CERVICAL LYMPHADENECTOMY

Lymphadenectomy is the surgical removal of one or more groups of lymph nodes. It is almost always performed as part of the surgical management of cancer. In the treatment of head and neck cancer, three areas must be addressed: the primary site, the neck, and sites of distant metastasis. Of these, disease in the neck is the least straightforward.

http://www.evmsent.org/neck_dissection.asp

level IIb: Submuscular recess Superior: Skull base Inferior: Carotid bifurcation (surgical) or inferior border of hyoid bone (radiologic) Lateral: Posterior border of sternocleidomastoid Medial: Spinal accessory nerve (surgical) or medial border of internal carotid (radiologic)

Clinical Significance Dissection of this group involves significant risk for shoulder dysfunction. In the absence of nodal disease in level IIa, it is not necessary to include level IIb for cancers of the oral cavity or larynx.

level III: Midjugular Superior: Carotid bifurcation (surgical) or inferior border of hyoid bone (radiologic) Inferior: Omohyoid muscle (surgical) or inferior border of cricoid (radiologic) Lateral: Posterior border of sternocleidomastoid Medial: Sternohyoid muscle (surgical) or medial border of common carotid (radiologic)

Clinical Significance There is a risk of malignancy from the oral cavity, nasopharynx, hypopharynx, and larynx.

http://www.imaios.com/en/e-Anatomy/Thorax-AbdomenPelvis/Lymph-nodes-CT

http://www.aafp.org/afp/2002/1201/p2103.html

http://thefosti.kilu.de/

Region Of Pharynx

http://quizlet.com/2554906/gi-system-flash-cards/

1. Nasopharynx - Nose open to the nasopharynx through choanae - Roof and posterior wall are lined inferior to the body of sphenoid bone and basilar part of the occipital bone - contains pharyngeal tonsil (adenoid) at the mucous of the roof and posterior wall - Lateral wall contains pharyngotympanic tube and salpingopharyngeal fold (salpingopharyngeus muscle) and tubal tonsil and pharyngeal recess

2.Oropharynx

http://biology.clc.uc.edu/fankhauser/labs/micr obiology/strep_detection/strep_test.htm

-Bound by soft palate, tongue and palatoglossal and palatopharyneal arches - Function in the deglutition (swallowing) - Contains palatine tonsil

3. laryngopharynx

- Extends from the superior border of the epiglottis and pharyngoepiglottic folds to the inferior border of the cricoid cartilage - Posterior and lateral wall are line by middle and inferior constrictor muscles and palatopharyngeus and stylopharyngeus - piriform recess (fossa) = a small depression of the laryngeal cavity on each side of the laryngeal inlet