Lymphatics and Brachial Plexus

Question 1

what are the 14 lymph node systems of the head and neck?

Answer 1

1. suboccipital
2. mastoid/postauricular
3. preauricular
4. parotid
5. retropharyngeal
6. suprahyoid
7. submandibular/submaxillary
8. submental
9. sublingual
10. thyrolinguofacial
11. anterior superficial and deep cervical chain
12. posterior cervical spinal nerve chain
13. posterior superficial cervical chain (aka transverse cervical artery chain)
14. internal jugular chain

Question 2

what part of the body does the right lymphatic duct drain?

Answer 2

right side of the face and neck, right arm, upper right torso

Question 3

what part of the body does the thoracic duct drain?

Answer 3

all parts of the body that the right lymphatic duct doesn’t drain

Question 4

what percent of the interstitial fluid drains back into the circulatory system? where does the remaining interstitial fluid drain?

Answer 4

• 90% drains back into the circulatory system
• the remaining 10% drains into the lymphatic system

Question 5

lymphatic drainage of the head and neck includes what two layers? what are the layers separated by?

Answer 5

• superficial tissues and deeper structures and viscera
• separated by deep cervical fascia
• drain into regional lymph nodes and deep cervical nodes

Question 6

where are the occipital lymph nodes located? what are the afferents and efferents?

Answer 6

• at the apex of the posterior triangle, superficial to trapezius
• afferent - back of scalp
• efferent - deep cervical lymph nodes

Question 7

where are the retroauricular (mastoid) lymph nodes located? what are their afferents and efferents?

Answer 7

• superficial to SCM and mastoid process and deep to auricularis posterior muscle
• afferent - strip of scalp above auricle; posterior external auditory meatus
• efferent - deep cervical nodes

Question 8

where are the parotid lymph nodes located? what are their afferents and efferents?

Answer 8

• parotid gland; superficial parotid nodes and deep parotid nodes
• afferent of superficial parotid nodes:
  
  • strip of scalp avoce the parotid salivary gland
  • lateral surface of auricle
  • anterior wall of external auditory meatus
  • lateral part of the eyelid
• afferent of deep parotid nodes:
  
  • middle ear
• efferent - deep cervical nodes

Question 9

where are the buccal lymph nodes located? what are their afferents and efferents?

Answer 9

• on the surface of buccinator muscle in relation to facial vein
• afferent - lower eye lid, part of cheek buccinator muscle, facial vein
• efferent - submandibular lymph node, then to deep cervical nodes

Question 10

where are the submandibular lymph nodes located? what are their afferents and efferents?

Answer 10

• below the mandible
• afferents - front of scalp, nose and adjacent cheek, upper and lower lip, frontal/maxillary/ethmoidal sinuses, upper and lower teeth, anterior 2/3 of tongue, floor of mouth, vestibulr, and gums
• efferent - deep cervical lymph nodes

Question 11

where are the submental lymph nodes located? what are their afferents and efferents?

Answer 11

• below the chin
• afferent - tip of tongue, floor of mouth beneath the tip of tongue, incisor teeth and associated gum, center part of lower lip, skin over chin
• efferent - submandibular node, deep cervical lymph nodes (jugulo-omohyoid nodes)

Question 12

where are the superficial cervical lymph nodes located? what are their afferents and efferents?

Answer 12

• below and slightly posterior to the ear
• afferent - skin over the angle of jaw, skin over apex of parotid salivary gland, and lobule of ear
• efferent - deep cervical lymph nodes

Question 13

draw out the brachial plexus

Answer 13

Question 14

what does the dorsal scapular nerve innervate? what cervical nerve does it branch off of?

Answer 14

• levator scapulae
• rhomboid major and minor
• branches off C5

Question 15

what does the long thoracic nerve innervate? what cervical nerve does it branch off of?

Answer 15

• serratus anterior
• branches from C5, C6, and C7 merge to form the long thoracic nerve

Question 16

what does the nerve to subclavius innervate? what cervical nerve does it branch off of?

Answer 16

• subclavius muscle
• branches from C5 and C6 merge to form the nerve to subclavius

Question 17

what does the suprascapular nerve innervate? what cervical nerve does it branch off of?

Answer 17

• supraspinatus and infraspinatus muscles
• branches from C4(?), C5, and C6 merge to form the suprascapular nerve

Question 18

what does the thoracodorsal nerve innervate? what cerivcal nerve does it branch off of?

Answer 18

• latissimus dorsi
• branches off of posterior cord (C6, C7, and C8)

Question 19

what do the upper and lower subscapular nerves innervate? what cervical nerves do they branch off of?

Answer 19

• subscapularis and teres major
• C5 and C6 via posterior cord

Question 20

what do the lateral and medial pectoral nerves innervate? what cervical nerves do they branch off of?

Answer 20

• lateral pectoral n. - pectoralis major; C5-7 via lateral cord
• medial pectoral n. - pectoralis major and minor; C8 and T1 via medial cord

Question 21

which 5 infraclavicular long branches of the brachial plexus serve the arm?

Answer 21

• musculocutaneous n.
• axillary n.
• radial n.
• median n.
• ulnar n.

Question 22

below T1, the spinal nerves begin to follow the ___

Answer 22

segmental body plan