Session 3 - Lymphatic Drainage Of The Head And Neck Flashcards
Lymphatic vessels provide a route for the spread of what?
Infection
Malignancies
The lymphatics is a low pressure system, what keeps lymph fluid moving?
Muscle contraction
Pulsation of arteries
Valves
All lymph fluid eventually drains into one of what two main lymphatic ducts?
Right lymphatic duct
Thoracic duct
The right lymphatic duct and thoracic duct drain into what veins?
Subclavian veins
What is lymphoedema?
The abnormal collection of protein-rich fluid causing tissue swelling due to a compromised lymphatic system.
Give some possible causes of lymphoedema.
Removal or enlargement of lymph nodes Infections (e.g. certain parasites) Damage to the lymphatic system (e.g. cancer treatments) Lack of limb movement Congenital (e.g. Milroy’s syndrome)
How do lymph nodes act as a defence against infection?
Physical filter
Phagocytic filter
Full of lymphocytes - activate and proliferate in response to antigens
What is lymphadenopathy?
Enlarged lymph nodes
What are the two main causes of lymphadenopathy?
Infection (most common)
Malignancy
How does lymphadenopathy caused by infection differ to lymphadenopathy caused by malignancy?
Infection - lymphadenopathy is tender, mobile
Malignancy - lymphadenopathy is hard, matted, non-tender
Give examples of conditions that present with cervical lymphadenopathy.
Upper respiratory tract infection Glandular fever Stomach cancer Lung cancer Laryngeal cancer Lymphoma
What is the difference between a terminal and regional lymph node?
Regional - superficial, drain specific areas
Terminal - deep, receive drainage from a number of regional lymph nodes
In the neck, superficial (regional) and deep (terminal) lymph nodes are separated by what layer of cervical fascia?
Investing layer of deep cervical fascia
In the neck, most deep lymph nodes are associated with what blood vessel?
Internal jugular vein
Name the superficial (regional) lymph nodes of the head.
Submental Submandibular Pre-auricular Post-auricular Occipital
Name the superficial (regional) cervical lymph nodes and the blood vessels they are associated with.
Superficial - external jugular vein
Posterior - external jugular vein
Anterior - anterior jugular vein
What is Waldeyer’s ring?
Collection of lymphatic tissue (nodules) surrounding the entrance to the aerodigestive tracts. Consists of the tonsils.
Name the tonsils.
Pharyngeal tonsils (adenoids)
Tubal tonsils
Palatine tonsils
Lingual tonsils
Which tonsil of Waldeyer’s ring can you most readily view when examining a patient’s oropharynx?
Palatine
Name the deep cervical lymph nodes.
Jugulo-digastric
Jugulo-omohyoid
Supraclavicular
Which tonsil do you see as enlarged in tonsillitis?
Palatine
The jugulo-digastric node receives lymph drainage from where?
Palatine tonsil, oral cavity and the tongue.
The jugulo-omohyoid node mainly receives lymph drainage from where?
Tongue, oral cavity, trachea, oesophagus and thyroid gland.
Which deep cervical lymph node enlarges in tonsillitis?
Jugulo-digastric
The supraclavicular lymph nodes receive lymph drainage from where?
Abdomen and thorax
What does Virchow’s node refer to?
An enlarged left supraclavicular lymph node, which may not necessarily be pathogenic.
What does Trosier’s sign refer to?
An enlarged, hard left supraclavicular lymph node secondary to a metastatic abdominal malignancy.
Give some clinical manifestations of disease involving the lymphatic system.
Lymphoedema
Swollen lymph nodes
Cervical lymphadenopathy
Summarise the key roles of the lymphatic system.
Remove excess fluid from interstitial space.
Return small proteins and fluid to circulation.
Immune defence and immune surveillance:
- physical and phagocytic barrier
- lymphocytes
