5.6 Lymphatics Flashcards
Maxillary sinusitis can result from the spread of infection from what?
posterior maxillary teeth
What is an infection of this venous sinus, which may result from the spread of a dental infection?
Cavernous sinus thrombosis
What does the occipital scalp drain into?
occipital nodes
What does the parietal scalp drain into?
mastoid or superficial parotid nodes
What drains the lateral face?
parotid nodes
What drains the mid portion of the face?
facial nodes
Where are superficial facial nodes located?
along facial vessels
Where are the deep facial nodes located?
along maxillary artery in IFT
What drains the chin, medial lower lip, lower incisors and gingiva, tip of tongue?
submental nodes
What do the submental nodes drain into?
submandibular nodes or deep cervical lymph nodes
What drains the lower eyelids, nose, check, maxillary sinus, upper lip, palate, sublingual and submandibular glands, body of tongue, all maxillary teeth except 3rd molars, all mandibular teeth except incisors?
Submandibular nodes
What doe submandibular nodes empty into?
deep cervical nodes
Where are the anterior superficial cervical nodes (anterior jugular chain) located?
along anterior jugular vein, superficial to infra hyoid mm.
What drains the skin and muscles of infra hyoid region of the neck?
Anterior jugular chain
What drains the trachea, larynx, and thyroid?
Deep anterior cervical nodes (juxtavisceral)
What is one of the pre laryngeal lymph nodes, where enlargement indicated thyroid disease?
Delphian node
What nodes are located in the buccopharyngeal fascia posterior to pharynx at the level of the atlas?
retropharyngeal nodes
What nodes primarily drain the nasal cavity and paranasal air sinuses, hard and soft palate, nasopharynx, posterior tongue?
Retropharyngeal nodes
What nodes are located along the EJV, superficial to SCM?
superficial lateral cervical nodes (cervical chain)
What drains the lower ear and parotid region?
superficial lateral cervical nodes (cervical chain)
What lymph node group receives all lymph from head and neck?
Internal jugular (deep cervical) chain
Where are the superior deep cervical chain nodes located?
surround IJV superior to omohyoid
What is the most superior of the superior deep chain cervical nodes?
jugulodigastric (tonsillar) node
What do the inferior deep cervical chain nodes drain?
superior deep cervical chain, anterior cervical and transverse cervical nodes
Where does most lymph from the tongue drain either directly or indirectly?
jugulo-omohyoid node (part of inferior deep cervical chain)
What does the superficial fascia of the head and face surround?
muscles of facial expression and their neurovasuclar supply
What are the attachments of the deep fascia of the head and face?
extends from the hyoid bone superiorly to the mandible and zygomatic arch
What structures does the deep fascia of the head and face cover?
muscles forming the floor of the mouth and the submandibular gland as a capsule
What does the splitting of the deep fascia of the head and face create?
parotid fascia
What contains fat, lymph nodes, muscles of facial expression, facial a/v, infraorbital a/v/n, mental a/v/n, and branches of CN VII?
superficial fascial spaces
Where is the buccal space located?
between buccinators and skin of the face
What is the typical source of infection to the buccal space?
maxillary and mandibular molars and premolars
Where does the buccal space communicate to?
canine space, masticator, parapharyngeal spaces
What are the typical symptoms of a buccal space infection?
large, tender swelling of cheek, may extend from phylum of lip to parotid region and superiorly to eye and eyelids
What is the typical source of infection to the canine space?
maxillary canine
Where does the canine space communicate to?
buccal space, cavernous sinus
What is the typical symptoms of infection to the canine space?
firm or fluctuant mass along lateral border of nose (obliteration of nasolabial fold) may extend up to medial angle of eye and periorbital area
Odontogenic infection is the most common pathologic condition to affect what space?
masticator space
What are the contents of the masticator space? (7)
mandibular ramus, TMJ, muscles of mastication, CN V3 and br., maxillary a. and br., pterygoid venous plexus, chorda tympani n.
What separates the masticator space posteriorly from the parotid region?
stylomandibular ligament
What are the typical sources of infection to the masticator space?
mandibular 3rd molars, followed in frequency by more anterior molars and bicuspids
What are the typical symptoms of a masticator space infection?
facial swelling, pain, muscle trismus
Infection from the masticator space can spread to the parapharyngeal space to invoke the ….
lateral oropharynx leading to airway compromise
Osteomyelitis of the mandible has been described as both a precursor to and a result of soft tissue infection in what space?
masticator
What are the contents of the sublingual space? (6)
sublingual gland, submandibular duct, deep portion of submandibular gland, lingual a/n/v, hypoglossal n., submandibular ganglion,
What is the typical source of infection of the sublingual space?
apices of 1st mandibular molars or premolars
What are the typical communications with the sublingual space?
submandibular, masticator, and parapharyngeal
What are the typical symptoms of a sublingual space infection?
elevated tongue with decreased mobility, swollen floor of the mouth, dysphagia
What are the contents of the submandibular space? (6)
submandibular gland, lymph nodes, hypoglossal n., n. to mylohyoid, facial a/v, ant. belly digastric m.
What is the typical source of infection to the submandibular space?
apices of 2nd and 3rd mandibular molars
What spaces are the major communications to the submandibular space?
sublingual and parapharyngeal
What are the symptoms of a submandibular space infection?
firm, painful swelling in submandibular region, dysphagia
What are the typical sources of infection to the submental space?
mandibular anteriors (incisors)
What are the typical communications to the submental spaces?
submandibular spaces on either side
What are the typical symptoms of a submental space infection?
hard midline swelling under chin
Ludwig’s Angina is typically the result of infections from what teeth?
2nd and 3rd mandibular molars
What are the 4 criteria of Ludwigs Angina?
(1) involves both the sublingual and submandibular spaces
(2) presence of gangrene or seroganguinous phlegm, but no pus
(3) Involves CT, muscle, and fascia but spares glandular tissue
(4) spread by contiguity of spaces not lymphatics
What are the typical sources of infection to the parapharyngeal space?
maxillary and mandibular molars
What are the typical symptoms of a parapharyngeal space infection?
pain and muscle truisms, swollen soft palate with deviated uvula, dysphagia, inability to palpate angle of mandible
The parapharyngeal space is the most frequently infected secondary space from what 5 primary areas?
masticator space, teeth, tongue, salivary glands, and tonsillar region
Where do infections from the parapharyngeal space spread?
retropharyngeal space –> mediastinum
What is the primary route of infection from head and neck into “danger space” and subsequently into the mediastinum?
retropharyngeal space
