Lymphatic vessels and nodes of head and neck
Last reviewed: 23.04.2024
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From the organs of the head lymph vessels deliver lymph to the lymph nodes, which lie in the form of small groups on the border of the head and neck [occipital, mastoid (ear), parotid, occlusal, facial, submandibular, chin]. From these nodes, lymph along the vessels goes to the superficial and deep lymph nodes of the neck (anterior, lateral, posterior), into which vessels from the neck organs also flow. The lymph nodes that carry the lymph nodes of the largest cervical chain - the lateral deep cervical (internal jugular) lymph nodes form the jugular (lymphatic) trunk.
Occipital lymph nodes (nodi lymphatici occipitales, total 1-6) lie on the superficial leaf of the cervical fascia, behind the place of attachment of the sternocleidomastoid muscle, and also under this leaf on the belt muscle of the head and under this muscle near the occipital blood vessels. Lymphatic vessels from the skin of the occipital region and from the deep tissues of the occiput approach the occipital lymph nodes. The endometrial lymphatic vessels of the occipital nodes are directed to the lateral deep cervical lymph nodes (nodes of the chain of the additional nerve).
The osteoplastic lymph nodes (nodi lymphatici mastoidei, only 1-4) are located behind the auricle on the mastoid process, at the attachment site of the sternocleidomastoid muscle. They take lymphatic vessels with lymph from the ear and the skin of the parietal region. The vascular lymph nodes of these nodes are directed to the parotid, superficial cervical (near the external jugular vein) and to the lateral deep cervical (internal jugular) lymph nodes.
Parotid lymph nodes (nodi lymphatici parotidei) are located in the area of the same salivary gland. Outside (lateral) of this gland are superficial parotid lymph nodes (1-4), and under the capsule of the gland and in the thick of the parotid gland, between its lobules, there are small, deep parotid (intragastular) lymph nodes (4-10). Lymphatic vessels from the skin and other organs of the frontal and parietal areas of the head, from the auricle, external auditory canal, auditory tube, upper lip, parotid gland are sent to the parotid lymph nodes. The vascular lymph nodes of these nodes approach the superficial (near the external jugular vein) and lateral deep (along the internal jugular vein) cervical lymph nodes.
Oropharynx lymph nodes (nodi lymphatici retropharyngeals, only 1-3) lie on the prevertebral plate of the cervical fascia behind the pharynx and on its lateral walls. These nodes are sent to the lymph vessels from the pharyngeal walls, the mucous membrane of the nasal cavity and the paranasal (accessory) sinuses, from the tonsils and the sky, the auditory tube and the middle ear drum. The outflowing lymphatic vessels of the peropharyngeal nodes flow into the lateral deep cervical (internal jugular) lymph nodes.
The mandibular lymph nodes (nodi lymphatici mandibulares, only 1-3) are unstable, lie in the subcutaneous base on the external surface of the body of the lower jaw, near the facial artery and vein. In the subcutaneous tissue (fiber) of the cheeks near the facial vessels there are also unstable (1-2) facial (buccal) lymph nodes (nodi lymphatici faciales, s.buccinatorii). The lymph nodes of these groups are guided by vessels from the skin of the face, soft tissues of the eyelid, nose, lips, cheeks. Their vascular vessels flow into the submandibular lymph nodes (nodi lymphatici submandibulares, total 6-8), which in the form of a chain lie under the body of the mandible in the submandibular triangle. Lymphatic vessels of submandibular junctions are directed down along the facial vein and flow into the lateral deep cervical (internal jugular) lymph nodes. The chin lymph nodes (nodi lymphatici submentales, total 1-8) are located on the underside of the chin and sublingual muscle, between the anterior abdominals of the right and left muscular muscles from the chin to the body of the hyoid bone.
The basis of the division of the lymph nodes of the neck is their relation to the superficial plate of the cervical fascia, and also to the large blood vessels of the neck. In connection with this, the surface cervical lymph nodes located on the surface plate and the deep ones located under it are isolated. Some regional groups of lymph nodes lie near the large vessels - the veins of the neck.
Surface cervical lymph nodes (nodi lymphatici cervicales superficiales, total 1-5), occurring in 3/4 cases, are located near the external jugular vein (1-3 nodes), on a trapezius muscle (1-2 nodes), in the posterior region of the neck and , rarely, near the anterior jugular vein (1 node). Their outgoing lymphatic vessels are directed to the lateral deep cervical lymph nodes, which lie near the internal jugular vein and the external branch of the accessory nerve.
Deep cervical lymph nodes (nodi lymphatici cervicales profundi) are concentrated in the anterior and lateral areas of the neck. To the anterior deep cervical lymph nodes are predgortane (nodi lymphatici prelaryngeales, only 1-2), thyroid (nodi lymphatici thyroidei, only 1-2), pre-tracheal (nodi lymphatici pretracheales, only 1-8), paratracheal (nodi lymphatici paratracheales, total 1-7), lying next to the trachea. In the lateral region of the neck there are numerous lymph nodes (11-68), which form several regional groups. These are lateral cervical deep (internal jugular) lymph nodes (nodi lymphatici cervicales laterales profundi, total 7-60). They are near the internal jugular vein; 1-8 lymph nodes in the form of a chain adjacent to the external branch of the accessory nerve. Near the superficial branch of the transverse artery of the neck is from 1 to 8 lymph nodes. In the lateral region of the neck there are also unstable lymph nodes (1-2), lying on the belt muscle of the head. According to the lymphatic vessels of these nodes, the lymph flows to the lateral cervical deep lymph nodes that adhere to the internal jugular vein from all its sides - from the base of the skull to the point of confluence with the subclavian vein. In the group of lateral cervical deep lymph nodes, a jugular-bipodermic node (nodus jugulodigastricus) and a jugular-scapular-hyoid node (nodus juguloomohyoideus) are isolated, to which mainly the lymphatic vessels of the tongue are directed. The first of these nodes is at the level of the intersection of the posterior abdomen of the digastric muscle with the internal jugular vein, and the second - at the place where the abdomen of the scapula is located on the surface of the anterior internal jugular vein.
The lymphatic vessels of the lateral cervical deep lymph nodes form on each side of the neck a jugular trunk (truncus jugularis, dexter et sinister). This trunk falls into the venous corner, or into one of the veins forming its corresponding side, or to the right lymphatic duct and the terminal thoracic duct (left).
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