Download MBBS Anatomy PPT 45 Anatomy Of Neck Notes

--- Content provided by‍ FirstRanker.com ---

? They are soft non palpable structure

? Draining infected , inflamed or area involved in

carcinomatous changes will cause the nodes to

--- Content provided by FirstRanker.com ---

become swollen , hard , painful and palpable

? They prevent disease from reaching major

--- Content provided by‌ FirstRanker.com ---

lymphatic channels

? Position of nodes denotes general location of

infection

--- Content provided by‌ FirstRanker.com ---

Lymphatic Drainage Of Head and Neck

Lymph nodes in the head and neck are

--- Content provided by⁠ FirstRanker.com ---

arranged in

A. Two horizontal rings and

B. Two vertical chains on either side of the

--- Content provided by​ FirstRanker.com ---

neck.

Lymphatic Drainage Of Head and Neck

--- Content provided by​ FirstRanker.com ---

A. Two horizontal rings

a) Outer superficial ring (pericervical ring.)
at junction of head and neck consists of

--- Content provided by FirstRanker.com ---

?

Occipital

?

--- Content provided by‌ FirstRanker.com ---

Retro-auricular

?

--- Content provided by‍ FirstRanker.com ---

preauricular (parotid)

?

submandibular

--- Content provided by⁠ FirstRanker.com ---

?

submental nodes

--- Content provided by⁠ FirstRanker.com ---

S. No

Nodes

--- Content provided by‍ FirstRanker.com ---

Location

1

Occipital (2-4)

--- Content provided by FirstRanker.com ---

Superior nuchal line between

sternocleidomastoid and

--- Content provided by‌ FirstRanker.com ---

trapezius

2

Mastoid (1-3),or

--- Content provided by‍ FirstRanker.com ---

Superficial to

Retroauricular

--- Content provided by​ FirstRanker.com ---

sternocleidomastoid

insertion

3

--- Content provided by FirstRanker.com ---

Preauricular (2-3)parotid

Anterior to ear over parotid

--- Content provided by​ FirstRanker.com ---

fascia

S.NO

Nodes

--- Content provided by​ FirstRanker.com ---

Location

4

--- Content provided by FirstRanker.com ---

Parotid (up to 10 or

About parotid gland

more)

--- Content provided by‌ FirstRanker.com ---

and under parotid
fascia
Deep to parotid
gland

--- Content provided by⁠ FirstRanker.com ---

5

Submental (2-3)

--- Content provided by⁠ FirstRanker.com ---

Submental triangle

6

Submandibular

--- Content provided by‌ FirstRanker.com ---

Submandibular

(3-6)

--- Content provided by​ FirstRanker.com ---

triangle adjacent
to submandibular
gland

Few Outlying Nodes

--- Content provided by​ FirstRanker.com ---

Facial

Superficial(up to 12) Distributed along

--- Content provided by‍ FirstRanker.com ---

Skin and mucous

Submandibular

Maxillary

--- Content provided by‌ FirstRanker.com ---

course of facial

membranes of

--- Content provided by‌ FirstRanker.com ---

nodes

Buccal

artery and vein

--- Content provided by​ FirstRanker.com ---

eyelids, nose, cheek

Mandibular
Deep

--- Content provided by‌ FirstRanker.com ---

Distributed along

Temporal and

--- Content provided by‌ FirstRanker.com ---

Superior deep

course of maxillary

infratemporal fossa cervical lymph

--- Content provided by FirstRanker.com ---

artery lateral to

Nasal pharynx

--- Content provided by‍ FirstRanker.com ---

nodes

lateral pterygoid

muscle

--- Content provided by‍ FirstRanker.com ---

Lymphatic Drainage Of Head and Neck

A. Two horizontal rings

--- Content provided by‍ FirstRanker.com ---

b) Inner deep ring is formed by clumps of
mucosa associated lymphoid tissue (MALT) located
primarily in the naso- and oro-pharynx (Waldeyer's
ring).

--- Content provided by‍ FirstRanker.com ---

Waldeyer's tonsil ar ring, consist of

a) Unpaired pharyngeal tonsil in the roof of the pharynx,

--- Content provided by​ FirstRanker.com ---

b) Paired palatine tonsils and

c) Lingual tonsils scat ered in the root of the tongue.

