Vasc. U3 .1 Lymphatic Pathways- Head and Neck FINAL PDF.pdf

Lymphatic Pathways FPV UNIT 3 Knowledge Check oName the 7 missing stages to the tubular system: Pre-lymphatic channels →___→___→___→___→___→___→___→ Subclavian Veins oWhat is a lymph node? oName locations in the body where nodes are highly concentrated oName the 5 (4 of which are in pairs) lympha...

Lymphatic Pathways FPV UNIT 3 Knowledge Check oName the 7 missing stages to the tubular system: Pre-lymphatic channels →___→___→___→___→___→___→___→ Subclavian Veins oWhat is a lymph node? oName locations in the body where nodes are highly concentrated oName the 5 (4 of which are in pairs) lymphatic trunks oDescribe the body areas from which they transport lymph from oLymph travels: proximally or distally? oName the mechanisms of how lymph travels along the vessels Lymph Nodes Review previous presentation for complete answer! Collections of concentrated lymphatic tissue that filters the blood of debris and pathogens, activating an immune response as required. House lymphocytes. Name of trunk Area of body it drains Lumbar Lower limbs Intestinal Abdominal organs Bronchomediastinal Breast tissue, thoracic organs, intercostal tissues Subclavian Upper limbs Jugular Head and neck • Smooth muscle layer • One way valves Intrinsic Extrinsic • Contraction of surrounding skeletal muscles • Thoracic pump (negative pressure created from abdominal breathing) • The flow of venous blood in subclavian veins drawing lymph in Unit Objectives To gain knowledge of the pathways in which lymph travels through the vessels and lymph nodes to the terminus in the following regions: ◦ Head and neck ◦ Upper limbs ◦ Lower limbs ◦ Pelvis and abdomen ◦ Thorax Although the exact number and position of nodes varies from person to person, the nodes are positioned in clusters in some distinct areas of the body. The nodes are located to ensure the lymph is thoroughly cleansed through them as it is then transported proximally towards the trunks and ducts. Dividing Lines The dividing lines in the diagram demonstrate the direction of flow of lymph, and the ‘lymphatic territories’. These lines only exist at a subcutaneous level. They determine quadrants that will mark the direction of thrust in manual lymphatic drainage. The black dots marked on this diagram correspond to the general location of nodes. Head and Neck Lymphatic Pathways of the Head and Neck Deep Superficial Deep anterior Lingual Head and face Neck Occipital Submandibular Deep lateral Superior Inferior Prelaryngeal Retropharyngeal Retro auricular Pre auricular Buccal Infrahyoid Pretracheal Submental Nodes tend to be positioned in clusters and can therefore be classified based on this, with clinical significance Paratracheal Lymphatic Pathways of the Head and Neck The lymph of the head and neck drains into two large clusters of nodes (along the course of the associated lymphatic vessels). o Superficial cervical group (head and neck groups) o Run laterally in a ring from the chin to the occiput o Deep cervical group (superior, inferior and other groups) o Lie in proximity to the course of the internal jugular vein, running superior to inferior The lymph running through the superficial nodes then runs through the superior and/or inferior group of the deep cervical nodes. The deep cervical nodes receives lymph directly from the collecting vessels of nearby tissue as well as that flowing through the superficial nodes. Superficial cervical group Deep cervical group Diagrammatical location of nodes Superficial Cervical Group This group can be sub divided into 6 further groups based on their location: oOccipital oRetroauricular Head and face oPre auricular or parotid oBuccal oSubmandibular oSubmental Neck Superficial Cervical Group Location and Flow Occipital- located over the insertion of the trapezius into the occiput. Lymph from the skin of the occiput drains into here. Retro auricular- posterior to the ear. Drain lymph from the lateral scalp. Preauricular/Parotidsitting anterior to the ear. Drain lymph from the lateral part of the face as well as the anterior and lateral scalp. Buccal nodes also have pathways running to here. Superficial Cervical Group Location and Flow Submandibularlocated posterior to the body of the mandible, near salivary glands. Drain lymph from lateral and superior lip, cheek, eyelid buccal and submental nodes. Buccal- located in the inside lining of the cheek. Drain lymph from the cheeks into submandibular and parotid nodes. Submental- anterior section of mandible, and inferior. Drain lymph from chin, inferior lip and anterior tongue. Important head and neck landmarks Deep Cervical Groups This group can be classified into further sub groups based on their locations: o Deep lateral cervical nodes (superior and inferior) o Retropharyngeal o Lingual o Infrahyoid o Prelaryngeal o Pretacheal o Paratracheal Deep Cervical Group Location and Flow Superior and inferior deep cervical nodes- located along the course of the internal jugular vein. Collect lymph from other lymph nodes such as the superficial groups. The superior set also flows to the inferior set. NB, Supraclavicular lymph nodes (deep inferior) have additional pathways Retropharyngeallocated between the pharynx and vertebral bodies. Drain lymph from the different parts of the pharynx. Deep Cervical Group Location and Flow Infrahyoid, prelaryngeal and pretracheal nodes are located beneath deep cervical fascia. Drain lymph from the anterior tissues of the neck. Paratracheal- located between the trachea and oesophagus. Drain lymph from the tissues of this space. Lingual- located at the base of the tongue/floor of the mouth. Drain lymph from the tongue. Lymphatic Pathways of the Head and Neck Deep Superficial Deep anterior Lingual Head and face Neck Occipital Submandibular Deep lateral Superior Inferior Prelaryngeal Retropharyngeal Retro auricular Pre auricular Buccal Infrahyoid Pretracheal Submental Remember that the anatomy of the lymphatic system varies from one person to the next and so this just provides a common example of a pathway Paratracheal From the Cervical Nodes to the Venous System As demonstrated, the lymph flowing through some, or multiple of the nodes discussed, gradually moves proximally. From the deep lateral inferior nodes, the post nodal collectors form the jugular trunks (left and right). The jugular trunks then enter either the right lymphatic duct or the thoracic duct before entering the terminus location- the angle where the internal jugular vein anastomoses with the subclavian vein (on the left and right). Superficial nodal group Occipital Retroauricular Parotid Buccal Submandibular Submental Area lymph drained from Nodes lymph drained to Deep nodal group Lateral Superior Lateral Inferior Retropharyngeal Lingual Infrahyoid Prelaryngeal Pretracheal Paratracheal Area lymph drained from Node/location lymph drained to