties at?

A

juntion of right internal jugular and right subclavian

36
Q

thoracic duct empties into?

A

junction of left internal jugular and left subclavian veins

37
Q

cisterna chyli?

A

most inferior part of thoracic duct at T12

38
Q

what region is drained by the right lymphatic duct?

A

right head and neck; upper right quadrant (right arm)

39
Q

what region is drained by the left lymphatic duct?

A

left head and neck, upper left quadrant; everything below cisterna chyli at T12

40
Q

heathy adults may have palpable nodes up to?

A

2cm

41
Q

generalozed lymphadenopathy is involvemnt of? caused by?

A

3+ noncontiguous lymph node areas

*caused by infectious mononucleosis (EBV), lupes (SLE), leukemias, lymphomas or viruses or autoimmune disease

42
Q

physical exams for lymphadenopathy?

A
  • localized vs generalized
  • size of nodes
  • texture
  • nodal tenderness/inflammation
  • splenomegaly
  • CBC= complete blood count
43
Q

things to consider for fascial abscesses

A
  • dental infection (periapcial abscess) to subperiosteal/periodontal abscess to potatntal space
  • cellulitis and braod abscess within space
  • lymph nodes involved by defealt but not palpebal
  • SOURCE is easily localized; 60-70% from MD molars
  • treatment= incision, drainage, bone removal, ANTIBIOTICS
44
Q

things to consider for swollen nodes

A
  • recently sick
  • palpable INCLUDING borders
  • usually NOT painful
  • past/current diagnosis of cancer
  • source not localized
  • lethargy, rapid weight loss, night weats
  • TREATMENT- need biopsy, removal last resort bc is causes lymphedema
45
Q

lymphedema

A

need lymph system to you don’t swell up with excess fluid, removal of lymph nodes causes lymphedema

Head and Neck Anatomy (46 decks)

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