Lymphatics of the Head & Neck - Herring

Question 1

The face, scalp, and
skin/subcutaneous tissue of the neck drain to what lymph nodes

Answer 1

Superficial

Question 2

Superficial lymphnodes drain to ______ network

Answer 2

Deep

Question 3

All deep lymph nodes surround the

Answer 3

IJV

Question 4

deep LNs form the

Answer 4

jugular trunks

Question 5

The jugular trunks drain into what 2 ducts

Answer 5

thoracic duct

right lymphatic duct

Question 6

The occipital region of the scalp drains to what lymph nodes

Answer 6

occipital LNs

Question 7

The occipital LNs empty to what LNs ? what levels ?

Answer 7

superior deep cervical LNs

level 5 to level 3

Question 8

The parietal region can drain to 2 LNs, what are they

Answer 8

mastoid nodes and parotid nodes

Question 9

where do the mastoid LNs drain to ________ and then _________

Answer 9

the lateral cervical nodes ; superior deep cervical nodes

level 5 to level 3

Question 10

where to the parotid LNs drain to

Answer 10

superior deep cervical nodes

Level 2

Question 11

the parotid nodes drain what?

Answer 11

the lateral face

Question 12

where do the parotid nodes empty primarily to

Answer 12

superior deep cervical nodes

level 2

Question 13

where do a smaller percentage of parotid nodes drain to

Answer 13

lateral cervical nodes along the EJV (level 5 to level 3)

Question 14

the mid portion of the face (inferior eyelids, nose, cheek, superior lip, lateral aspects of inferior lip) drains towards the _______ nodes

Answer 14

facial

Question 15

the facial nodes empty to what nodes and then to what nodes

Answer 15

submandibular nodes (level 1b to level 2) ; superior deep cervical nodes

Question 16

the chin, medial lower lip, mandbular incisors & gingivae, and tip of tongue drain to the

Answer 16

submental nodes

Question 17

the primary route the submental nodes drain to is to the

Answer 17

superior deep cervical nodes (level 2)

Question 18

a smaller percentage the submental nodes drain to is to the

Answer 18

submandibular nodes (level 1b)

Question 19

all of the following drain to where:

facial nodes
maxillary sinus
palate
sublingual glands
submandibular glands
anterolateral tongue
anterior nasal cavity
all maxillary teeth (e/x 3rd molar)
all mandibular teeth (e/x incisors)

Answer 19

submandibular lymph nodes

Question 20

the submandibular nodes drain to what

Answer 20

superior deep cervical nodes (level 2)

Question 21

what 5 structures form the superficial horizontal ring

Answer 21

submental
submandibular
parotid
mastoid
occipital

Question 22

what cervical nodes drain skin and muscles of the infrahyoid region

Answer 22

anterior cervical nodes

Question 23

the anterior cervical nodes empty to

Answer 23

inferior deep cervical nodes (level IV)

Question 24

the lateral cervical nodes travel with the

Answer 24

EJV

Question 25

what drains the lower ear and partoid region

Answer 25

lateral cervical nodes

Question 26

the lateral cervical nodes empty to lymph nodes in the

Answer 26

posterior triangle (level 5)

Question 27

LNs in the posterior triangle empty to what cervical nodes

Answer 27

superior and inferior deep (levels 3-4)

Question 28

What nodes are between investing layer of deep cervical fascia and viscera of neck

Answer 28

deep anterior cervical (juxtavisceral) nodes

Question 29

the trachea, larynx, and thyroid glands are drained by what nodes

Answer 29

deep anterior cervical (juxtavisceral) nodes

Question 30

the deep anterior cervical (juxtavisceral) nodes are composed of 3 groups, what are they

Answer 30

paratracheal pretracheal prelaryngeal

Question 31

paratracheal LNs empty to

Answer 31

inferior deep cervical nodes (level IV)

Question 32

pretracheal LNs empty to

Answer 32

inferior deep cervical nodes (level IV)

Question 33

prelaryngeal LNs empty to

Answer 33

superior deep cervical nodes (level III)

Question 34

what LNs are located in the buccopharyngeal fascia at the level of atlast (extend to C2/3)

Answer 34

retropharyngeal nodes

Question 35

The following structures are drained by what LNs: - Nasal cavity - Paranasal sinuses - Hard & soft palate - Nasopharynx - Posterior tongue

