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Lymphatic System of The Head & Neck

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The Lymphatic SystemA drainage system ( one way ) that is responsible for removal of

extra fluid from tissue spaces & return it to the blood

Consists of:

1. Lymphatic vessels

tubes similar in their str. to ??

transport lymph

2. Lymphatic tissues

No circulation in lymphatic system

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Lymphatic TissueC.T. structures that contain large number of

lymphocytes (immune cells)

- They help defend the body against disease causing agents

ThymusSpleen

Tonsils

Lymph NodesLymph nodules (GIT, appendix)

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Lymphatic system is a connectionbetween two body systems:

Lymph Vessels:C.V.S.

Lymph Tissue:

Immune System

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The LymphThe name given to tissue fluid once it has entered

a lymphatic vessel through lymphatic capillary

Fluid within the blood Plasma

Plasma filter through bld. Capillariesinto tissue spaces interstitial fluid

Interstitial fluid passes into lymphvessels lymph

Lymph = interstitial fluid + lymphocytes

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Functions of The Lymphatic System

1. Draining excess interstitial fluid

2. Carrying out immune response:initiating highly specific immune mechanism by T & B

lymphocytes

T-cells : release of cytotoxic (cell-killing) substancesB-cells : plasma cells ??

3. Transporting dietary lipids & lipid soluble vitamins:A (?), D(?), E, & K

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Lymphatics of The Head & Neck

Regional Groups of Lymph Nodes:11 groups

Waldeyers Tonsillar Ring:

4 kinds (?)

Terminal Group of Lymph Nodes:DCL

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Regional Groups of Lymph Nodes

2 post. part of the head:occipital & mastoid

2 ant. part of the head:

parotid & buccal

2 beneath the mandiblesubmental & submandibular

2 along superficial jugular veins

ant. Cerv. & superficial cerv.

3 deep, related with organs:

retropharyngeal

laryngeal

tracheal

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Regional Groups of Lymph Nodes

3 Questions

Where each one is located?(Location)

Where they receive lymph from?(Afferent vessels)

Where they drain lymph into?

(Efferent vessels)

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Occipital Lymph Nodes

Over occipital BoneAt the apex of ?

Afferent V.:back of SCALP

Efferent V.:DCLN

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Mastoid (Retroauricular) Lymph Nodes

Over lat. surface ofmastoid process

Afferent V.:SCALP auriclepost. Med. Auriclepost. Wall of EAM

Efferent V.:DCLN

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Parotid Lymph Nodes

On or in the parotid gland

Afferent V.:SCALP parotidlat. surface of auricle

ant. wall of EAMlat. eyelidsmiddle ear (nodes in g.)

Efferent V.:DCLN

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Buccal Lymph Nodes

Over buccinator m.Close to ?? V.

Afferent V.:ant. SCALP & forehead

ant. Part of faceNose

Efferent V.:

??

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Submandibular Lymph NodesWithin submandibular

Superficial to submand. Sv.G.*deep to??

Afferent V.:buccal L.N.Upper liplat. Lower lipfrontal, max. & ethmoidal airsinuses

upper & lower teeth, Except?gingiva, Except?Floor of mouth

Efferent V.: ??

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Submental Lymph Nodes

Within submental

Afferent V.:tip of tongue

lower incisors & associatedgumscentral lower lip

Efferent V.:submandibular L.N.

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Anterior Cervical Lymph Nodes

Along the course of ?

Afferent V.:ant. neck

Efferent V.:DCLN

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Superficial Cervical Lymph Nodes

Along the course of ?

Afferent V.:angle of mandible

lobule of auricle

Efferent V.:DCLN

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Waldeyers Tonsillar Ring

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Waldeyers Tonsillar Ring

Pharyngeal Tonsil:single, roof of ??

Tubal Tonsils:on lat. Walls of ??

Palatine Tonsils:on lat. Walls of ??

Lingual Tonsil:single, floor of ??

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Deep Cervical Lymph Nodes

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DCLNA chain of L.N. located along the course of ?? and

mainly on its ?? Aspect

Extends from the base of the skull to the root of the neckWithin which fascial layer??

Afferent V.: receive lymph from all lymphatic structures in

the head & neck

Efferent V.: join to form Jugular lymph trunk

Rt. Lymphatic duct or thoracic duct

Venous system ( where? )

* 2 clinically important Nodes: jugulodigastric & jugulo-omohyoid

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Jugulodigastric NodeMost sup. Node of DCLN

Below & behind angle ofmandible

Lymph drainage from:

1.? 2.?

Jugulo-omohyoid NodeOn or close to intermediate

tendon of omohyoid m.

Lymph drainage from:1.?

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Enlargement of Lymph Nodes

Enlarged L.N. is an indication of either an inflammatory process (viral or bacterial infection) or tumor in the region that drainsinto this node

Examination of the nodes is very important in determining the

nature of the pathological process:

- Soft & tender enlarged nodes acute inflammatory process(infection)

Example: Tonsilitis: ?? Nodes

- Firm multinodular or large volume rubbery nodes tumorspread (metastasis)

Example: Lymphoma