Professional Documents
Culture Documents
of
Head and Neck
Introduction
• Lymph is removed from tissues by
lymphatic channels which drain into
regional lymph nodes.
• Efferent channels then drain to more
proximal nodes
• Their efferent then drain into major
veins in the root of neck.
• However, virtually, all nodes have
collateral channels which bypass the
node.
• This accounts for distant metastasis
without involvement of the primary
nodes.
Lymph Tissue of Head & Neck
• Head & Neck is drained by 2 groups of
lymphoid tissue namely:
– (1) Adenoid Tissue
– (2) Lymph Glands.
• (1) Adenoid Tissue surrounds the entrance to
pharynx and is called Waldeyer’s
Lymphatic Ring
• (2) Lymph Glands are arranged in:
(i) Circular Chain and (ii) Vertical Chain.
Lymphatics of the Head & Neck
Waldeyer’s Lymphatic Ring
• Superior:
– Pharyngeal Tonsils or adenoids.
– Site: on roof of pharynx.
• Inferior:
– Lingual tonsil at the base of tongue.
• Laterally:
– Palatine tonsils
Lymphatic Drainage:
– Jugulo-digastric node (superior deep
cervical nodes) main lymph gland of
tonsil
– Situated just below posterior belly of
digastric muscle & angle of lower
jaw and at the junction of common
facial and internal jugular veins
Waldeyer’s Lymphatic Ring
Lymph nodes of the Head and Neck
• Preauricular nodes:
– lie within parotid gland
– Drain temporal part, lateral surface
of auricle, anterior wall of external
meatus, and lateral part of eyelids
– Drain into deep cervical group
• Buccal node:
– lies over buccinator muscle on facial
vein
– drain into submandibular group
Posterior auricular and Occipital Nodes
• Retropharyngeal nodes:
– lie in retropharyngeal space,
between pharyngeal wall and
prevertebral fascia
– receive lymph from nasal part of
pharynx, auditory tube and upper
cervical vertebrae
• Laryngeal nodes:
– in front of larynx
• Tracheal nodes:
– lateral and in front of trachea
– receive from thyroid gland
Deep Cervical Lymph nodes
• Upper group:
– Receive lymph from posterior part
of the tongue, tonsil, ear, nose,
sinuses, upper part of pharynx and
larynx.
– Jugulo-digastric nodes lie just below
posterior belly of digastric muscle,
and is clinically palpable below
angle of mandible.
– Drain the back of tongue and tonsils
Lower group and Jugulo-omohyoid nodes
• Lower group:
– Receive lymph from anterior
part of face, scalp, anterior
two third of tongue, lower
part of pharynx and larynx
and thyroid gland.
– Jugulo-omohyoid nodes
related to intermediate
tendon of omohyoid muscle
and is concerned with
drainage of lymph from
anterior part of tongue
Lymphatic Drainage of the Tongue
Jugular Lymph Trunk