Medical Gross Anatomy
Anatomy Tables - Lymphatics
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Medical Gross Anatomy |
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Lymphatics of the Head and Neck - Listed Alphabetically |
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| Structure | Location | Afferents from | Efferents to | Regions drained | Notes |
| accessory nodes | posterior triangle of the neck, arranged along the accessory n. | occipital nodes, retroauricular nodes | transverse cervical chain of nodes | occipital region and posterior scalp | accessory nodes also collect lymph from the nape of the neck and the region overlying the supraspinatous fossa |
| anterior auricular nodes | subcutaneous connective tissue anterior to the ear | lymphatic vessels from the side of the head | superior parotid nodes; superior deep cervical nodes | anterior part of the parietal region of the scalp; anterior surface of the ear and external acoustic meatus | anterior auricular nodes are 1 or 2 in number |
| anterior jugular nodes | along the anterior jugular vein | lymphatic vessels from the anterior inferior part of the neck | inferior deep cervical nodes | skin and mm. of the anterior infrahyoid region of the neck | anterior jugular nodes are located between the superficial layer of deep cervical fascia and the infrahyoid mm. |
| anterior mediastinal nodes | along the course of the brachiocephalic vessels and aorta | lymphatic vessels from the anterior mediastinum and middle mediastinum | bronchomediastinal trunk | thymus, anterior respiratory diaphragm, pericardium, part of the heart | anterior mediastinal nodes are from 2 to 5 in number |
| auricular nodes, anterior | subcutaneous connective tissue anterior to the ear | lymphatic vessels from the side of the head | superior parotid nodes; superior deep cervical nodes | anterior part of the parietal region of the scalp; anterior surface of the ear and external acoustic meatus | anterior auricular nodes are 1 or 2 in number |
| bronchomediastinal trunk | along the course of the brachiocephalic v. | union of efferents from the paratracheal nodes, parasternal nodes and anterior mediastinal nodes | left: thoracic duct; right: right lymphatic duct | thoracic wall and viscera; medial part of the mammary gland | right bronchomediastinal trunk receives lymph from the lower lobe of the left lung; bronchomediastinal trunk may drain directly into the venous system on either side |
| bronchopulmonary nodes | hilum of the lung | pulmonary nodes | tracheobronchial nodes | lung | bronchopulmonary nodes are also known as: hilar nodes |
| cervical nodes, deep | in and around carotid sheath posterior and lateral to the internal jugular v. | lymphatic vessels and numerous node groups from the head and neck | jugular trunk | head and neck | superior and inferior subdivisions of deep cervical nodes are delineated by the crossing of the omohyoid m. |
| cervical nodes, superficial | in superficial fascia and along superficial vessels of the head & neck | lymphatic vessels from superficial structures in head & neck | varies by group; ultimate destination is the jugular trunk | head & neck | several groups are designated by location: occipital, retroauricular, anterior auricular, superficial parotid, facial, submental, submandibular, external jugular, anterior jugular |
| deep cervical nodes | in and around carotid sheath posterior and lateral to the internal jugular v. | lymphatic vessels and numerous node groups from the head and neck | jugular trunk | head and neck | superior and inferior subdivisions of deep cervical nodes are delineated by the crossing of the omohyoid m. |
| deep cervical nodes, inferior | around the internal jugular v., inferior to the crossing of the omohyoid m. | superior deep cervical nodes; numerous node groups of the neck | jugular trunk | head and neck | inferior deep cervical nodes are in direct continuity with the superior deep cervical chain of nodes |
| deep cervical nodes, superior | around the internal jugular v., superior to the crossing of the omohyoid m. | numerous node groups of the head and upper neck, including retropharyngeal nodes and deep parotid nodes | inferior deep cervical nodes | head and the superior part of the neck | the superior deep cervical node group has many large nodes; the jugulodigastric and juguloomohyoid nodes are members of this group |
| external jugular nodes | along the external jugular v. | lymphatic vessels from the side of the head | superior deep cervical nodes | inferior part of the ear and the parotid region | there are one or two nodes in this group |
