Lymph of Head/Neck Flashcards
Lymph from oral cavity and nasopharynx likes to…
Cross the midline -> oral cancer metastasize to lymph nodes bilaterally
Deep cervical nodes are…
Situated along internal jugular vein
Superior deep cervical are near…
Posterior belly of digastric muscles
Inferior deep cervical are near…
Omohyoid
Level I lymph
Submental and submandibular triangles, includes submental and sublingual nodes
Where does level I receive lymph?
Lips, face, oral cavity, anterior nasal cavity, submandibular gland
Where does level I drain?
Levels II + III
What is lymphadenopathy in level I associated with?
Disease of the oral cavity (tongue, lips), anterior nasal cavity, face (melanoma), lymphomas and leukemia
Level II lymph
Boundaries are base of the skull, posterior border of the SCM and level of the hyoid bone (~upper 1/3 of SCM); includes the superior deep cervical nodes (JD nodes)
Where does level II lymph receive lymph from?
Auricle, nasal cavity, oral cavity (palatine tonsil – tonsillitis!),
pharynx, larynx, parotid (nodes + gland), suboccipital nodes, retropharyngeal nodes and level I
Where does level II lymph drain?
Levels III - V
What is lymphadenopathy in level II indicate?
Disease of auricle, oral/nasal cavity, pharynx, larynx, thyroid gland, parotid gland
What is level III lymph?
Boundaries are level of the hyoid bone to inferior border of the cricoid cartilage and posterior border of the SCM (~middle 1/3 of SCM); includes nodes along the middle 1/3 of the internal jugular vein
What does level III receive lymph from?
Oral cavity, levels I + II
Where does lymph from level III drain to?
Level IV
Level IV lymph
boundaries are level of the cricoid cartilage to clavicle and posterior border of the SCM (~lower 1/3 of SCM); includes the inferior deep cervical nodes (JO nodes)
Where does level IV receive lymph from?
Level I, level III, posterior scalp and paratracheal nodes
Where does level IV drain?
Thoracic duct + R lymphatic duct
What does lymphadenopathy in level IV associated with?
Disease of the oral cavity, larynx, and thyroid gland; usually via spread from level I (submental nodes), level III or paratracheal nodes
Level V
Posterior triangle of the neck; includes the posterior cervical and supraclavicular nodes
Where does level V receive lymph from?
Posterior scalp (suboccipital nodes), nasopharynx, retropharyngeal nodes, axillary nodes and levels II – III
Where does level V drain?
IV
Lymphadenopathy in level V indicates…
the posterior cervical nodes is associated with infections of the posterior scalp
Lymphadenopathy in the supraclavicular nodes is associated with abdominal/thoracic
neoplasia (see Virchow’s node), thyroid, laryngeal cancer; distant metastasis (from ovary, prostate, testicle)
Level VI
Anterior midline between hyoid and sternal notch; includes prelaryngeal, pretracheal and paratracheal nodes
Where does level VI receive lymph from?
Larynx, laryngopharynx, thyroid, trachea, cervical esophagus
Where does level VI drain?
Level II - IV
Level VII
Anterior midline below sternal notch; includes superior mediastinal nodes