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ESA 4 - Head and Neck > Lymphatics of the Head and Neck > Flashcards

Lymphatics of the Head and Neck Flashcards

1
Q

What is the lymphatic system?

A

A network of drainage vessels

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2
Q

What does the lymphatic system consist of?

A
  • Fluid - lymph
  • Drainage vessels
  • Lymphatic tissues
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3
Q

What are the lymphatic tissues?

A

Lymph nodes, a type of lymphoid organ

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4
Q

How many lymph nodes are there in the body?

A

800

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5
Q

How many lymph nodes are there in the neck?

A

300

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6
Q

Describe the structure of lymph nodes

A

Connective tissue structures, with a tough, fibrous outer capsule, and reticular connective tissue inside

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7
Q

What do lymph nodes contain?

A

Large collections of lymphocytes and macrophages

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8
Q

Where do lymph nodes play a key role?

A

In immune defence

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9
Q

What do all substances transported in lymph pass through?

A

1 or more lymph nodes

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10
Q

What immune defences do lymph nodes have?

A
  • Physical filter
  • Phagocytic filter
  • Full of lymphocytes
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11
Q

What happens to the lymphocytes in lymph nodes?

A

They activate and proliferate in response to antigens

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12
Q

Where are the specific regions in the body where lymph nodes may be palpable?

A
  • Neck (cervical)
  • Armpit (axillary)
  • Diaphragm
  • Spleen
  • Abdominal
  • Pelvic
  • Groin (femoral)
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13
Q

What may lymph draining into lymph nodes contain?

A

Pathogens

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14
Q

What are the lymphoid organs?

A
  • Spleen
  • Thymus
  • Tonsils
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15
Q

What happens to the lymph fluid?

A

It returns to the blood circulation

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16
Q

Where are lymph vessels found?

A

Throughout the body, with a few exceptions

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17
Q

What parts of the body do not have a lymphatic circulation?

A
  • Eyeball
    • Cornea
    • Lens
  • Inner ear
  • Cartilage
  • CNS
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18
Q

Why is there debate regarding the lymphatic circulation of the CNS?

A

Recent research has identified small lymphatic vessels lining the dura

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19
Q

How can lymph nodes be organised?

A

Into regional (or superficial) and terminal (or deep) groups

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20
Q

How are regional and terminal lymph nodes seperated?

A

By investing layer of deep cervical fascia in the neck

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21
Q

What are the regional groups of lymph nodes found in the area of the head and neck?

A
  • Occipital
  • Pre- and post- auricular
  • Submandibular
  • Sternocleidomastoid
  • Submental
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22
Q

What do regional lymph nodes do?

A

Drain specific areas

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23
Q

Where do regional lymph nodes in the neck lie?

A

Superficially within superficial cervical fascia

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24
Q

What is the result of regional lymph nodes lying superficially within superficial cervical fascia?

A

They can be readily palpated, especially when enlarged

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25
Q

Where does lymph from superficial lymph nodes drain?

A

Into the deep lymph nodes

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26
Q

Where does the submandibular node drain?

A
  • Upper lip and teeth
  • Lateral lower part of lip
  • Most of face
  • Anterior nasal cavity
  • Tongue (middle)
  • Submandibular and sublingual glands
27
Q

Where does the submental node drain?

A
  • Lower lip/teeth (central)
  • Anterior chin
  • Tip of tongue
  • Floor of mouth
28
Q

Where does the pre-auricular node drain?

A
  • Scalp
  • Anterior part of ear (auricle)
  • Parotid gland
  • Some sources indicate conjunctiva and eyelids
29
Q

Where does the post-auricular (mastoid) lymph node drain?

A
  • Scalp
  • Posterior part of ear (auricle)
  • Ear canal
30
Q

Where does the occipital lymph node drain?

A

Occipital area of scalp and neck

31
Q

Where do the superficial cervical lymph nodes drain?

A

Skin of neck

32
Q

What are the deep cervical lymph nodes of the head and neck?

