Lymphatics head/neck

Question 1

Where do lymph vessels above the umbilicus drain?

Answer 1

Axillary lymph nodes first, then go deeper

Question 2

Where do llymph vessels below the level of the umbilicus drain?

Answer 2

Superficial inguinal lymph nodes first, then pierce deep body wall

Question 3

What is the plan for deep flow of lymphatics?

Answer 3

Lymp from legs + pelvis + abdomen follow blood vessels to cysterna chyli (right of the aorta below diaphragm)

Thoracic duct continues to the junction of the left internal jugular and subclavian veins

Subclavian trunk (from axillary/upper limbs), Jugular trunk (from head), and bronchiomediastinal trunks (from heart and lungs) also empty here

Question 4

Where does the deep lymph of the lower extremity converge?

Answer 4

Deep inguinal lymph node

Question 5

What are the lymph rings of the head and neck?

Answer 5

Superficial ring - collar chain around submental, submandibular, parotid, mastoid, and occipital

Deep ring - sheath of nodes around visceral unit of neck (pharynx, larynx, esophagus)

Question 6

Describe tongue lymphatics.

Answer 6

Anterior 2/3 to the superficial ring

Posterior 1/3 drains to deep ring

Question 7

Describe jaw lymphatics.

Answer 7

Mandible and lower teeth out of manidbular canal to deep cervical ring

Upper jaw drains out of infraorbital foramento superficial ring

Question 8

Where does lymph from tonsils drain?

Answer 8

Deep ring of cervical nodes

Question 9

What are the three types of tonsils in the head/neck?

Answer 9

Pharyngeal tonsils - roof of nasopharynx

Palatine tonsils - lateral walls of oropharynx between palatoglossal and palatopharyngeal arches

Lingual tonsils - posterior 1/3 of the tongue

Question 10

Indicate the lymphatic vessels or nodes that lymph from the following will drain into next: Submandibular nodes

Answer 10

Plexus on/in carotid sheath that will form jugular trunk

Question 11

Indicate the lymphatic vessels or nodes that lymph from the following will drain into next: posterior scalp

Answer 11

Occipital nodes on the superficial cervical ring of lymphatics

Question 12

Indicate the lymphatic vessels or nodes that lymph from the following will drain into next: superficial cervical ring

Answer 12

Plexus on/in the carotid sheath that will form the jugular trunk

Question 13

Indicate the lymphatic vessels or nodes that lymph from the following will drain into next: skin of face

Answer 13

Submandibular nodes of the superficial cervical ring of lymphatics

Question 14

Indicate the lymphatic vessels or nodes that lymph from the following will drain into next: pharynx

Answer 14

Deep plexus/sheath of lymphatics/nodes surrounding the visceral unit

Question 15

Indicate the lymphatic vessels or nodes that lymph from the following will drain into next: maxilla interior

Answer 15

Out of the infraorbital forame, down to superficial cervical ring

Question 16

Indicate the lymphatic vessels or nodes that lymph from the following will drain into next: mandible interior

Answer 16

Out of the mandibular canal into the deep plexus/sheath of lymphatics/nodes surrounding the visceral unit

Question 17

Indicate the lymphatic vessels or nodes that lymph from the following will drain into next: Anterior 2/3 of the tongue

Answer 17

Through the mylohyoid muscle into the submental/submandibular nodes of the superficial cervical ring

Question 18

Indicate the lymphatic vessels or nodes that lymph from the following will drain into next: Posterior 1/3 of the tongue

Answer 18

Deep plexus/sheath of lympatics/nodes surrounding the visceral unit