Superficial and deep vertical Chains of cervical

--- Content provided by FirstRanker.com ---

nodes

a) Superficial Vertical Chain

--- Content provided by⁠ FirstRanker.com ---

I. Along external Jugular vein-called

superficial cervical LN

I . Along anterior Jugular vein- called

--- Content provided by⁠ FirstRanker.com ---

anterior cervical LN

Superficial Vertical Chain

--- Content provided by FirstRanker.com ---

i. Along external

Jugular vein-called

superficial cervical

--- Content provided by​ FirstRanker.com ---

LN

i . Along anterior

--- Content provided by‍ FirstRanker.com ---

Jugular vein- called

anterior cervical LN

--- Content provided by⁠ FirstRanker.com ---

Deep vertical chain

consists of superior and

inferior groups of deep

--- Content provided by‍ FirstRanker.com ---

cervical nodes related

to the carotid sheath

--- Content provided by​ FirstRanker.com ---

Deep cervical glands

Numerous and of large size:

Form a chain along the carotid sheath, lying by

--- Content provided by​ FirstRanker.com ---

the side of the pharynx, esophagus, and trachea,

and extending from the base of the skull to the root

--- Content provided by FirstRanker.com ---

of the neck.

Deep cervical glands

They are usually described in two groups:

--- Content provided by​ FirstRanker.com ---

(1) Superior deep cervical glands lying under the

Sternocleidomastoid in close relation with the internal

--- Content provided by FirstRanker.com ---

jugular vein, some of the glands lying in front of and others

behind the vessel;

Jugulodigastric LN- Part of superior deep cervical group

--- Content provided by​ FirstRanker.com ---

of LN at Junction of internal jugular vein and posterior

digastric muscle
Deep cervical glands

--- Content provided by‍ FirstRanker.com ---

They are usually described in two groups:

(2) Inferior deep cervical glands may extend beyond the

--- Content provided by‍ FirstRanker.com ---

posterior margin of the Sternocleidomastoideus into the

supraclavicular triangle, where they are closely related to

the brachial plexus and subclavian vein.

--- Content provided by‍ FirstRanker.com ---

Jugulo-omohyoid - Above junction of internal jugular vein

and omohyoid muscle

--- Content provided by⁠ FirstRanker.com ---

Few outlying LN

Accessory (2-6)

Along accessory

--- Content provided by⁠ FirstRanker.com ---

Occipital nodes

Transverse cervical

--- Content provided by⁠ FirstRanker.com ---

nerve in posterior

Mastoid nodes

nodes

--- Content provided by‌ FirstRanker.com ---

triangle

Lateral neck and

--- Content provided by‍ FirstRanker.com ---

shoulder

Transverse cervical Along transverse

Accessory nodes

--- Content provided by‌ FirstRanker.com ---

Jugular trunk or

(1-10)

--- Content provided by​ FirstRanker.com ---

cervical blood

Apical axillary nodes directly into thoracic

vessels at level of

--- Content provided by FirstRanker.com ---

Lateral neck

duct or right

--- Content provided by‍ FirstRanker.com ---

clavicle

Anterior thoracic

lymphatic duct or

--- Content provided by‌ FirstRanker.com ---

wall

independently into

--- Content provided by​ FirstRanker.com ---

junction of internal

jugular vein and

subclavian vein

--- Content provided by FirstRanker.com ---

All lymph vessels of the head and neck drain

into the inferior deep cervical nodes, either

--- Content provided by​ FirstRanker.com ---

directly from the tissues or indirectly via

nodes in outlying groups.

--- Content provided by​ FirstRanker.com ---

Paravisceral deep nodes-

? Retropharyngeal(lie in the buccopharyngeal

--- Content provided by​ FirstRanker.com ---

fascia, behind the upper part of the pharynx )

? Infrahyoid (Ant. to thyrohyoid membrane )
? Prelaryngeal( On conus elasticus and cricovocal

--- Content provided by FirstRanker.com ---

membrane)

? Pretracheal(Ant to trachea)
? Paratracheal(Along RLN)
? Subclavian(Subclavian triangle)

--- Content provided by‍ FirstRanker.com ---

Deep vertical chain receive in addition to direct

area of drainage

--- Content provided by‍ FirstRanker.com ---

- All efferent from pericervical ring
- Efferents from superficial cervical nodes
- Efferents from other paravisceral deep nodes-retropharyngeal,

infrahyoid,prelaryngeal,pretracheal,paratracheal,subclavian

--- Content provided by⁠ FirstRanker.com ---

Final drainage of lymph

All lymph from head and neck finally drain to ipsilateral

lower deep cervical LN- Terminal group

--- Content provided by‍ FirstRanker.com ---

Efferent- Jugular lymph trunk- terminate at or near

jugulosubclavian venous junction

--- Content provided by‍ FirstRanker.com ---

On left side usually joins the thoracic duct

on the right side either joins the right lymphatic duct or

empties independently at the junction of the IJV and

--- Content provided by⁠ FirstRanker.com ---

subclavian vein