Lymph drainaige

Question 1

where do the lymphatic ducts drain into

Answer 1

right and left subclavian veins

Question 2

what are the names of the two main lymphatic ducts

Answer 2

right lymphatic duct and thoracic duct

Question 3

what ducts are the main draining vessels of the head and neck

Answer 3

jugular trunks

Question 4

where are the lymph nodes

Answer 4

between the lymph capillaries and the lymph vessels

Question 5

what lymph node may be enlarged in tonsilitis

Answer 5

jugulodigastric (neck, posterior belly of digastric crossing the IVJ

Question 6

what do the upper deep cervical lymph nodes receive lymph from

Answer 6

superficial lymph node groups

tongue and tonsils

feeds to lower deep nodes and jugular trunk

Question 7

where is juguloomohyoid node

Answer 7

part of lower deep cervical nodes

drains anterior 2/3rds of tongue

Question 8

where are the lower deep cervical nodes

Answer 8

back of neck and scalp

Question 9

what do the lower deep cervical nodes drain

Answer 9

superficial pectoral region
tongue
superficial deep cervical glands

feeds to jugular trunk

Question 10

what is the drainage of the anterior 2/3rd of tongue

Answer 10

juguloomohyoid node

Question 11

what node is just below the external auditory meatus

Answer 11

jugulodigastric node

Question 12

what is the general lymph drainage of the face

Answer 12

most lymph goes from superficial nodes in the face into deep cervical nodes in the neck (superior then inferior)

Question 13

what do the submental nodes drain (then to submandibular)

Answer 13

floor of the mouth beneath the tongue tip, incisor and gum, central lower lip, chin skin

Question 14

what do the buccal nodes drain (then to submandibular nodes)

Answer 14

lower eyelid, cheek, buccinator, facial vein

Question 15

what do the submandibular nodes drain (then to deep cervical nodes)

Answer 15

nose, cheek, lower lip, frontal/max/ethmoidal sinuses

upper/lower teeth, ant 2/3 of tongue

Question 16

What do the parotid nodes drain (to superior deep cervical)

Answer 16

eyelid, nose, external acoustic meatus, tympanic cavity

parts of nasal pharynx

Question 17

what do the mastoid aka post auricular nodes drain (superior deep cervical)

Answer 17

strip of scalp above auricle, posterior external auditory meatus

Question 18

what do the occipital nodes drain (to deep cervical)

Answer 18

back of the scalp

Question 19

what do the superficial cervical nodes drain

Answer 19

skin over jaw angle, parotid apex and lobule of ear

Question 20

what do the retropharyngeal nodes drain

Answer 20

pharynx, auditory tube, soft palate, hard palate, nose

Question 21

what do the paratracheal nodes drain

Answer 21

neighbouring structures

thyroid

Question 22

where are the deep lymph nodes

Answer 22

surround the larynx, trachea and pharynx, oesophagus

Question 23

what do the retropharyngeal nodes drain

Answer 23

nasal cavities/nasal pharynx, auditory tube

Question 24

what is the first node in drainage of the nasopharynx

Answer 24

node of rouviere

Question 25

what node enlargement is associated with poor prognosis in thyroid cancer

Answer 25

delphian node

aka pretracheal node on the cricothryoid membrane

Question 26

what is the drainage of the thyroid

Answer 26

pretracheal/ paratracheal/ prelaryngeal to deep cervical nodes

Question 27

what is the lymph drainage from the lips

Answer 27

submandibular lymph nodes

submental lymph nodes

Question 28

what is the lymph drainage of the back of the tongue

Answer 28

superior deep cervical lymph nodes including jugulodigastric

Question 29

what is the lymph drainage of the side of the tongue

Answer 29

inferior deep cervical nodes + juguloomohyoid and submandibular nodes

Question 30

what is the lymph drainage of the tip of the tongue

Answer 30

submental

Question 31

why might tongue lesions present on both sides of the neck

Answer 31

significant drainage on both sides and crosses over the tongue

Question 32

what tumour makes up 90% of all oral cancers

Answer 32

squamous cell carcinoma

floor of mouth and tongue

Question 33

what is the prognosis of squamous cell carcinomas in the tongue strongly dependant on

Answer 33

whether there are detectable metastases in cervical lymph nodes

contralateral lymph node metastases suggests poor prognosis

Question 34

what is virchow’s node

Answer 34

enlarged left supraclavicular node

abdominal/stomach tumour

Question 35

what tonsils make up waldeyer’s ring

Answer 35

pharyngeal tonsil
palatine tonsil
lingual tonsil

Question 36

what is waldeyers ring

Answer 36

an interrupted circle of protective lymph tissue

upper ends of alimentary respiratory tracts

Question 37

what are tonsils

Answer 37

lymphoid nodules invaginated epithelium which increases contact with digested organisms

facilitates immunity

Question 38

where is the pharyngeal tonsil

Answer 38

back of nasopharynx

Question 39

where is the palatine tonsil

Answer 39

back of oropharynx

Question 40

where is the lingual tonsil

Answer 40

bottom of tongue

Question 41

what is the N in TMN staging based on

Answer 41

lymph node sidedness , number and size

Question 42

what is the sentinel node

Answer 42

hypothetical first lymph node draining a cancer

Question 43

how can you ID the sentinel node

Answer 43

imaging

test by histopathology

Question 44

what is lymphoscintigraphy

Answer 44

senetinel lymph node mapping

Question 45

what is another possible means of tumour spread in the head and neck

Answer 45

perineural

trigeminal, facial and hypoglossal nerves are important routes

Question 46

what fossa is an important cross roads for perineural and perivascular spread

Answer 46

pterygopalatine fossa

communicates with the orbit, oral cavity, nasal cavity and middle cranial fossa

Question 47

where is lymph drainage of the brain

Answer 47

lymphatics run alongside dural sinuses and goes to deep cervical nodes