Lymphatics of the Head & Neck

Question 1

What are the three main function of the lymphatic system?

Answer 1

Transports large protein molecules from tissue fluid into the bloodstream, returns excess tissue fluid to bloodstream, produces lymphocytes

Question 2

What are lymph nodes?

Answer 2

Swellings found along the lymphatic system

Question 3

What are the functions of lymph nodes?

Answer 3

Produce lymphocytes, filter lymph thus preventing foreign bodies from entering bloodstream

Question 4

What type of lymph vessels drain lymph to a node?

Answer 4

Afferent

Question 5

What type of lymph vessels drain lymph from a node?

Answer 5

Efferent

Question 6

What is a good way to remember which type of lymph vessel leaves a node?

Answer 6

Efferent = Exit

Question 7

Are lymph vessels always specific to a node?

Answer 7

Yes

Question 8

What is the difference between the enlargement of a gland or node topographically speaking?

Answer 8

Glands are wholesome enlargements while nodes are lumpy

Question 9

What are the three superficial nodes of the head?

Answer 9

Occipital, mastoid, and parotid

Question 10

What are the four superficial nodes of the neck?

Answer 10

Submandibular, submental, anterior cervical, superficial cervical

Question 11

Which lymph nodes are usually palpable?

Answer 11

Occipital, mastoid, parotid, submandibular, submental, anterior cervical, superficial cervical

Question 12

Where can the occipital superficial nodes be found?

Answer 12

Where the trapezius muscle meets the sternocleidomastoid

Question 13

Where can the mastoid superficial nodes be found?

Answer 13

Behind the ear

Question 14

Where can the parotid superficial nodes be found?

Answer 14

In front of the ear

Question 15

Which superficial nodes of the neck must be palpated with less force and why?

Answer 15

Submandibular, highly vascular area

Question 16

Which nodes form as a chain on the external surface of the sternocleidomastoid and follow the course of the external jugular vein?

Answer 16

Superficial cervical

Question 17

Why are the deep cervical nodes not palpable?

Answer 17

Due to carotid sheath and being internal to the sternocleidomastoid

Question 18

Which nodes follow the course of the internal jugular vein?

Answer 18

Deep cervical

Question 19

Which node drains the tongue?

Answer 19

Jugulodigastric and jugulo-omohyoid nodes

Question 20

Which deep cervical node is found near the posterior belly of the digastric muscle?

Answer 20

Jugulodigastric node

Question 21

Which deep cervical node is found near the intermediate tendon of the omohyoid?

Answer 21

Jugulo-omohyoid node

Question 22

All lymphatics of the head and neck drain directly or indirectly into which nodes?

Answer 22

Deep cervical nodes

Question 23

What form the right and left jugular trunks?

Answer 23

Efferents of the deep cervical nodes

Question 24

Which jugular trunk drains into the junction between the internal jugular and subclavian veins?

Answer 24

Right jugular trunk

Question 25

Which jugular trunk drains into the thoracic duct?

Answer 25

Left jugular trunk

Question 26

What is the largest lymph vessel in the body?

Answer 26

Thoracic duct

Question 27

Where does lymph go after reaching the jugular trunks?

Answer 27

Bloodstream

Question 28

How is lymph moved throughout the system?

Answer 28

Skeletal muscular contraction

Question 29

Because skeletal muscle contraction is associated with lymph movement, what two things could be useful for preventing lymphatic issues?

Answer 29

Exercise (clears toxins from tissues) & massage

Question 30

What bodily system is useful for tracking the spread of cancer cells?

Answer 30

Lymphatic system

Question 31

What do afferents of the submental nodes drain?

Answer 31

Central portions of the lower lip, floor of mouth, and tip of the tongue

Question 32

What do afferents of the submandibular nodes drain?

Answer 32

Cheek, side of nose, upper lip, lateral part of lower lip, gums, and margin of the tongue

Question 33

What is the term for the spread of cancer via the lymphatic system?

