Lymphatics of the Head & Neck - Herring Flashcards
The face, scalp, and
skin/subcutaneous tissue of the neck drain to what lymph nodes
Superficial
Superficial lymphnodes drain to ______ network
Deep
All deep lymph nodes surround the
IJV
deep LNs form the
jugular trunks
The jugular trunks drain into what 2 ducts
thoracic duct
right lymphatic duct
The occipital region of the scalp drains to what lymph nodes
occipital LNs
The occipital LNs empty to what LNs ? what levels ?
superior deep cervical LNs
level 5 to level 3
The parietal region can drain to 2 LNs, what are they
mastoid nodes and parotid nodes
where do the mastoid LNs drain to ________ and then _________
the lateral cervical nodes ; superior deep cervical nodes
level 5 to level 3
where to the parotid LNs drain to
superior deep cervical nodes
Level 2
the parotid nodes drain what?
the lateral face
where do the parotid nodes empty primarily to
superior deep cervical nodes
level 2
where do a smaller percentage of parotid nodes drain to
lateral cervical nodes along the EJV (level 5 to level 3)
the mid portion of the face (inferior eyelids, nose, cheek, superior lip, lateral aspects of inferior lip) drains towards the _______ nodes
facial
the facial nodes empty to what nodes and then to what nodes
submandibular nodes (level 1b to level 2) ; superior deep cervical nodes
the chin, medial lower lip, mandbular incisors & gingivae, and tip of tongue drain to the
submental nodes
the primary route the submental nodes drain to is to the
superior deep cervical nodes (level 2)
a smaller percentage the submental nodes drain to is to the
submandibular nodes (level 1b)
all of the following drain to where:
facial nodes
maxillary sinus
palate
sublingual glands
submandibular glands
anterolateral tongue
anterior nasal cavity
all maxillary teeth (e/x 3rd molar)
all mandibular teeth (e/x incisors)
submandibular lymph nodes
the submandibular nodes drain to what
superior deep cervical nodes (level 2)
what 5 structures form the superficial horizontal ring
submental
submandibular
parotid
mastoid
occipital
what cervical nodes drain skin and muscles of the infrahyoid region
anterior cervical nodes
the anterior cervical nodes empty to
inferior deep cervical nodes (level IV)
the lateral cervical nodes travel with the
EJV
what drains the lower ear and partoid region
lateral cervical nodes
the lateral cervical nodes empty to lymph nodes in the
posterior triangle (level 5)
LNs in the posterior triangle empty to what cervical nodes
superior and inferior deep (levels 3-4)
What nodes are between investing layer of deep cervical fascia and viscera of neck
deep anterior cervical (juxtavisceral) nodes
the trachea, larynx, and thyroid glands are drained by what nodes
deep anterior cervical (juxtavisceral) nodes
the deep anterior cervical (juxtavisceral) nodes are composed of 3 groups, what are they
paratracheal
pretracheal
prelaryngeal
paratracheal LNs empty to
inferior deep cervical nodes (level IV)
pretracheal LNs empty to
inferior deep cervical nodes (level IV)
prelaryngeal LNs empty to
superior deep cervical nodes (level III)
what LNs are located in the buccopharyngeal fascia at the level of atlast (extend to C2/3)
retropharyngeal nodes
The following structures are drained by what LNs:
- Nasal cavity
- Paranasal sinuses
- Hard & soft palate
- Nasopharynx
- Posterior tongue
retropharyngeal nodes
The retropharyngeal nodes empty to what nodes
superior and inferior deep cervical nodes (levels 2, 3, 4)
A deep ring on lymphatic tissue is called _______ ring
Waldeyer’s
Waldeyer’s ring forms around entrance to
GI tract
Waldeyer’s Ring consists of what 4 tonsils
palatine
lingual
pharyngeal
tubal
what lymph nodes receive ALL lymph from head & neck
deep cervical (internal jugular) nodes
the deep cervical (internal jugular) nodes empty via the _______ to what ducts
jugular trunks to thoracic duct (left side) or lymphatic duct
the superior deep cervical chain is superior to the
omohyoid
what levels is the superior deep cervical chain
levels 2 and 3
the superior deep cervical chain drain to the
inferior deep cervical chain
the inferior deep cervical chain is at or inferior to the
omohyoid
what drains the superior deep cervical chain and superficial cervical nodes (levels 2, 3, 5, 6)
inferior deep cervical chain
what level/group receives drainage from skin of the mental region, mid-lower lip, tip
of the tongue, anterior floor of the mouth, mandibular incisors
Level 1A / submental group
what are the assoicated primary malignancies with Level 1A/submental group
Malignancies of the floor of the mouth, tip of the tongue, anterior mandibular alveolar ridge, and medial lower lip
what level/group receives drainage from level 1A, lower nasal cavity, hard & soft palates, maxillary & mandibular alveolar ridges (most), skin & mucosa of cheek, upper lip, lateral lower lip, anterolateral tongue, sublingual gland, submandibular gland, maxillary sinus, lower eyelid
Level 1B / submandibular group
what are the assoicated primary malignancies with Level 1B/submandibular group
Malignancies from most of oral cavity, soft tissues of mid-face, submandibular gland
What is the most commonly involved LN level
Upper Jugular Group (subdivides parotid space into 2, 3, 4)
What level/group receives drainage from levels 1A & 1B, lateral face, parotid gland, parotid nodes, retropharyngeal nodes, nasal cavity, upper pharynx, ear
Level 2 / upper jugular group
what are the associated primary malignancies with Level 2/ upper jugular group
Malignancies of nasal and oral cavities, nasopharynx, oropharynx, major salivary glands
what level / group receives drainage from level II and V, retropharyngeal, prelaryngeal
(level VI), base of tongue, palatine tonsils, larynx,
laryngopharynx, thyroid gland
Level 3 / middle jugular group
what are the associated primary malignancies with level 3 / middle jugular group
Malignancies of oral cavity, nasopharynx, oropharynx, laryngopharynx, and larynx
What level/group receives drainage from levels III and V, retropharyngeal, pretracheal,
paratracheal (level VI), larynx, laryngopharynx, thyroid gland, cervical trachea, cervical esophagus
Level IV / lower jugular group
what are the associated primary malignancies with level IV / primary jugular group
Malignancies of the laryngopharynx, lower larynx, cervical trachea, cervical esophagus, thyroid gland
What level/group receives drainage from occipital, mastoid lymph nodes (small percentage of parotid nodes), skin of lateral and posterior neck and shoulder, pharynx
Level V / posterior triangle group
what is the associated primary malignancy of level V / posterior triangle group
malignancies of the pharynx
what level / group receives drainage from the skin of anterior neck, lower face, floor of mouth, larynx, thyroid gland
level VI / anterior group
What are the associated primary malignancies of Level VI / anterior group
Malignancies of lower lip & chin (advanced gingiva-mandibular carcinoma), floor of mouth, thyroid gland, larynx