Lymphatics of the Head & Neck Flashcards
What are the three main function of the lymphatic system?
Transports large protein molecules from tissue fluid into the bloodstream, returns excess tissue fluid to bloodstream, produces lymphocytes
What are lymph nodes?
Swellings found along the lymphatic system
What are the functions of lymph nodes?
Produce lymphocytes, filter lymph thus preventing foreign bodies from entering bloodstream
What type of lymph vessels drain lymph to a node?
Afferent
What type of lymph vessels drain lymph from a node?
Efferent
What is a good way to remember which type of lymph vessel leaves a node?
Efferent = Exit
Are lymph vessels always specific to a node?
Yes
What is the difference between the enlargement of a gland or node topographically speaking?
Glands are wholesome enlargements while nodes are lumpy
What are the three superficial nodes of the head?
Occipital, mastoid, and parotid
What are the four superficial nodes of the neck?
Submandibular, submental, anterior cervical, superficial cervical
Which lymph nodes are usually palpable?
Occipital, mastoid, parotid, submandibular, submental, anterior cervical, superficial cervical
Where can the occipital superficial nodes be found?
Where the trapezius muscle meets the sternocleidomastoid
Where can the mastoid superficial nodes be found?
Behind the ear
Where can the parotid superficial nodes be found?
In front of the ear
Which superficial nodes of the neck must be palpated with less force and why?
Submandibular, highly vascular area
Which nodes form as a chain on the external surface of the sternocleidomastoid and follow the course of the external jugular vein?
Superficial cervical
Why are the deep cervical nodes not palpable?
Due to carotid sheath and being internal to the sternocleidomastoid
Which nodes follow the course of the internal jugular vein?
Deep cervical
Which node drains the tongue?
Jugulodigastric and jugulo-omohyoid nodes
Which deep cervical node is found near the posterior belly of the digastric muscle?
Jugulodigastric node
Which deep cervical node is found near the intermediate tendon of the omohyoid?
Jugulo-omohyoid node
All lymphatics of the head and neck drain directly or indirectly into which nodes?
Deep cervical nodes
What form the right and left jugular trunks?
Efferents of the deep cervical nodes
Which jugular trunk drains into the junction between the internal jugular and subclavian veins?
Right jugular trunk
Which jugular trunk drains into the thoracic duct?
Left jugular trunk
What is the largest lymph vessel in the body?
Thoracic duct
Where does lymph go after reaching the jugular trunks?
Bloodstream
How is lymph moved throughout the system?
Skeletal muscular contraction
Because skeletal muscle contraction is associated with lymph movement, what two things could be useful for preventing lymphatic issues?
Exercise (clears toxins from tissues) & massage
What bodily system is useful for tracking the spread of cancer cells?
Lymphatic system
What do afferents of the submental nodes drain?
Central portions of the lower lip, floor of mouth, and tip of the tongue
What do afferents of the submandibular nodes drain?
Cheek, side of nose, upper lip, lateral part of lower lip, gums, and margin of the tongue
What is the term for the spread of cancer via the lymphatic system?
Lymphogenous metastasis
What is another name for a signal node?
Sentinel node
What is a sentinel node?
An enlarged supraclavicular node, usually on the left side
What is significant about sentinel nodes from a clinical viewpoint?
Often the first indication of a visceral tumor of the thorax or abdomen
What is a lymphoma?
A primary tumor of the lymph nodes
To what age do those with Hodgkin’s Disease usually live?
20s-30s
To what age do those with non-Hodgkin’s Disease usually live?
Rarely past 2 years (poor prognosis)
What does a tender or painful enlarged lymph node typically indicate?
Infection
What does a hard and painless enlarged lymph node typically indicate?
Cyst development or cancer
What is filariasis?
Parasitic infection of lymph nodes (worms)
What three things make up a breast?
Mammary glands, fat, and fibrous tissue
Between which ribs is the breast located?
Second and sixth
Between what two features is the breast located?
Sternum and midaxillary line
What is the midaxillary line?
A vertical line dividing the armpit into anterior and posterior halves
Where is the nipple usually located in terms of ribs?
Fourth intercostal space
What is the areola?
Ring of pigmented skin which surrounds the nipple
What is the axillary process (tail)?
Portion of the breast which extends back into the armpit
What part of the breast is a frequent site for cancer?
Axillary process
What are the suspensory ligaments of the breast?
Strong fibrous septa which support the breast and which run through the breast from the skin to the deep layer of superficial fascia
What type of gland is a mammary gland?
Modified sweat gland
Where is the mammary gland located?
In the superficial fascia
How much glandular tissue does each mammary gland possess?
15-20 lobes
To where does each lobe of glandular tissue of the mammary gland open?
Onto the tip of the nipple through a lactiferous duct
What is a lactiferous sinus?
An expansion of the lactiferous duct which serves as a reservoir for milk during lactation
Why is it important to have more than one lactiferous duct?
In case of blockage
What arteries make up the blood supply to the breast?
Internal thoracic, thoracoacromial, lateral thoracic, and intercostal arteries
What percentage of lymph from the breast drains into the axillary nodes?
75%
To which four locations does lymph drain from the breast?
Axillary nodes, parasternal nodes, nodes of the opposite breast, and nodes of the anterior abdominal wall
What is the most common female cancer?
Breast
Before entering the bloodstream, where does breast cancer spread to?
Lymphatics
Where does breast cancer typically spread to first?
Axilla
To where do the posterior intercostal veins drain?
Azygos and hemiazygos veins
How does breast cancer spread to the vertebral column and brain?
Through connections to the vertebral venous plexus
What are the three clinical signs of breast cancer?
Dimpling, inverted nipples, leathery thickening of skin
Why does dimpling occur in breast cancer?
Due to invasion of suspensory ligament
Why do inverted nipples occur in breast cancer?
Due to invasion of lactiferous ducts
What is the a big chiropractic note about breast cancer?
It is one cause of midthoracic back pain in females