A
  • Jugulo-digastric (also called tonsillar node)
  • Jugulo-omohyoid
  • Supraclavicular
33
Q

Which deep cervical lymph node is most frequently enlarged?

A

Jugulo-digastric

34
Q

Where is the jugulo-digastric node located?

A

Just below and behind the angle of the mandible

35
Q

What does the jugulo-digastric lymph node drain?

A
  • Palatine tonsil
  • Oral cavity
  • Posterior 1/3 of tongue
  • Pharynx
  • Larynx
36
Q

What is the jugulo-omohyoid lymph node mainly associated with?

A

Lymph drainage of;

  • Tongue
  • Oral cavity
  • Trachea
  • Oesophagus
  • Thyroid gland
37
Q

Where are the supraclavicular lymph nodes found?

A

In root of neck on either side

38
Q

Where do the supraclavicular lymph nodes recieve lymph from?

A

The abdomen and thorax

39
Q

What happens to the lymph drained from the abdomen and thorax to the supraclavicular node?

A

It drains via the thoracic duct into venous circulation

40
Q

What is the left supraclavicular node known as?

A

Virchow’s node

41
Q

What does Virchow’s node drain?

A

Abdomen and thorax

42
Q

What does the right supraclavicular node drain?

A
  • Mid section chest
  • Oesophagus
  • Lungs
43
Q

Where do terminal lymph nodes lie within the neck?

A

Deep to the investing layer of cervical fascia

44
Q

What do the terminal lymph nodes of the head and neck recieve?

A

All lymph of the head and neck, either directly or indirectly from regional groups

45
Q

What are the terminal lymph nodes of the head and neck closely related to?

A

The carotid sheath, in particular the jugular vein

46
Q

Describe the path of lymph in the head and neck

A

Head and neck superficial lymph nodes drain into deep cervica lymph nodes, which surround the IJV before draining via the thoracic duct into the subclavian vein

47
Q

What is the most common cause of swelling in the neck?

A

Enlarged cervical lymph nodes

48
Q

What may an enlarged lymph node signal?

A

Disease in the area it drains

49
Q

What diseases can be indicated by an enlarged cervical lymph node?

A
  • Infection (most common)
  • Malignancy
50
Q

How do enlarged lymph nodes feel in infection?

A
  • Tender
  • Mobile
51
Q

How do enlarged lymph nodes feel in malignancy?

A
  • Hard
  • Matted
  • Non-tender
52
Q

What should be done if a lymph node is found to be enlarged?

A
  • Comprehensive history
  • Examine area of tissue it drains
  • If malignancy is supsected, examine other lymph nodes and body systems
53
Q

What is lymphodema?

A

An abnormal collection of protein-rich fluid causing tissue swelling due to compromised lymphatic system

54
Q

What can cause lymphodema?

A
  • Removal or enlargement of lymph nodes
  • Infections
  • Damage to lymphatic system
  • Lack of limb movement
  • Congenital
55
Q

What kind of infections may cause lymphodema?

A

Certain parasites

56
Q

How may the lymphatic system be damaged?

A

Cancer treatments

57
Q

Why can lack of limb movement cause lymphodema?

A

Muscle contraction assists movement of lymph fluid

58
Q

Give an example of a congenital condition that can cause lymphoedema?

A

Milroy’s syndrome

59
Q

When is the jugulo-digastric node swollen and tender?

A

In tonsillitis

60
Q

When may the jugulo-omohyoid node be enlarged?

A

In infection or disease of tongue, oral cavity, trachea, oesophagus, or thyroid gland

61
Q

When may supraclavicular lymph nodes be enlarged?

A

In late stages of malignancies of abdomen and thorax

62
Q

Is an enlarged left supraclavicular lymph node always pathological?

A

No

63
Q

What is Trosier’s sign?

A

An enlarged, hard, left supraclavicular lymph node

64
Q

What is Trosier’s sign considered a sign of?

A

A sign of metastatic abdominal malignancy

ESA 4 - Head and Neck (30 decks)

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