Oro-facial lymphatics

Question 1

What does the lymphatic system do?

Answer 1

1. Removes excess fluid from the tissues of the body and returns it (as lymph) to the venous system
2. Carries fats from the GI tract to the venous system
3. Produces immune cells in the defence against infection and cancer

Question 2

What is fluid left in the tissues called and what happens after it is taken up the lymphatic vessels?

Answer 2

Excess fluid left in the tissues is called tissue fluid.

Once this fluid is taken up by lymphatic vessels it is called lymph.

Question 3

Give the drainage of lymph system for the grey area and the pink area.

Answer 3

• All the tissues in the grey area will eventually drain back to the thoracic duct

and then will drain into the left venous angle (which is formed by the left internal jugular vein and left subclavian vein joining together to form the left venous angle where the thoracic duct will drain into)

• The right lymphatic duct receives blood from the pink area of tissues and will drain into the right venous angle (which is formed of the right internal jugular vein and right subclavian vein)

Question 4

What is edema?

Answer 4

Odema is the abnormal collection of fluid in the tissues. (i.e lymphatic system is not working properly)

Question 5

How is lymph produced?

Answer 5

•Lymph is produced as blood flows through capillary beds in the anatomical structures of the head & neck (except the brain).

Question 6

What are Regional lymph nodes?

e.g what is the tip of the tongues regional lymph node?

Answer 6

The REGIONAL lymph nodes are the group of nodes which FIRST receive lymph from any given structure/area.

From the tip of the tongue the first regional lymph node which will receive fluid is called submental lymph nodes.

Question 7

What are the 2 groups of lymph nodes in the head and neck?

Answer 7

• the superficial ring
• the deep cervical nodes.

Question 8

What are the lymph nodes in the superficial ring?

Answer 8

Question 9

What is the first line of denfence in the oral cavity?

Answer 9

Waldeyer’s (defensive) Ring of lymphoid tissue.

Circumscribes the naso- and oropharynx, with some of its tonsillar tissue located above and some below the soft palate

Question 10

What is one of the most essential tonsilar functions?

Answer 10

The generation of B cells in the germinal centres of the tonsil.

Question 11

What node drains the palatine tonsil?

Answer 11

Jugulo-digastric node

Question 12

What is the Lymphatic Drainage of the Teeth & Gingivae?

Answer 12

Submental nodes first then

Submandibular nodes then

Deep cervical nodes

Question 13

What is the lymphatic drainage of the tongue?

(common exam question)

Answer 13

• Posterior 1/3rd:

drains BI-laterally to superior deep cervical nodes

• Anterior 2/3rds:

1. middle drains BI-laterally to inferior deep cervical nodes
2. tip drains BI-laterally to submental nodes
3. sides drain UNI-laterally to submandibular nodes