Lymphatics

From IKE

Head and neck

Basics

Superficial lymph glands and lymphatic vessels of head and neck.

There are several superficial regional groups of lymph nodes

Occipital

• at the apex of the posterior triangle. They drain the back of the scalp

Retro-auricular (mastoid)

• over the mastoid process
• They drain the scalp and part of the external auditory meatus

Parotid (pre-auricular)

• on or within the parotid gland
• They receive lymph from the scalp, upper face (including the eyelids), auricle, external auditory meatus, and middle ear

Submandibular

• over the superficial part of the submandibular gland
• They drain the anterior scalp, nose, face, posterior and lateral tongue, tonsils, teeth (except incisors) and associated gums

Submental

• in the submental triangle
• They drain centrally-located structures (e.g., tip of the tongue), anterior floor of the mouth, incisor teeth and associated gums, central parts of the face, lips and chin

Superficial cervical

• along the external jugular vein
• They receive lymph from skin over the angle of the jaw and parotid gland, and from the auricle

Deep cervical

• generally arranged along the internal jugular vein
• Some, however, may be detached from the main chain (e.g., retropharyngeal in the retropharyngeal space, laryngeal and tracheal)
• The deep cervical nodes receive lymph directly from neighbouring structures and from the other regional groups of nodes in the head and neck
• The lower, deep cervical nodes communicate with axillary nodes.

• Two of the deep cervical nodes are named individually:
  • jugulo-digastric
    • located where the internal jugular vein is crossed by the posterior belly of the digastric muscle
    • drains (directly or indirectly) the tonsils and lateral tongue
  • jugulo-omohyoid
    • located where the internal jugular vein is crossed by the posterior belly of the omohyoid muscle
    • drains the anterior tongue.

Drainage

• All superficial regional lymph nodes ultimately drain to deep cervical nodes which are associated with the internal jugular vein in the neck.
• Efferents of deep cervical nodes form the jugular lymph trunk, which drains into the thoracic duct (left) or right lymph duct (right), or directly into the origin of the corresponding brachiocephalic vein.

Resources

• Gross anatomy head and neck notes (PDF)