GENERAL SURGERY II RESEARCH
NAME: MENNA HAYTHAM KATAMISH 2024-
ID: 20236651 2025
Cervical lymph
nodes
[COMPANY NAME] | [Company address]
General surgery II research
Cervical lymph nodes
Cervical lymph nodes are lymph nodes found in the neck. Half of the lymph
nodes of the body are present in the neck and they’re classified into two
main chains which are the circular chain and the vertical chain. These lymph
nodes are subject to a few different pathological conditions including
tumors, infection and inflammation.
Aim of the research
This research aims to explain:
The classification of cervical lymph nodes
Drainage areas
Pathology
Clinical features and investigations
Treatment
Levels of cervical lymph nodes
Conclusion
references
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Classification of cervical lymph nodes
Cervical lymph nodes are classified in two main chains:
1. The circular chain
2. The vertical (longitudinal) chain
a) The circular chain
I. Inner (Waldeyer's ring).
II. Outer (submental ->occipital).
b) The vertical chain
I. Superficial group (scattered
a. nodes superficial to deep fascia)
II. Deep group (deep to deep
fascia) & consist of a median
and two lateral groups.
A)Circular Chain
I. Inner circular Layer
Waldeyer's lymphatic ring
The Waldeyer's lymphatic ring (also called Waldeyer's tonsillar ring) consists
of:
A single pharyngeal tonsil
A pair of tubal tonsils
A pair of palatine tonsils
A single lingual tonsil
Waldeyer's tonsillar ring, consisting of an unpaired pharyngeal tonsil on the
roof of the pharynx, paired palatine tonsils and lingual tonsils scattered in
the root of the tongue.
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II. Outer circular layer (paracervical
collar)
Consists of:
1. Submental LNs.
2.Submandibular LNs.
3.Parotid (preauricular) LNs.
4.Postauricular LNs.
5.Occipital LNs
B)The vertical Layer
I. Superficial VL
lymph nodes that lie superficial to deep fascia scattered in the
subcutaneous tissue.
It’s not of surgical importance.
They are divided into:
Superficial anterior cervical; along the anterior jugular vein.
Superficial lateral cervical; along the external jugular vein in the
posterior triangle
II. The Deep Vertical Layer
This layer constitutes the major head and neck lymph node groups.
It includes:
Upper deep cervical; above the level of hyoid bone, and along the
internal jugular vein.
Middle deep cervical; between the level of hyoid bone and cricoid
cartilage, and along the internal jugular vein.
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Lower deep cervical; below the level of cricoid cartilage, and along
the internal jugular vein
Supraclavicular nodes; in the posterior triangle.
Draining Areas of cervical Lymph Nodes
The superficial anterior cervical lymph nodes that are situated adjacent to
the anterior jugular vein. These nodes drain lymph from the infrahyoid
region, isthmus of the thyroid gland, inferior larynx to the deep lateral
cervical lymph nodes.
The deep anterior cervical lymph nodes that are situated mostly in the
midline and can be divided into four groups of nodes including the
prelaryngeal, thyroid, paratracheal and pretracheal nodes. They drain lymph
from the larynx, trachea, and thyroid to the deep lateral cervical lymph
nodes.
The superficial lateral cervical lymph nodes that are situated adjacent to the
external jugular vein. They drain lymph from the parotid nodes to the
supraclavicular nodes.
The deep lateral cervical lymph nodes that are situated adjacent to the
internal jugular vein. They can be subdivided into superior and inferior
groups. These nodes receive the majority of lymph from the head and neck
region and drain to the jugular trunk.
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The accessory lymph nodes that are the most lateral group of cervical
nodes, located adjacent to the accessory nerve. These nodes drain lymph
from the lateral neck, pharynx and shoulder regions and empty them into
the supraclavicular nodes.
The supraclavicular lymph nodes that are situated at the root of the neck.
These nodes receive lymph from the deep lateral cervical lymphatic vessels
and empty into the jugular trunk on each side.
The retropharyngeal lymph nodes are situated posterior to the pharynx.
These nodes receive afferents from the nasal cavities, paranasal sinuses,
soft palate, palatine arch, outer and middle ear and drain into the superior
and inferior deep lateral cervical lymph nodes of the neck.
Common treatments for swollen cervical lymph
nodes
If you’re experiencing common, mild swelling, there are a few options
available to help manage it either directly or indirectly, such as:
Antibiotics
Antivirals
NSAIDs as Ibuprofen (Advil)
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Enough rest
Warm and wet washcloth compress
On the other hand, if the lymph nodes are swelling because of cancerous
growth, treatment may include:
Chemotherapy
Irradiation therapy
Surgical removal of the LN
Levels of cervical LNs
It is divided into six levels as follows:
I- Submental and submandibular nodes
II- Upper jugulodigastric group
III- Middle jugular nodes draining naso- and oropharynx, oral cavity,
hypopharynx, larynx.
IV- Inferior jugular nodes draining hypopharynx, subglottic larynx, thyroid,
and esophagus.
V- Posterior triangle group
VI- Anterior compartment group
Conclusion
In summary, all lymphatic vessels from the head and neck drain directly or
indirectly into the deep cervical lymph nodes. The lymph from these deep
nodes passes to the jugular lymphatic trunk, which joins the thoracic duct
on the left side and the internal jugular vein or brachiocephalic vein on the
right side
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References
Kirk's General Surgical Operations textbook
Oxford academic
ResearchGate research papers
Radiopaedia.org
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