Lymphatic Drainage Of Head And Neck 5ux6y

LYMPHATIC DRAINAGE OF HEAD & NECK By Dr. Htar Htar Aung School of Medicine

Objectives At the end of this plenary, the students should be able to 1. describe the components of the lymphatic system. 2. describe the regional lymph nodes of head and neck. 3. describe the deep cervical lymph nodes. 4. apply the clinical importance of lymphatic drainage

Lymphatic system - provides for the drainage of surplus tissue fluid and leaked plasma proteins to the bloodstream - is also for the removal of debris from cellular and - decomposition provides a infection. (relatively)

predictable route for the spread of certain types of cancerous

COMPONENTS Lymph - tissue fluid (clear water) - is similar in composition to plasma. Lymphatic plexus - network of lymphatic capillaries Lymphatic Vessels (lymphatics) - a nearly bodywide network of thin-walled vessels - occur almost everywhere blood capillaries are found except teeth, bone, bone marrow and the central nervous system. Lymph nodes - small masses of lymphatic tissue Lymphoid organs - thymus, red bone marrow, spleen, tonsils,

Lymph Drainage of the Head and Neck Lymph nodes of the head and neck are arranged as - a regional collar that extends from below the chin to the back of the head and - a deep vertical terminal group that is embedded in the carotid sheath in the neck

1.Regional nodes From the nearby region & then drain to the Deep cervical nodes 2.Deep cervical nodes receive all the lymphatics from H&N -from deep cervical nodes to Jugular trunk Left. – Thoracic duct Right.-

Regional nodes L .nodes encircling the junction between H.&N. Occipital receive lymph from the back of the scalp Mastoid receive from the scalp above the ear, the auricle, and the external auditory meatus. Preauricular(Parotid) receive lymph from the scalp above the parotid gland, the

Sub mandibular -superficial to the submandibular salivary gland just below the lower margin of the jaw -receive from the front of the scalp; the nose; the cheek; the upper lip and the lower lip (except the central part); the frontal, maxillary, and ethmoid sinuses; the upper and lower teeth (except the lower incisors); the anterior two thirds of the tongue (except the tip); the floor of the mouth and vestibule; and the gums Submental Buccal(facial) - lymph from the tip of the tongue, the floor of the anterior part of in thethe cheek over the the lie mouth, buccinator incisor teeth, muscle the center part of the lower lip, and the skin over

Lymph nodes along superficial veins Anterior cervical - along anterior jugular vein - receive lymph from the skin and superficial tissues of the front of the neck Superficial cervical - along External Jugular Vein - drain lymph from the skin over the angle of

External jugular

Ant.jugular

Around the Viscerae  Retropharyngeal lie behind the pharynx and in front of the vertebral column. receive lymph from the nasal pharynx, the auditory tube, and the vertebral column • Laryngeal lie in front of the larynx. receive lymph from the larynx. • Tracheal

Deep Cervical nodes • Location -along Internal Jugular Vein in carotid sheath - receives the lymph from all groups from the regional nodes • -*Jugulo-digastric Located below and behind the angle of mandible drains from Tonsil & tongue

Deep cervical

Deep Cervical nodes • -*Jugulo-omohoid - posterior to Internal Jugular vein - close to the Omohyoid - drains from Tongue • -*Supra clavicular secondary eg. From Ca.Breast &

Deep cervical

Lymph nodes of Head & Neck

Clinical applications • Regional nodes can be palpated when enlarged Eg. Submandibular nodes in pathology of scalp, face, tongue, tooth or maxillary sinus

Palpation of submandibular lymph nodes

Examination of the Deep Cervical Lymph Nodes - should be examined from behind the patient. - by asking the patient to flex the neck slightly to reduce the tension of the muscles.

Palpation of supraclavicular lymph nodes

Clinical applications • Enlargement of Retropharyngeal node can cause “Dysphagia” • Deep cervical nodes Secondary Carcinomatous deposits in this group • Radical Neck Dissections - aim to remove all tissue that bears lymph nodes in one piece - Deep cervical lymph nodes and tissues around them are removed as completely as possible

- usually performed when cancer invades the cervical lymphatics

Thank You