CERVICAL LYMPH NODES

DEPT OF ANATOMYARMED FORCES MEDICAL COLLEGE

PUNE- 411040

CERVICAL LYMPH NODES

• Arranged into deep & superficial chains.

• Deep jugular chain extends from base of skull to clavicle. Divided into superior, middle & inferior groups of lymph nodes.

• Superficial nodes drain to deep nodes. These are – submental – Submandibular– Facial/buccal– Preauricular– Postauricular– Occipital– Superficial cervical– Ant cervical

Occipital nodes

Outer circleRetropharyngealnodes

Innermost circle

Submental nodes

Submandibularnode

Nasopharyngeal tonsilTubal tonsil

Palatine tonsil

Lingual tonsil

Mastoid nodes

IJV

Parotid nodes

Paratrachealnodes

Pretracheal nodes

Inner circle

Deep cervicalnodes

CERVICAL LYMPH NODES

SUPERFICIAL CERVICAL NODES• Submental nodes- chin, middle of lower lip,

tip of tongue & anterior mouth. Drain into submandibular nodes.

• Submandibular nodes- upper lip, lateral lower lip, lower nasal cavity, anterior mouth & skin of cheek. Drain into superior deep jugular nodes.

• Superficial cervical nodes (along EJV) receive drainage from cutaneous lymphatics of face, esp from around parotid gland, behind the ear, parotid & occipital nodes. Drain into superior deep jugular nodes.

• Nodes in posterior triangle lie along spinal accessory nerve. Drain parietal & occipital regions of scalp. Upper nodes drain to superior deep jugular nodes & lower nodes drain into supraclavicular nodes.

• Anterior scalene (Virchow's) nodes receive drainage from thoracic duct- located at junction of thoracic duct & left subclavian vein. Usually site of metastases from lower part of body (e.g. stomach).

• Supraclavicular nodes receive drainage from spinal accessory nodes & from infraclavicular sources.

Occipital nodes

Postauricular nodes

Superf cervical nodes

Submandibular nodesSubmental nodes

Preauricular nodes

SUPERFICIAL CERVICAL NODES

Preauricular nodes

Parotid group

Facial (buccal)group

Submandibular nodes

Submental nodes

Ant. cervical group

Occipital nodes

Post. auricular nodes

Superf cervical group

SUPERFICIAL CERVICAL NODES

Submentalnodes Submandibular

nodes

Preauricularnodes

Submental nodes

Submandibularnodes

Preauricularnodes

LYMPHATICS FROM FACE

DEEP CERVICAL NODESSuperior deep jugular nodes • Primary drainage- soft palate, tonsils,

palatoglossal & palatopharyngeal arches, posterior tongue, base of tongue, pyriform sinus & larynx above vocal folds.

• Also from superficial nodes in upper head & neck (retropharyngeal, spinal accessory, parotid, superficial cervical & submandibular nodes).

Middle deep jugular nodes • Primary drainage- larynx above vocal

folds, lower pyriform sinus & posterior cricoid.

• Receive secondary drainage from deep jugular nodes above them & lower retropharyngeal nodes.

Inferior deep jugular nodes • Primary drainage- thyroid, trachea &

cervical esophagus. • Receive secondary drainage from deep

jugular nodes above them & paratracheal nodes.

Tonsil

Preauricular nodesPost auricular nodes

Occipital nodes Ant & Post tongue

Submental nodes

Submandibular nodesCommon facial vein

Ant cervical nodes

JD nodes

Superf cervical nodes

JO nodes

Supraclavicularnodes

Jugular lymph trunk

Subclavian lymph trunk

CERVICAL LYMPH NODES

DEEP CERVICAL NODES

Retropharyngeal & paratrachealnodes • Lie posteriorly around midline viscera• Receive from these viscera & from

deep structures in midline of head- nasopharynx, posterior nasal cavity, PNS, posterior oropharynx.

• Drain towards deep jugular chain

Facial vein

IJV

JD NODES

JO NODES

Intermediate tendon

DIGASTRIC (PB)

SUPRACLAVICULAR NODES

Masseter

OH (Sup belly)

OH (Inf belly)

DIGASTRIC (AB)

DEEP CERVICAL NODES