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ESA 4 - Head and Neck > Lymphatics of the Head and Neck > Flashcards

Lymphatics of the Head and Neck Flashcards

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1
Q

What is the lymphatic system?

A

A network of drainage vessels

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2
Q

What does the lymphatic system consist of?

A
  • Fluid - lymph
  • Drainage vessels
  • Lymphatic tissues
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3
Q

What are the lymphatic tissues?

A

Lymph nodes, a type of lymphoid organ

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4
Q

How many lymph nodes are there in the body?

A

800

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5
Q

How many lymph nodes are there in the neck?

A

300

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6
Q

Describe the structure of lymph nodes

A

Connective tissue structures, with a tough, fibrous outer capsule, and reticular connective tissue inside

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7
Q

What do lymph nodes contain?

A

Large collections of lymphocytes and macrophages

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8
Q

Where do lymph nodes play a key role?

A

In immune defence

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9
Q

What do all substances transported in lymph pass through?

A

1 or more lymph nodes

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10
Q

What immune defences do lymph nodes have?

A
  • Physical filter
  • Phagocytic filter
  • Full of lymphocytes
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11
Q

What happens to the lymphocytes in lymph nodes?

A

They activate and proliferate in response to antigens

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12
Q

Where are the specific regions in the body where lymph nodes may be palpable?

A
  • Neck (cervical)
  • Armpit (axillary)
  • Diaphragm
  • Spleen
  • Abdominal
  • Pelvic
  • Groin (femoral)
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13
Q

What may lymph draining into lymph nodes contain?

A

Pathogens

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14
Q

What are the lymphoid organs?

A
  • Spleen
  • Thymus
  • Tonsils
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15
Q

What happens to the lymph fluid?

A

It returns to the blood circulation

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16
Q

Where are lymph vessels found?

A

Throughout the body, with a few exceptions

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17
Q

What parts of the body do not have a lymphatic circulation?

A
  • Eyeball
    • Cornea
    • Lens
  • Inner ear
  • Cartilage
  • CNS
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18
Q

Why is there debate regarding the lymphatic circulation of the CNS?

A

Recent research has identified small lymphatic vessels lining the dura

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19
Q

How can lymph nodes be organised?

A

Into regional (or superficial) and terminal (or deep) groups

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20
Q

How are regional and terminal lymph nodes seperated?

A

By investing layer of deep cervical fascia in the neck

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21
Q

What are the regional groups of lymph nodes found in the area of the head and neck?

A
  • Occipital
  • Pre- and post- auricular
  • Submandibular
  • Sternocleidomastoid
  • Submental
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22
Q

What do regional lymph nodes do?

A

Drain specific areas

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23
Q

Where do regional lymph nodes in the neck lie?

A

Superficially within superficial cervical fascia

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24
Q

What is the result of regional lymph nodes lying superficially within superficial cervical fascia?

A

They can be readily palpated, especially when enlarged

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25
Where does lymph from superficial lymph nodes drain?
Into the deep lymph nodes
26
Where does the submandibular node drain?
* Upper lip and teeth * Lateral lower part of lip * Most of face * Anterior nasal cavity * Tongue (middle) * Submandibular and sublingual glands
27
Where does the submental node drain?
* Lower lip/teeth (central) * Anterior chin * Tip of tongue * Floor of mouth
28
Where does the pre-auricular node drain?
* Scalp * Anterior part of ear (auricle) * Parotid gland * *Some sources indicate conjunctiva and eyelids*
29
Where does the post-auricular (mastoid) lymph node drain?
* Scalp * Posterior part of ear (auricle) * Ear canal
30
Where does the occipital lymph node drain?
Occipital area of scalp and neck
31
Where do the superficial cervical lymph nodes drain?
Skin of neck
32
What are the deep cervical lymph nodes of the head and neck?
* Jugulo-digastric *(also called tonsillar node)* * Jugulo-omohyoid * Supraclavicular
33
Which deep cervical lymph node is most frequently enlarged?
Jugulo-digastric
34
Where is the jugulo-digastric node located?
Just below and behind the angle of the mandible
35
What does the jugulo-digastric lymph node drain?
* Palatine tonsil * Oral cavity * Posterior 1/3 of tongue * Pharynx * Larynx
36
What is the jugulo-omohyoid lymph node mainly associated with?
Lymph drainage of; * Tongue * Oral cavity * Trachea * Oesophagus * Thyroid gland
37
Where are the supraclavicular lymph nodes found?
In root of neck on either side
38
Where do the supraclavicular lymph nodes recieve lymph from?
The abdomen and thorax
39
What happens to the lymph drained from the abdomen and thorax to the supraclavicular node?
It drains via the thoracic duct into venous circulation
40
What is the left supraclavicular node known as?
Virchow's node
41
What does Virchow's node drain?
Abdomen and thorax
42
What does the right supraclavicular node drain?
* Mid section chest * Oesophagus * Lungs
43
Where do terminal lymph nodes lie within the neck?
Deep to the investing layer of cervical fascia
44
What do the terminal lymph nodes of the head and neck recieve?
All lymph of the head and neck, *either directly or indirectly from regional groups*
45
What are the terminal lymph nodes of the head and neck closely related to?
The carotid sheath, in particular the jugular vein
46
Describe the path of lymph in the head and neck
Head and neck superficial lymph nodes drain into deep cervica lymph nodes, which surround the IJV before draining via the thoracic duct into the subclavian vein
47
What is the most common cause of swelling in the neck?
Enlarged cervical lymph nodes
48
What may an enlarged lymph node signal?
Disease in the area it drains
49
What diseases can be indicated by an enlarged cervical lymph node?
* Infection *(most common)* * Malignancy
50
How do enlarged lymph nodes feel in infection?
* Tender * Mobile
51
How do enlarged lymph nodes feel in malignancy?
* Hard * Matted * Non-tender
52
What should be done if a lymph node is found to be enlarged?
* Comprehensive history * Examine area of tissue it drains * If malignancy is supsected, examine other lymph nodes and body systems
53
What is lymphodema?
An abnormal collection of protein-rich fluid causing tissue swelling due to compromised lymphatic system
54
What can cause lymphodema?
* Removal or enlargement of lymph nodes * Infections * Damage to lymphatic system * Lack of limb movement * Congenital
55
What kind of infections may cause lymphodema?
Certain parasites
56
How may the lymphatic system be damaged?
Cancer treatments
57
Why can lack of limb movement cause lymphodema?
Muscle contraction assists movement of lymph fluid
58
Give an example of a congenital condition that can cause lymphoedema?
Milroy's syndrome
59
When is the jugulo-digastric node swollen and tender?
In tonsillitis
60
When may the jugulo-omohyoid node be enlarged?
In infection or disease of tongue, oral cavity, trachea, oesophagus, or thyroid gland
61
When may supraclavicular lymph nodes be enlarged?
In late stages of malignancies of abdomen and thorax
62
Is an enlarged left supraclavicular lymph node always pathological?
No
63
What is Trosier's sign?
An enlarged, hard, left supraclavicular lymph node
64
What is Trosier's sign considered a sign of?
A sign of metastatic abdominal malignancy

ESA 4 - Head and Neck (30 decks)

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