Answer 35

retropharyngeal nodes

Question 36

The retropharyngeal nodes empty to what nodes

Answer 36

superior and inferior deep cervical nodes (levels 2, 3, 4)

Question 37

A deep ring on lymphatic tissue is called _______ ring

Answer 37

Waldeyer's

Question 38

Waldeyer's ring forms around entrance to

Answer 38

GI tract

Question 39

Waldeyer's Ring consists of what 4 tonsils

Answer 39

palatine lingual pharyngeal tubal

Question 40

what lymph nodes receive ALL lymph from head & neck

Answer 40

deep cervical (internal jugular) nodes

Question 41

the deep cervical (internal jugular) nodes empty via the _______ to what ducts

Answer 41

jugular trunks to thoracic duct (left side) or lymphatic duct

Question 42

the superior deep cervical chain is superior to the

Answer 42

omohyoid

Question 43

what levels is the superior deep cervical chain

Answer 43

levels 2 and 3

Question 44

the superior deep cervical chain drain to the

Answer 44

inferior deep cervical chain

Question 45

the inferior deep cervical chain is at or inferior to the

Answer 45

omohyoid

Question 46

what drains the superior deep cervical chain and superficial cervical nodes (levels 2, 3, 5, 6)

Answer 46

inferior deep cervical chain

Question 47

what level/group receives drainage from skin of the mental region, mid-lower lip, tip of the tongue, anterior floor of the mouth, mandibular incisors

Answer 47

Level 1A / submental group

Question 48

what are the assoicated primary malignancies with Level 1A/submental group

Answer 48

Malignancies of the floor of the mouth, tip of the tongue, anterior mandibular alveolar ridge, and medial lower lip

Question 49

what level/group receives drainage from level 1A, lower nasal cavity, hard & soft palates, maxillary & mandibular alveolar ridges (most), skin & mucosa of cheek, upper lip, lateral lower lip, anterolateral tongue, sublingual gland, submandibular gland, maxillary sinus, lower eyelid

Answer 49

Level 1B / submandibular group

Question 50

what are the assoicated primary malignancies with Level 1B/submandibular group

Answer 50

Malignancies from most of oral cavity, soft tissues of mid-face, submandibular gland

Question 51

What is the most commonly involved LN level

Answer 51

Upper Jugular Group (subdivides parotid space into 2, 3, 4)

Question 52

What level/group receives drainage from levels 1A & 1B, lateral face, parotid gland, parotid nodes, retropharyngeal nodes, nasal cavity, upper pharynx, ear

Answer 52

Level 2 / upper jugular group

Question 53

what are the associated primary malignancies with Level 2/ upper jugular group

Answer 53

Malignancies of nasal and oral cavities, nasopharynx, oropharynx, major salivary glands

Question 54

what level / group receives drainage from level II and V, retropharyngeal, prelaryngeal (level VI), base of tongue, palatine tonsils, larynx, laryngopharynx, thyroid gland

Answer 54

Level 3 / middle jugular group

Question 55

what are the associated primary malignancies with level 3 / middle jugular group

Answer 55

Malignancies of oral cavity, nasopharynx, oropharynx, laryngopharynx, and larynx

Question 56

What level/group receives drainage from levels III and V, retropharyngeal, pretracheal, paratracheal (level VI), larynx, laryngopharynx, thyroid gland, cervical trachea, cervical esophagus

Answer 56

Level IV / lower jugular group

Question 57

what are the associated primary malignancies with level IV / primary jugular group

Answer 57

Malignancies of the laryngopharynx, lower larynx, cervical trachea, cervical esophagus, thyroid gland

Question 58

What level/group receives drainage from occipital, mastoid lymph nodes (small percentage of parotid nodes), skin of lateral and posterior neck and shoulder, pharynx

Answer 58

Level V / posterior triangle group

Question 59

what is the associated primary malignancy of level V / posterior triangle group

Answer 59

malignancies of the pharynx

Question 60

what level / group receives drainage from the skin of anterior neck, lower face, floor of mouth, larynx, thyroid gland

Answer 60

level VI / anterior group

Question 61

What are the associated primary malignancies of Level VI / anterior group

Answer 61

Malignancies of lower lip & chin (advanced gingiva-mandibular carcinoma), floor of mouth, thyroid gland, larynx