Lymphatics of the Head and Neck

Question 1

Lymphatic System

Answer 1

• Returns excess fluid within the tissues back to the vascular circulatory system
• Afferent Lymphatic Vessels -> Lymph Nodes -> Efferent Lymphatic Vessels -> Lymphatic Trunks -> Lymphatic Ducts -> Blood Vascular System

Question 2

Lymph Nodes

Answer 2

• Functions to rid the lymph of any pathogens

Question 3

In the Head and Neck flow

Answer 3

• Lymph tends to follow the venous drainage, with all lymph eventually flowing into the deep cervical lymph nodes to return to the venous blood

Question 4

Major Lymph Nodes Groups of the head and neck

Answer 4

• Pericervical Collar (superficial lymph nodes) (x2)
• Superficial Cervical Group (x2)
• Intermediate (anterior deep) cervical group (x2)
• Deep Cervical Group (superior and inferior) (x2)

Question 5

Pericervical Collar (superficial lymph nodes) (x2)

Answer 5

o The lymph nodes near the junction of the head and neck, forming a ‘collar’ or ring around the head/superior cervical region.

o These lymph nodes are primarily responsible for draining the face and scalp.

Question 6

Superficial Cervical Group (x2)

Answer 6

o Lymph nodes located along the external jugular vein superficial to the sternocleiodomastoid muscle.

o Primarily drain the posterolateral scalp and direct lymph to the deep cervical lymph nodes.

Question 7

Intermediate (anterior deep) cervical group (x2)

Answer 7

o Deep cervical lymph nodes, but are located in the anterior and central region of the neck draining the neck structures and some deep structures of the head.

o Direct lymph to the deep cervical lymph nodes (superior and inferior).

Question 8

Deep Cervical Group (superior and inferior) (x2)

Answer 8

o These lymph nodes make up most of the deep cervical lymph nodes.

o Related to the internal jugular vein and divided into superior and inferior groups separated by the tendon of the omohyoid muscle

Question 9

Pericervical Lymph Nodes: Occipital

Answer 9

drain posterior aspect of scalp and superior aspect of neck

Question 10

Pericervical Lymph Nodes: Mastoid/retroauricular

Answer 10

superficial to mastoid process.

Drain posterolateral aspect of the scalp and behind the ear

Question 11

Pericervical Lymph Nodes: Parotid/preauricular

Answer 11

superficial to the parotid glands.

Drain anterior aspect of scalp and parts of the face.

Lie anterior to the ear.

Question 12

Pericervical Lymph Nodes: Submandibular

Answer 12

Drain parts of the head and neck (deep head, superficial neck).

Salivary glands, part of the mouth and part of the nasal cavity

Question 13

Pericervical Lymph Nodes: Submental

Answer 13

Inferior to the chin.

Drain the median part of the face, specifically the lower lip and the chin region

Question 14

Pericervical Lymph Nodes: Facial

Answer 14

Lie lateral to the mouth.

Join directly into the submandibular lymph nodes and drain the lateral region of the face

Question 15

Efferent Lymphatic Vessels of Pericervical Collar

Answer 15

• Occipital and mastoid lymph nodes drain to superficial cervical lymph nodes
• Parotid and submandibular lymph nodes drain to superior deep cervical lymph nodes
• Submental lymph nodes drain to the deep cervical lymph nodes via the submandibular lymph nodes (or directly into the deep cervical lymph nodes).

Question 16

Superficial Cervical Lymph Nodes

Answer 16

• Afferent vessels from mastoid and occipital lymph nodes

* Efferent vessels drain to superior or inferior deep cervical lymph nodes (depending on their location)

Question 17

Intermediate (anterior deep) cervical lymph nodes

Answer 17

• The prelaryngeal lymph nodes drain lymph from the thyroid gland.
• The paratracheal and pretracheal lymph nodes drain lymph from the thyroid gland and larynx.

Question 18

Intermediate (anterior deep) cervical lymph nodes: Efferent Drainage

Answer 18

o The efferent vessels of the prelaryngeal lymph nodes drain to superior deep lymph nodes.

o The efferent vessels of the paratracheal lymph nodes drain to inferior deep lymph nodes.

o The efferent vessels of the pretracheal lymph nodes drain to inferior deep lymph nodes via the paratracheal lymph nodes

Question 19

Retropharyngeal Lymph Nodes

Answer 19

o Located posterior to the nasopharynx and drains lymph from the pharynx.

o Efferent vessels drain to the superior deep lymph nodes.

Question 20

Efferent Lymphatic Vessels from the Deep Cervical Lymph Nodes

Answer 20

• In order for the lymph from the head and neck to drain back into the venous blood, the lymph will flow from the deep cervical lymph nodes into the jugular lymphatic trunks (on the left and right side).
• From the right and left jugular trunks, the lymph will flow into the right lymphatic duct and thoracic duct, respectively, to reenter the venous circulation at the confluence of the internal jugular veins and subclavian veins.

Question 21

Formation of lymphatic trunks

Answer 21

• The lymphatic trunks occur when afferent lymphatic vessels converge.
• These trunks then flow into the largest lymphatic vessels - lymphatic ducts.

Question 22

Thoracic Duct

Answer 22

• Drains most of the lymph in the body while the right lymphatic duct only drains the right side of the head, neck, thorax and upper limb

Question 23

Prominent lymph node of superior deep lymph node

Answer 23

the jugulodigastric lymph node, which receives lymph from the tonsils and tongue.

Question 24

Prominent lymph node of inferior deep lymph node

Answer 24

the jugulo-omohyoid lymph node, which receives lymph from the tongue.

Question 25

3 trunks of the neck region

Answer 25

• There are three trunks in the neck region (on the left and right), the jugular trunks receiving lymph from the deep cervical lymph nodes, the subclavian trunks receiving lymph from the axillary lymph nodes and the bronchomediastinal trunks receiving lymph from lymph nodes in the thorax.

Left side - flow into thoracic duct
Right side - flow into right lymphatic duct