Lymphatics: deep lymph nodes, Waldeyer’s Ring, clinical Flashcards
where do the deep (cervical) lymph nodes receive lymph from?
all of the lymph from the head and neck
how do the deep (cervical) lymph nodes receive all the lymph from H+N?
either directly or indirectly via the superficial lymph nodes
how are deep lymph nodes organised?
into a vertical chain
where are deep lymph nodes located?
within close proximity to the internal jugular vein within the carotid sheath
what do the efferent vessel from the deep cervical lymph nodes converge to form?
the jugular lymphatic trunks
how can the nodes be divided?
into superior and inferior deep cervical lymph nodes
what do deep cervical lymph nodes comprise of?
prelaryngeal, pretracheal, paratracheal, retropharyngeal, infrahyoid, jugulodigastric (tonsilar), jugulo-omohyoid and supraclavicular nodes
what are Virchow’s nodes?
supraclavicular nodes
where are Virchow’s nodes located?
left supraclavicular fossa (immediately superior to the clavicle)
where do Virchow’s nodes receive lymphatic drainage from?
abdominal cavity
what is the finding of an enlarged lymph node known as?
Troisier’s sign
what does Troisier’s sign indicate?
presence of cancer in the abdomen - specifically gastric cancer that has spread through the lymph vessels
what does Waldeyer’s tonsillar ring refer to?
the collection of lymphatic tissue surrounding the superior pharynx
what do the lymphatic tissue of Waldeyer’s tonsillar ring respond to?
responds to pathogens that may be ingested or inhaled
what are the tonsils that make up the Waldeyer’s tonsillar ring?
Lingual tonsil
Palatine tonsils
Tubal tonsils
Pharyngeal tonsil
where are Lingual tonsils located?
on the posterior base of the tongue
where are palatine tonsils located?
located on each side between the palatoglossal and glossopharyngeal arches
which part of the ring do palatine tonsils form?
lateral
how can palatine tonsils be seen?
These are the common ‘tonsils’ that can be seen within the oral cavity
where are tubal tonsils located?
these are located where each Eustachian tube opens into the nasopharynx
which part of the ring do tubal tonsils form?
lateral
which part of the ring do lingual tonsils form?
antero-inferior
what are Pharyngeal tonsils also known as?
nasopharyngeal / adenoid tonsil
where are pharyngeal tonsils located?
located in the roof of the nasopharynx, behind the uvulva
which part of the ring do pharyngeal tonsils form?
postero-superior part
clinical: which tonsils can be inflammed? cause?
The palatine tonsils can become inflamed due to a viral or bacterial infection
how do palatine tonsils appear when inflamed due to a viral or bacterial infection?
they appear red and enlarged
what are palatine tonsils accompanied by when inflamed?
accompanied by enlarged jugulo-digastric lymph nodes
how can chronic infection of the palatine tonsils be treated? called?
with their removal, a tonsillectomy
When performing a tonsillectomy, where might there be bleeding from?
there may be bleeding primarily from the external palatine vein and secondarily from the tonsilar branch of the facial artery
If an infection spreads to the peritonsillar tissue, what can it cause?
cause abscess formation
what can abscess formation in peritonsillar tissue from infection to palatine tonsils cause?
can cause deviation of the uvula
what is deviation of uvula known as?
quinsy
what is quinsy?
a medical emergency
why is quinsy a medical emergency?
it can potentially cause obstruction of the pharynx
how is quinsy treated?
draining of the abscess and antibiotics
