Lymphatic System of The Head & Neck

The Lymphatic System

A 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

Lymphatic Tissue
C.T. structures that contain large number of lymphocytes (immune cells) - They help defend the body against disease causing agents Thymus Spleen

Tonsils
Lymph Nodes Lymph nodules (GIT, appendix)

Lymphatic system is a connection between two body systems: Lymph Vessels: C.V.S.

Lymph Tissue: Immune System

The Lymph
The name given to tissue fluid once it has entered a lymphatic vessel through lymphatic capillary

Fluid within the blood Plasma

Plasma filter through bld. Capillaries into tissue spaces interstitial fluid

Interstitial fluid passes into lymph vessels lymph

Lymph = interstitial fluid + lymphocytes

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) substances B-cells: plasma cells ?? 3. Transporting dietary lipids & lipid soluble vitamins: A (?), D(?), E, & K

Lymphatics of The Head & Neck

Regional Groups of Lymph Nodes: 11 groups Waldeyers Tonsillar Ring: 4 kinds (?) Terminal Group of Lymph Nodes: DCL

Regional Groups of Lymph Nodes

2 post. part of the head: occipital & mastoid 2 ant. part of the head: parotid & buccal 2 beneath the mandible

submental & submandibular

2 along superficial jugular veins ant. Cerv. & superficial cerv. 3 deep, related with organs: retropharyngeal laryngeal tracheal

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)

Occipital Lymph Nodes

Over occipital Bone At the apex of ?
Afferent V.: back of SCALP Efferent V.: DCLN

Mastoid (Retroauricular) Lymph Nodes

Over lat. surface of mastoid process

Afferent V.: SCALP auricle post. Med. Auricle post. Wall of EAM Efferent V.: DCLN

Parotid Lymph Nodes

On or in the parotid gland
Afferent V.: SCALP parotid lat. surface of auricle ant. wall of EAM lat. eyelids middle ear (nodes in g.) Efferent V.: DCLN

Buccal Lymph Nodes

Over buccinator m. Close to ?? V.
Afferent V.: ant. SCALP & forehead ant. Part of face Nose Efferent V.: ??

Submandibular Lymph Nodes

Within submandibular Superficial to submand. Sv.G. *deep to?? Afferent V.: buccal L.N. Upper lip lat. Lower lip frontal, max. & ethmoidal air sinuses upper & lower teeth, Except? gingiva, Except? Floor of mouth Efferent V.: ??

Submental Lymph Nodes

Within submental

Afferent V.: tip of tongue lower incisors & associated gums central lower lip
Efferent V.: submandibular L.N.

Anterior Cervical Lymph Nodes

Along the course of ?

Afferent V.: ant. neck

Efferent V.: DCLN

Superficial Cervical Lymph Nodes

Along the course of ?

Afferent V.: angle of mandible lobule of auricle Efferent V.: DCLN

Waldeyers Tonsillar Ring

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 ??

Deep Cervical Lymph Nodes

DCLN
A 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 neck Within 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

Jugulodigastric Node
Most sup. Node of DCLN Below & behind angle of mandible Lymph drainage from: 1.? 2.?

Jugulo-omohyoid Node
On or close to intermediate tendon of omohyoid m. Lymph drainage from: 1.?

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 drains into 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 tumor spread (metastasis) Example: Lymphoma