3 - Blood and lymph

Question 1

What are the superficial lymph nodes of the face?

Answer 1

Submental 
Submandible
Pre-auricular 
Post-auricular 
Occipital

Question 2

What are the cervical lymph nodes?

Answer 2

In relation to SCM
Superficial
Posterior
Anterior

Question 3

What are the deep lymph nodes?

Answer 3

Jugulo-digastric
Jugulo-omohyoid
Supraclavicular

Question 4

What is Waldeyer’s ring?

Answer 4

Ring shaped collection of lymph nodules consisting of the tonsils:
Pharyngeal tonsils 
Tubal tonsils 
Palatine tonsils
Lingual tonsils

Question 5

What is the function of the supraclavicular nodes and what pathologies affect them?

Answer 5

Lymph transport from abdomen and thoracic cavity so affected by maligancies from there
Left: Virchow’s node (gastric cancer), abdominal and throacic malignancies
Right: Mid chest, oesophagus and lung malignancies

Question 6

Where does the common carotid bifurcate and what pathology affects it?

Answer 6

Bifurcates at superior border of thyroid cartilage
Bifurcation causes turbulence, site of atheroma and stenosis, rupture of clot can cause embolism that travels to brain - stroke

Question 7

Describe the route of the internal carotid artery

Answer 7

Enters skull through carotid canal in petrous part of temporal bone
Turns medially and horizontally
Enters cranial cavity, making S bend
Travels through cavernous sinus

Question 8

What is a regional node?

Answer 8

Nodes that lie superficially within superficial cervical fascia, readily palpable

Question 9

What is a terminal node?

Answer 9

Nodes that lie deep to investing layer of cervical fascia, close to cartoid sheath - IJV

Question 10

Describe the jugulo-digastric node

Answer 10

Found behind angle of mandible
Receives lymph from palatine tonsils, oral cavity and tongue
Swollen in tonsillitis

Question 11

Describe the jugulo-omehyoid node

Answer 11

Drains tongue, oral cavity, trachea, oesophagus and thyroid

Question 12

What is Trosiers sign?

Answer 12

Enlarged, hard left supraclavicular node secondary to metastatic abdominal malignancy

Question 13

What is lymphoedoma?

Answer 13

Abnormal collection of protein rich fluid causing tissue swelling

Question 14

Why does the lymphatic system not need a central pump?

Answer 14

Low pressure as if it was higher than venous pressure, fluid wouldn’t flow down pressure gradient

Question 15

Describe the valves of the lymph system

Answer 15

Passive constriction - skeletal muscle outside lymph vessels and pumping arteries push fluid through
Intrinsic constriction - smooth muscle contracts when stretched

Question 16

Which arteries travel through the parotid gland?

Answer 16

Maxillary

Superficial temporal

Question 17

What forms the angular vein?

Answer 17

Supraorbital and supratrochlear, which then drain into facial vein which drains into IJV

Question 18

What are emissary veins and why are they potentially dangerous?

Answer 18

Connections between venous drainage and dural venous sinuses
Allow infection from scalp to spread to cranial cavity and affect the meninges

Question 19

What is the danger of a septic thrombus in the facial vein?

Answer 19

From facial vein infection can spread to cavernous sinus, causing a cavernous sinus thrombus