7. Lymphatic Drainage of H/N Flashcards
Lymphatic System: a passive, centripetal, vascular system
• Returns a portion of the extracellular (interstitial) fluid to the
systemic circulation through a thin-walled system of vessels.
• Arises from a network of highly permeable ____ arising blindly in tissues.
• With muscle contraction, fine filaments anchoring vessels to surrounding CT transfer tensional forces to endothelial cells, ____ spaces between cells allowing proteins and large particles present in the interstitial fluid to enter the lymphatic capillaries.
• Lymphatic capillaries collect this fluid from most parts of the body, after which it is passed through successively larger ____ and a network of nodes, trunks and ducts until it is returned to the ____ circulation at the base of the ____.
• The lymphatic system also absorbs and transports ____ and fats as dense and milky ____ from the ____ of the digestive system
lymphatic capillaries opening vasa lymphatica venous neck fatty acids chyle lacteals
Smaller vasa lymphatica act as tributaries which ultimately drain centrally to larger ____
Lymph nodes, ____ lymphoid organs of varying size,
lie at various points along this drainage system. The nodes present as round, oval or bean-shaped, usually featuring a depressed ____ on one side, through which ____ lymphatic vessels enter and ____ vessels emerge.
In the nodes:
• Pathologic cells, viruses, bacteria and cellular debris are filtered
from the clear, faintly yellow and slightly opalescent fluid; and
• B & T lymphocytes and APC’s initiate immune response to
foreign antigens
Though most trunks have ____ valves that prevent retrograde flow, these valves may become ____, thereby permitting
lymphatic flow and the spread of disease to occur ____.
Valvular incompetence is one potential cause of ____
lymphatic trunks secondary hilum afferent efferent
bicuspid
incompetent
centrifugally
lymphedema
Lymphatic vessels from superficial tissues of the head usually drain
first to the following local groups of nodes:
Parotid: drain the - EAM & auricle - \_\_\_\_ - Eyelids - \_\_\_\_ - Soft palate - \_\_\_\_
Superficial parotid nodes embedded in the gland are known nodes are aka ____ nodes
Mastoid (retro-auricular)
drain the ____ and auricle
Occipital
drain the ____
Buccal -drain the Buccal mucosa of the \_\_\_\_ vestibule - Nose - \_\_\_\_
middle ear
temple
posterior nasal cavity
preauricular
scalp
scalp
oral
upper lip
Lymphatic vessels from superficial tissues of the head usually drain
first to the following local groups of nodes:
- Superficial cervical
Lingual nodes:
lie on the superficial aspect of the ____
Submental nodes: drain - \_\_\_\_ - Chin - \_\_\_\_ - Anterior oral floor
Submandibular nodes: drain - \_\_\_\_ - Buccal & Submental nodes
Also: Anterior cervical
hyoglossus
lower lip
lingual apex
oral and perioral tissues
Anterior Cervical (inconsistent)
- ____
- ____
- ____
- ____
infrahyoid
prelaryngeal
paratracheal
pretracheal
These five groups of nodes are described collectively as comprising a ____ (____) at the junction of the head and neck
- Parotid
- Mastoid
- Occipital
- Submental
- Submandibular
superficial ring
pericervical collar
Ultimately, all lymphatics
of the head and neck drain to the ____ along the
carotid sheath, either ____ from tissues
or ____ through the aforementioned groups of outlying regional nodes
The “collecting” nodes along the internal jugular vein are referred to as ____ or ____ nodes
deep cervical lymph nodes
directly
indirectly
jugular
lateral deep cervical
Submandibular nodes
are associated with the ____ gland and the ____ vessels as they course over the inferior border of the mandible
submandibular salivary
facial
The submandibular salivary gland and lymph nodes are found in the ____ (____) triangle
submandibular
digastric
Submandibular nodes
receive lymphatics which accompany the ____ vessels and drain the lower ____ and the lateral part of the ____
Submandibular nodes also receive some of the drainage from the: • \_\_\_\_ • \_\_\_\_; and • \_\_\_\_ nodes
facial
face
anterior tongue
buccal
submental
lingual
Lymphatic drainage of most of the oral cavity is directed toward the \_\_\_\_ nodes, specifically: o \_\_\_\_ teeth, o Vestibular gingivae of maxilla and mandible o \_\_\_\_gingivae o Upper lip o Lateral parts of \_\_\_\_ o Posterior floor of mouth o Lateral body of \_\_\_\_
But there are some important exceptions…
submandibular maxillary mandibular lingual lower lip tongue
BUT the mandibular incisors may drain directly to the ____ nodes
Mandibular teeth drain directly to ____ nodes
Lymphatic drainage
of the mucosa and gingivae of the hard palate
may be directed thru the ____ to the
____ and ____ nodes
submental superior deep cervical superior constrictor retropharyngeal superior deep cervical
Embedded in the fascia between the posterior pharynx and vertebral column:
\_\_\_\_ nodes Also drain lymph from: - \_\_\_\_ - \_\_\_\_ - \_\_\_\_
Efferents drain to the ____ and ____ nodes
retropharyngeal
nasal cavity
soft palate
middle ear
jugulodigastric
superior deep cervical
Submental lymph nodes
Receive drainage from: • Anterior floor of the \_\_\_\_ • Median \_\_\_\_ • Apex of the \_\_\_\_ • \_\_\_\_
mouth
lower lip
tongue
chin
Submental nodes are found in the ____
submental triangle
Submental lymph nodes
Lying superficial to the ____ muscles, these nodes are the most significant structures in the submental triangle these nodes, in turn, drain to the ____ nodes
mylohyoid
submandibular
____ cell carcinoma of the lower lip, resulting from chronic sun exposure or a lifetime of pipe-smoking will metastasize to Submental nodes if ____
Submandibular nodes if ____
sqaumous
median (midline)
lateral (corners of mouth)
The lymphatic plexus of the lingual mucosa is continuous with an ____ plexus
Posterior to the vallate papillae, the tongue is drained by ____ vessels draining to ____ nodes
With the exception of the apex, the anterior tongue is drained by :
• Marginal vessels to ____ nodes
• Median vessels to ____ nodes
intramuscular
dorsal lymph
superior deep cervical
submandibular
deep cervical
Curiously,
vasa lymphatica draining each half of the tongue may cross the ____ and permit cancerous lesions arising on either lateral border of the tongue to metastasize to the ____ submental and submandibular nodes
midline
contralateral