Answer 33

Lymphogenous metastasis

Question 34

What is another name for a signal node?

Answer 34

Sentinel node

Question 35

What is a sentinel node?

Answer 35

An enlarged supraclavicular node, usually on the left side

Question 36

What is significant about sentinel nodes from a clinical viewpoint?

Answer 36

Often the first indication of a visceral tumor of the thorax or abdomen

Question 37

What is a lymphoma?

Answer 37

A primary tumor of the lymph nodes

Question 38

To what age do those with Hodgkin's Disease usually live?

Answer 38

20s-30s

Question 39

To what age do those with non-Hodgkin's Disease usually live?

Answer 39

Rarely past 2 years (poor prognosis)

Question 40

What does a tender or painful enlarged lymph node typically indicate?

Answer 40

Infection

Question 41

What does a hard and painless enlarged lymph node typically indicate?

Answer 41

Cyst development or cancer

Question 42

What is filariasis?

Answer 42

Parasitic infection of lymph nodes (worms)

Question 43

What three things make up a breast?

Answer 43

Mammary glands, fat, and fibrous tissue

Question 44

Between which ribs is the breast located?

Answer 44

Second and sixth

Question 45

Between what two features is the breast located?

Answer 45

Sternum and midaxillary line

Question 46

What is the midaxillary line?

Answer 46

A vertical line dividing the armpit into anterior and posterior halves

Question 47

Where is the nipple usually located in terms of ribs?

Answer 47

Fourth intercostal space

Question 48

What is the areola?

Answer 48

Ring of pigmented skin which surrounds the nipple

Question 49

What is the axillary process (tail)?

Answer 49

Portion of the breast which extends back into the armpit

Question 50

What part of the breast is a frequent site for cancer?

Answer 50

Axillary process

Question 51

What are the suspensory ligaments of the breast?

Answer 51

Strong fibrous septa which support the breast and which run through the breast from the skin to the deep layer of superficial fascia

Question 52

What type of gland is a mammary gland?

Answer 52

Modified sweat gland

Question 53

Where is the mammary gland located?

Answer 53

In the superficial fascia

Question 54

How much glandular tissue does each mammary gland possess?

Answer 54

15-20 lobes

Question 55

To where does each lobe of glandular tissue of the mammary gland open?

Answer 55

Onto the tip of the nipple through a lactiferous duct

Question 56

What is a lactiferous sinus?

Answer 56

An expansion of the lactiferous duct which serves as a reservoir for milk during lactation

Question 57

Why is it important to have more than one lactiferous duct?

Answer 57

In case of blockage

Question 58

What arteries make up the blood supply to the breast?

Answer 58

Internal thoracic, thoracoacromial, lateral thoracic, and intercostal arteries

Question 59

What percentage of lymph from the breast drains into the axillary nodes?

Answer 59

75%

Question 60

To which four locations does lymph drain from the breast?

Answer 60

Axillary nodes, parasternal nodes, nodes of the opposite breast, and nodes of the anterior abdominal wall

Question 61

What is the most common female cancer?

Answer 61

Breast

Question 62

Before entering the bloodstream, where does breast cancer spread to?

Answer 62

Lymphatics

Question 63

Where does breast cancer typically spread to first?

Answer 63

Axilla

Question 64

To where do the posterior intercostal veins drain?

Answer 64

Azygos and hemiazygos veins

Question 65

How does breast cancer spread to the vertebral column and brain?

Answer 65

Through connections to the vertebral venous plexus

Question 66

What are the three clinical signs of breast cancer?

Answer 66

Dimpling, inverted nipples, leathery thickening of skin

Question 67

Why does dimpling occur in breast cancer?

Answer 67

Due to invasion of suspensory ligament

Question 68

Why do inverted nipples occur in breast cancer?

Answer 68

Due to invasion of lactiferous ducts

Question 69

What is the a big chiropractic note about breast cancer?

Answer 69

It is one cause of midthoracic back pain in females