Lymphatics of the head and neck Flashcards

1
Q

what is the function of the lymphatic system?

A
  • drainage of surplis tissue fluid and leaked plasma proteins to the bloodstream
  • removal of debris from cellular decomposition and infection
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2
Q

what lymphatic structure is found at the left venous angle?

A

the thoracic duct

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3
Q

where does most of the bodies lymph re-enter the vascular system? what area is the exception?

A
  • the thoracic duct
  • the exception is the right superior quadrant
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4
Q

what structures drain into the right lymphatic duct?

A
  • right upper limb
  • right side of head & neck
  • right side of thorax
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5
Q

how can the lymph nodes of the head be described?

A

paired lymph nodes (either superficial or deep)

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6
Q

what are the 5 groups of paired superficial lymph nodes located in the head?

A
  • occipital
  • posterior auricular
  • anterior auricular
  • superficial parotid
  • facial
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7
Q

In a healthy patient, how would lymph nodes present?

A

usually small, soft and free/mobile in the surrounding tissue

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8
Q

In a pathological/malignant setting, how would lymph nodes present?

A
  • enlarged
  • tender
  • hard
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9
Q

how many superficial parotid nodes are there?

A

up to 10

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10
Q

What area of the face does the posterior auricular, anterior auricular and superficial parotid nodes drain?

A
  • external ear
  • lacrimal gland
  • adjacent regions of scalp & face
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11
Q

what do the occipital nodes drain?

A

the scalp of the occipital region

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12
Q

where

A
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13
Q

where do the superficial lymph nodes of the face empty into?

A

deep cervical nodes

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14
Q

where are the facial lymph nodes located?

A

located along the facial vein & split into four subgroups:
- the malar region
- nasolabial
- buccal
- mandibular

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15
Q

What may result in the enlargement of a facial lymph node?

A

infections of the teeth

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16
Q

what are the deep lymph nodes of the head?

A
  • deep parotid nodes
  • retropharyngeal nodes
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17
Q

where are the retropharyngeal nodes located? what do they drain?

A

located & drain posterior to palate, pharynx, paranasal sinus & nasal cavity

18
Q

Nodes of the neck/cervical lymph nodes are paired and unilaterally drain either the right of left tissues… what is the exception?

A

the midline submental nodes
- drain tissue in the submental triangle bilaterally

19
Q

what are the four groups of superficial cervical lymph nodes?

A
  • submental
  • submandibular
  • external jugular
  • anterior jugular
20
Q

what structures do they submental lymph nodes drain?

A
  • lower lip
  • both sides of chin
  • floor of mouth
  • apex of tongue
  • mandibular incisors (with associated periodontium & gingiva)
21
Q

what are examples of infections that can cause swelling of the submental nodes?

A
  1. Epstein-Barr virus
  2. Cytomegalovirus
  3. Dental infections including peridontitis **
22
Q

How many submandibular lymph nodes are there? where are these nodes located?

A

Approx. 3 to 6 nodes
- located in the submandibular triangle at the inferior border of the mandibular ramus
- just superficial to the submandibular salivary gland

23
Q

what structures do the submandibular nodes drain?

A
  • cheeks
  • upper lip
  • body of the tongue
  • anterior hard palate
  • most of the teeth & associated periodontium/gingiva
24
Q

what lymph nodes drain the maxillary third molars?

A

superior deep cervical lymph nodes

25
Q

where do all of the superficial cervical lymph nodes drain to?

A

the deep cervical lymph nodes

26
Q

where are the deep cervical lymph nodes located?

A

approx. 15 to 30 located along the length of the internal jugular vein on each side of neck (deep to the SCM muscle)

27
Q

what structures do the superior deep cervical nodes drain?

A
  • posterior nasal cavity
  • posterior hard palate
  • soft palate
  • base of tongue
  • maxillary third molars
  • TMJ
  • oesophagus
  • trachea
  • thyroid gland
28
Q

Why is the drainage of the posterior of the tongue interesting?

A

Drainage is bilateral, so pathological may appear in the lymph nodes on either side as opposed to just the affected side

29
Q

Where is the jugulodigastric node? what does it drain?

A

Located posterior to the angle of the mandible & inferior to the posterior belly of digastric
- drains the palatine tonsils

30
Q

what do the inferior deep cervical nodes drain?

A
  • posterior part of the scalp & neck
  • superficial pectoral region
  • part of the arm
31
Q

where is the jugulo-omohyoid lymph node located? what does it drain?

A

Located at the angle where the omohyoid crosses the internal jugular vein
- receives lymph from submental triangle

32
Q

what cancer are the inferior deep cervical lymph nodes at risk of helping to spread?

A

breast cancer
- these nodes communicate the axillary lymph nodes that drain the breast region

33
Q

Why are the supraclavicular lymph nodes particularly at risk for involving the spread of cancer?

A

Lie very close to the thoracic duct

34
Q

What may enlargened lymph nodes indicate?

A

A current or recent past pathology/area of immune activity
- can point to systemic or local disease

35
Q

what occurs in lymphogenous spread of cancer?

A

cancer cells travel via lymphatics, are filtered & trapped in lymph nodes, which become secondary cancer sites

36
Q

If lymph nodes are swollen & tender, what does this suggest?

A

Inflammation/infection

37
Q

If lymph nodes are hard & painless nodes, what does this indicate?

A

Malignancy

38
Q

If the submandibular lymph nodes are swollen, where is the relevant malignancy/pathology going to be?

A
  • oral cavity
  • face
  • nasal cavity
  • maxillary sinus
39
Q

If the supraclavicular lymph nodes are swollen, where is the relevant malignancy/pathology going to be?

A

Thorax & abdomen

40
Q

if the submandibular lymph nodes are enlarged, where might the infection be?

A
  • oral cavity
  • face
  • nasal cavity
  • maxillary sinus