Human Anatomy - Kotsan I. Ya. 2009

Lymphatic System
Lymphatic vessels and regional lymph nodes of specific body regions
Lymphatic vessels and nodes of the head and neck

From the structures of the HEAD, Lymphatic vessels run towards the Lymph Nodes, which form clusters along the border between the head and the neck. Among them, the main groups of nodes include: occipital, mastoid, parotid, retropharyngeal, facial, submandibular, and submental. From these nodes, lymph flows downwards through vessels to the superficial and deep cervical lymph nodes, which also receive lymphatic vessels from the neck Organs.

The occipital lymph nodes (nodi lymphatici occipitales) are located on the Superficial layer of the Cervical fascia, posterior to the attachment site of the sternocleidomastoid Muscle, as well as deep to this fascial layer on and beneath the splenius capitis muscle near the occipital Blood Vessels. They receive lymph from the Skin and deep Tissues of the occipital region, as well as the posterior PARTS OF THE parietal and temporal Regions of the head. Efferent lymphatic vessels from the occipital nodes drain into the lateral deep cervical lymph nodes.

The mastoid (retroauricular) lymph nodes (nodi lymphatici mastoidei) are situated posterior to the auricle on the mastoid process, receiving lymphatic vessels from the auricle and the skin of the parietal region. Efferent vessels from these nodes pass to the parotid, superficial cervical, and lateral deep cervical lymph nodes.

The parotid lymph nodes (nodi lymphatici parotidei) are located in the region of the salivary gland of the same name. They are divided into superficial parotid lymph nodes (nodi lymphatici parotidei superficiales), which lie superficially (On the surface) of this gland, and deep parotid lymph nodes (nodi lymphatici parotidei profundi), which are situated beneath the glandular capsule and within the parenchyma of the parotid gland between its lobules. The parotid lymph nodes receive lymphatic vessels from the skin and other structures of the frontal and parietal regions of the head, the auricle, the external acoustic meatus, the auditory tube, the upper lip, and the parotid gland.

Efferent lymphatic vessels from these nodes drain into the superficial and lateral deep cervical lymph nodes.

The retropharyngeal lymph nodes (nodi lymphatici retropharyngeales) lie on the prevertebral layer of the cervical fascia, posterior to the Pharynx and along its lateral walls. These nodes receive lymphatic vessels from the pharyngeal walls, the mucous membrane of the Nasal cavity and Paranasal Sinuses, the Tonsils and palate, the auditory tube, and the tympanic cavity of the Middle ear. Efferent lymphatic Vessels of the retropharyngeal nodes empty into the lateral deep cervical lymph nodes.

The facial lymph nodes (nodi lymphatici faciales) are inconstant; they collect lymph from the facial skin, Muscles of facial expression, the mucous membrane of the cheek, Lips, Gums, oral mucous glands, the periosteum of the oral and nasal regions, as well as the submandibular and sublingual glands. Efferent vessels of the facial lymph nodes drain into the submandibular lymph nodes.

The submental lymph nodes (nodi lymphatici submentales) are located on the Inferior surface of the mylohyoid muscle, between the anterior bellies of the right and left digastric muscles; they collect lymph from the floor of the Oral Cavity, the tip of the Tongue, and the lower lip. Efferent vessels of the submental nodes empty into the submandibular lymph nodes.

The submandibular lymph nodes (nodi lymphatici submandibulares) are located within the submandibular triangle, anterior and posterior to the salivary gland of the same name. They receive lymph from the efferent vessels of the facial and submental lymph nodes, as well as from the skin of the face, tongue, and gums. Efferent lymphatic vessels of the submandibular nodes run inferiorly along the facial vein and drain into the lateral deep cervical lymph nodes.

The Classification of the cervical lymph nodes is based on their topographic relationship to the superficial layer of the cervical fascia and the major Blood vessels of the neck. Accordingly, they are divided into superficial cervical nodes, which lie on the superficial layer of the cervical fascia, and deep cervical nodes, located beneath it. Certain regional groups of nodes are situated adjacent to the major Veins OF THE neck.

The superficial cervical lymph nodes (nodi lymphatici cervicales superficiales) are located near the External Jugular Vein, on the trapezius muscle, in the posterior region of the neck. Their efferent vessels lead to the lateral deep cervical nodes, which lie along the Internal jugular vein.

The deep cervical lymph nodes (nodi lymphatici cervicales profundi) are situated in the anterior and lateral regions of the neck.

The anterior deep cervical nodes include the prelaryngeal lymph nodes (nodi lymphatici prelaryngeales), thyroid lymph nodes (nodi lymphatici thyroidei), pretracheal lymph nodes (nodi lymphatici pretracheales), and paratracheal lymph nodes (nodi lymphatici paratracheales).

The lateral region of the neck contains numerous lymph nodes that form several regional groups. These include the lateral deep cervical (internal jugular) lymph nodes (nodi lymphatici cervicales laterales profundi), numbering 7–60, which are located along the internal jugular vein; 1–8 lymph nodes arranged in a chain along the external branch of the Accessory nerve; and 1–8 lymph nodes situated near the transverse cervical artery. Among the lateral deep cervical nodes, special attention should be given to the jugulodigastric node (nodus jugulodigastricus) and the jugulo-omohyoid node (nodus juguloomohyoideus). The former is located on the internal jugular vein at the level of the greater horn of the Hyoid bone. The latter lies on the internal jugular vein directly superior to the omohyoid muscle. They receive lymphatic vessels from the tongue either directly or via the submental and submandibular lymph nodes. Cancer Cells may metastasize to these nodes when a tumor affects the tongue.

The efferent lymphatic vessels of the lateral deep cervical (internal jugular) lymph nodes form the jugular trunk on each side of the neck, which empties into the corresponding venous angle.