Lymph nodes in head and neck are as follows:
a. Superficial group
b. Deep group
c. Deepest group
SUPERFICIAL GROUP
Buccal and Mandibular Nodes
The buccal node lies on the buccinator, and the mandibular node at the lower border of the mandible near the anteroinferior angle of the masseter, in close relation to the mandibular branch of the facial nerve.
They drain part of the cheek and the lower eyelid.
Their efferents pass to the anterosuperior group of deep cervical nodes
Preauricular Nodes
Drain parotid gland, temporal region, middle ear, etc
Their efferents pass to the posterosuperior group of deep cervical nodes
Occipital Nodes
The occipital nodes lie at the apex of the posterior triangle superficial to the attachment of the trapezius.They drain the occipital region of the scalp. Their efferents pass to the supraclavicular members of the posteroinferior group of deep cervical nodes
Anterior Superficial Cervical Nodes
The anterior cervical nodes lie along the anterior jugular vein and are unimportant.
The suprasternal lymph node is a member of this group.
They drain the skin of the anterior part of the neck below the hyoid bone.
Their efferents pass to the deep cervical nodes of both sides
Lateral Superficial Cervical Nodes
The superficial cervical nodes lie along the external jugular vein superficial to the sternocleidomastoid.They drain the lobule of the auricle, the floor of the external acoustic meatus, and the skin over the lower parotid region and the angle of the jaw.
Their efferents pass round both borders of the muscle to reach the upper and lower deep cervical nodes.
DEEP GROUP
1. Submental ond Submandibular Nodes
Submental nodes lie deep to the chin.These drain the lymph from tip of tongue and anterior part of floor of mouth.The submandibular nodes drain lateral surface of tongue, lower gums and teeth and central area of forehead.
2. Upper lateral Group around lnternal Jugular Vein
The jugulodigastric node is a member of this group.
It lies below the posterior belly of the digastric, between the angle of the mandible and the anterior border of the sternocleidomastoid, in the triangle bounded by the posterior belly of the digastric, the facial vein and the internal jugular vein.
It is the main node draining the tonsil.3. Middle Lateral Group around Internal Jugular vein
These drain thyroid and parathyroid glands. They receive efferents from prelaryngeal, pretracheal and paratracheal lymph nodes.
4. Lower Lateral Nodes around lnternal Jugular vein
The jugulo-omohyoid node is a this group.It lies just above the intermediate tendon of the omohyoid, under cover of the posterior border of the sternocleidomastoid.It is the main lymph node of the tongue.
5. Lymph Nodes in Posterior Triangle
Efferents of the deep cervical lymph nodes join together to form the jugular lymph trunks, one on each side.The left jugular trunk opens into the thoracic duct. The right trunk may open either into the right lymphatic duct, or directly into the angle of junction between the internal jugular and subclavian veins.
DEEPEST GROUP
Prelaryngeal and Pretracheal Nodes
The prelaryngeal and pretracheal nodes lie deep to the investing fascia,the prelaryngeal nodes on the cricothyroid membrane, and the pretracheal in front of the trachea below the isthmus of the thyroid gland. They drain the larynx, the trachea and the isthmus of the thyroid.
They also receive afferents from the anterior cervical nodes.Their efferents pass to the nearby deep cervical nodes.
Paratracheal NodesThe paratracheal nodes lie on the sides of the trachea and oesophagus along the recurrent laryngeal nerves. They receive lymph from the oesophagus, the trachea and the larynx, and pass it on to the deep cervical nodes.
Retropharyngeal Nodes
The retropharyngeal nodes lie in front of the prevertebral fascia and behind the buccopharyngeal fascia covering the posterior wall of the pharynx.
They extend laterally in front of the lateral mass of the atlas and along the lateral border of the longus capitis.They drain the pharynx, the auditory tube, the soft palate, the posterior part of the hard palate, and the nose.
Their efferents pass to the upper lateral group of deep cervical nodes.Waldeyer's ring comprises lingual, palatine, tubal and nasopharyngeal tonsils
MAIN LYMPH TRUNKS AT THE ROOT OF THE NECK
1. The thoracic duct is the largest lymph trunk of the body.It begins in the abdomen from the upper end of the cisterna chyli, traverses the thorax, andends on the left side of the root of the neck by opening into the angle of junction between the left internal jugular vein and the left subclavian vein Before its termination, it forms an arch at the level of the transverse process of vertebra C7 rising 3 to 4 cm above the clavicle.
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29 авг 2024