Lymph drainaige Flashcards
where do the lymphatic ducts drain into
right and left subclavian veins
what are the names of the two main lymphatic ducts
right lymphatic duct and thoracic duct
what ducts are the main draining vessels of the head and neck
jugular trunks
where are the lymph nodes
between the lymph capillaries and the lymph vessels
what lymph node may be enlarged in tonsilitis
jugulodigastric (neck, posterior belly of digastric crossing the IVJ
what do the upper deep cervical lymph nodes receive lymph from
superficial lymph node groups
tongue and tonsils
feeds to lower deep nodes and jugular trunk
where is juguloomohyoid node
part of lower deep cervical nodes
drains anterior 2/3rds of tongue
where are the lower deep cervical nodes
back of neck and scalp
what do the lower deep cervical nodes drain
superficial pectoral region
tongue
superficial deep cervical glands
feeds to jugular trunk
what is the drainage of the anterior 2/3rd of tongue
juguloomohyoid node
what node is just below the external auditory meatus
jugulodigastric node
what is the general lymph drainage of the face
most lymph goes from superficial nodes in the face into deep cervical nodes in the neck (superior then inferior)
what do the submental nodes drain (then to submandibular)
floor of the mouth beneath the tongue tip, incisor and gum, central lower lip, chin skin
what do the buccal nodes drain (then to submandibular nodes)
lower eyelid, cheek, buccinator, facial vein
what do the submandibular nodes drain (then to deep cervical nodes)
nose, cheek, lower lip, frontal/max/ethmoidal sinuses
upper/lower teeth, ant 2/3 of tongue
What do the parotid nodes drain (to superior deep cervical)
eyelid, nose, external acoustic meatus, tympanic cavity
parts of nasal pharynx
what do the mastoid aka post auricular nodes drain (superior deep cervical)
strip of scalp above auricle, posterior external auditory meatus
what do the occipital nodes drain (to deep cervical)
back of the scalp
what do the superficial cervical nodes drain
skin over jaw angle, parotid apex and lobule of ear
what do the retropharyngeal nodes drain
pharynx, auditory tube, soft palate, hard palate, nose
what do the paratracheal nodes drain
neighbouring structures
thyroid
where are the deep lymph nodes
surround the larynx, trachea and pharynx, oesophagus
what do the retropharyngeal nodes drain
nasal cavities/nasal pharynx, auditory tube
what is the first node in drainage of the nasopharynx
node of rouviere
what node enlargement is associated with poor prognosis in thyroid cancer
delphian node
aka pretracheal node on the cricothryoid membrane
what is the drainage of the thyroid
pretracheal/ paratracheal/ prelaryngeal to deep cervical nodes
what is the lymph drainage from the lips
submandibular lymph nodes
submental lymph nodes
what is the lymph drainage of the back of the tongue
superior deep cervical lymph nodes including jugulodigastric
what is the lymph drainage of the side of the tongue
inferior deep cervical nodes + juguloomohyoid and submandibular nodes
what is the lymph drainage of the tip of the tongue
submental
why might tongue lesions present on both sides of the neck
significant drainage on both sides and crosses over the tongue
what tumour makes up 90% of all oral cancers
squamous cell carcinoma
floor of mouth and tongue
what is the prognosis of squamous cell carcinomas in the tongue strongly dependant on
whether there are detectable metastases in cervical lymph nodes
contralateral lymph node metastases suggests poor prognosis
what is virchow’s node
enlarged left supraclavicular node
abdominal/stomach tumour
what tonsils make up waldeyer’s ring
pharyngeal tonsil
palatine tonsil
lingual tonsil
what is waldeyers ring
an interrupted circle of protective lymph tissue
upper ends of alimentary respiratory tracts
what are tonsils
lymphoid nodules invaginated epithelium which increases contact with digested organisms
facilitates immunity
where is the pharyngeal tonsil
back of nasopharynx
where is the palatine tonsil
back of oropharynx
where is the lingual tonsil
bottom of tongue
what is the N in TMN staging based on
lymph node sidedness , number and size
what is the sentinel node
hypothetical first lymph node draining a cancer
how can you ID the sentinel node
imaging
test by histopathology
what is lymphoscintigraphy
senetinel lymph node mapping
what is another possible means of tumour spread in the head and neck
perineural
trigeminal, facial and hypoglossal nerves are important routes
what fossa is an important cross roads for perineural and perivascular spread
pterygopalatine fossa
communicates with the orbit, oral cavity, nasal cavity and middle cranial fossa
where is lymph drainage of the brain
lymphatics run alongside dural sinuses and goes to deep cervical nodes
