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Head and Neck Anatomy > H&N lymphatics > Flashcards

H&N lymphatics Flashcards

1
Q

directions of lymph flow

A
  • superior to inferior
  • superficial to deep
  • anterior to posterior
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2
Q

superficial lymph nodes

A 
1 retroauricular
2 occipital 
3 superficial parotid 
4 mastoid 
5 anterior superficial cervical
6 lateral superficial cervical
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3
Q

retroauricular lymph nodes

A
  • drains posterolateral scalp

* located posterior to auricle

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4
Q

occipital lymph nodes

A
  • drains occipital scalp
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5
Q

superficial parotid lymph nodes

A
  • drains lateral face, scalp, EAM, buccal mucosa

* located on top of fascia covering parotid gland

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6
Q

mastoid lymph nodes

A
  • drains posterolateral scalp and posterior ear

* located on top of mastoid process

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7
Q

anterior superficial cervical lymph nodes

A
  • drains anterior neck

* located anterior SCM

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8
Q

lateral superficial cervical lymph nodes

A
  • drains posterolateral neck

* located posterior-ish SCM

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9
Q

deep parotid nodes are DEEP

A
  • drains EAM, auditory tube, middle ear

* embedded IN or deep to parotid tissue

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10
Q

name the 6 cervical node quadrants

A

1) submental and submandibular -SF
2) jugulodigastric -deep
3) juxtavisceral -deep
4) jugulo-omohyoid -deep
5) posterior triangle nodes -SF
6) anterior jugular (cervical) nodes -SF

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11
Q

1) submental and submandibular

A

submental= chin, anterior gingiva, tip of tongue, anterior floor of mouth, medial lower lip and MD INCISORS

submandibular= uppier lip, lateral lower lip,cheeck, teeth, sublingual and submandibular glands… BULK of oral cavity except MD incisors

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12
Q

submental nodes drain into?

A

submandibular nodes before they drain into jugulodigastric

maybe deep anterior jugular (cervical) nodes

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13
Q

5) posterior triangle nodes

A

within posterior triangle

*posterior neck

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14
Q

6) anterior jugular (cervical) nodes

A

skin and muscles of the anterior infrahyoid region

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15
Q

2) jugulodigastric -deep

A
  • *all of head
  • junction of jugulars along posterior line of digastric
  • upper deep cervical nodes, all oral cavity/pharynx, tonsils, all superior superficial nodes
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16
Q

3) juxtavisceral -deep

A
  • unique to viscera, collects from 2

* esophagus, larynx, trachea, thyroid gland

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17
Q

4) jugulo-omohyoid -deep

A

head and neck above this level

  • most inferior
  • no new drainage
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18
Q

what are the internal nodes?

A

tonsils!

1) pharyngeal tonsil
2) tubal tonsil
3) palatine tonsil
4) lingual tonsil

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19
Q

what is waldeyers lymphatic rings?

A

simply refers to internal ring of tonsils that are collecting all of the lymph from deep within

20
Q

what are tonsils?

A

mounds od lymph tissue that eventually drain into jugular chain of nodes OR directly into retropharengeal or jugular digastirc nodes

21
Q

outer and inner ring or ‘waldeyer’s lymphatic rings’?

A

Inner

1) pharyngeal tonsil
2) tubal tonsil
3) palatine tonsil
4) lingual tonsil

Outer

1) retropharyngeal node -deep
2) jugulodigastric node- deep
3) jugular chain of nodes -deep
4) submandibular nodes
5) submental nodes

22
Q

jugulofacial venous juntion

A

where common facial and jugular vein meet

23
Q

the internal jugular and subclavian v meet to form?

A

the venous angle and brachiocehalic vein

24
Q

jugulosubclavian venous junction

A

thoracic duct on left
lymphatic duct on right
***where lymph drainage meets venous angle

25
drainage of the ear * anterior * posterior * inferior
* anterior (ear canal)= to parotid, superficial * posterior= drains into mastoid nodes * inferior (lobule)= drains directly into jugulo-digastirc deep nodes
26
MD incisors drain into?
submental nodes in submental triangle (and apex of tongue)
27
all teeth except MD incisors drain into?
submandibular nodes
28
3rd molars can drain directly into?
deep cervical nodes | *so can spread infections faster and deeper; biggest prob
29
apex of tongue (anterior part) drains into?
submental
30
rest of tongue (exlcusing apex and root) drain into?
submandibular
31
root of tongue drains in?
deep cervical nodes (upper group) and jugulodigastric nodes
32
drainage order of tongue
submental > submandibular >deep cervical nodes > jugulofacial venous junctions > jugular nodes
33
why is extensive metastasis of cancer/lesions of tongue a big deal?
both ipsilateral AND contralateral drainage! easy to spread due to large overlap
34
venous angle is the junction of?
internal jugular and subclavian
35
Right lymphatic duct empties at?
juntion of right internal jugular and right subclavian
36
thoracic duct empties into?
junction of left internal jugular and left subclavian veins
37
cisterna chyli?
most inferior part of thoracic duct at T12
38
what region is drained by the right lymphatic duct?
right head and neck; upper right quadrant (right arm)
39
what region is drained by the left lymphatic duct?
left head and neck, upper left quadrant; everything below cisterna chyli at T12
40
heathy adults may have palpable nodes up to?
2cm
41
generalozed lymphadenopathy is involvemnt of? caused by?
3+ noncontiguous lymph node areas | *caused by infectious mononucleosis (EBV), lupes (SLE), leukemias, lymphomas or viruses or autoimmune disease
42
physical exams for lymphadenopathy?
- localized vs generalized - size of nodes - texture - nodal tenderness/inflammation - splenomegaly - CBC= complete blood count
43
things to consider for fascial abscesses
- dental infection (periapcial abscess) to subperiosteal/periodontal abscess to potatntal space - cellulitis and braod abscess within space - lymph nodes involved by defealt but not palpebal - SOURCE is easily localized; 60-70% from MD molars - treatment= incision, drainage, bone removal, ANTIBIOTICS
44
things to consider for swollen nodes
- recently sick - palpable INCLUDING borders - usually NOT painful - past/current diagnosis of cancer - source not localized - lethargy, rapid weight loss, night weats - TREATMENT- need biopsy, removal last resort bc is causes lymphedema
45
lymphedema
need lymph system to you don't swell up with excess fluid, removal of lymph nodes causes lymphedema

Head and Neck Anatomy (46 decks)

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