| facial nodes | along the course of the facial a. and v. | lymphatic vessels from the face | submandibular nodes | eyelids, nose, cheek and lips | facial nodes are grouped inferior to the orbit; at the angle of the mouth and over the mandible |
| hilar nodes | at hilum of lung | pulmonary nodes | tracheobronchial nodes | lung | also known as: bronchopulmonary nodes |
| inferior deep cervical nodes | around the internal jugular v., inferior to the crossing of the omohyoid m. | superior deep cervical nodes; numerous node groups of the neck | jugular trunk | head and neck | inferior deep cervical nodes are in direct continuity with the superior deep cervical chain of nodes |
| inferior tracheobronchial nodes | inferior to tracheal bifurcation | bronchopulmonary nodes, left side inferior tracheobronchial nodes drain into right inferior tracheobronchial nodes | right superior tracheobronchial nodes | lower lobes of the lungs; middle mediastinum; posterior mediastinum | left inferior tracheobronchial nodes drain to the right side |
| infraclavicular nodes | along the cephalic v. in the deltopectoral groove | lymphatic vessels from the superficial upper limb | apical axillary nodes | skin and superficial fascia of the upper limb | infraclavicular nodes may become inflamed during infections of the superficial tissues of the upper limb |
| jugular lymphatic trunk | carotid sheath in root of neck | deep cervical nodes | left: thoracic duct near its termination; right: right lymphatic duct or junction of right subclavian and right internal jugular vv. | head & neck | jugular trunk carries most of the lymph from the head and neck |
| jugular nodes, anterior | along the anterior jugular vein | lymphatic vessels from the anterior inferior part of the neck | inferior deep cervical nodes | skin and mm. of the anterior infrahyoid region of the neck | anterior jugular nodes are located between the superficial layer of deep cervical fascia and the infrahyoid mm. |
| jugular nodes, external | along the external jugular v. | lymphatic vessels from the side of the head | superior deep cervical nodes | inferior part of the ear and the parotid region | there are one or two nodes in this group |
| jugulodigastric node | anterolateral to internal jugular v. where it is crossed by posterior belly of the digastric | superior deep cervical nodes | inferior deep cervical nodes | oral cavity, tongue, palatine tonsil | a member of the superior deep cervical node group; important node to palpate during physical exam |
| juguloomohyoid node | lateral to internal jugular v. where it is crossed by superior belly of omohyoid | superior deep cervical nodes | inferior deep cervical nodes | submental region and tip of tongue; head & neck above this level | an important node to examine in cases of oral cancer caused by use of tobacco products |
| juxtavisceral nodes | adjacent to the cervical viscera | cervical viscera | superior deep cervical nodes, inferior deep cervical nodes | esophagus, larynx, trachea and thyroid gland | four groups of juxtavisceral nodes are recognized: infrahyoid, prelaryngeal, pretracheal and paratracheal |
| occipital nodes | superior nuchal line, along the course of the occipital a. and v. | lymphatic vessels from the posterior head and neck | accessory nodes | occipital part of the scalp and the superior neck | occipital nodes are 2 or 3 nodes located between the attachments of the sternocleidomastoid m. and the trapezius m. |
| parasternal nodes | lateral border of sternum, along the course of the internal thoracic vessels | anterior phrenic nodes, lymphatic vessels from the anterior thoracic wall | larger lymphatic vessels in the root of the neck | medial side of the mammary gland; medial part of the anterior chest wall and muscles | parasternal nodes constitute an important drainage pattern in cases of cancer of the mammary gland; one or two parasternal nodes may be found in the anterior end of intercostal spaces 1-6; also known as: sternal nodes |
| paratracheal nodes | coursing along the lateral surface of the trachea and esophagus | superior tracheobronchial nodes | bronchomediastinal trunk | lungs, trachea, upper esophagus, the part of the larynx below the vocal folds | paratracheal nodes are an important group of nodes in cases of pulmonary infection or lung cancer; also known as: tracheal nodes |
| parotid nodes, deep | on the lateral side of the pharyngeal wall, deep to the parotid gland | lymphatic vessels from the ear | superior deep cervical nodes | external acoustic meatus, auditory tube, middle ear | deep parotid nodes are part of the deep cervical chain of nodes |
| parotid nodes, superficial | superficial to the parotid gland and also deep to the parotid fascia | anterior auricular nodes | superior deep cervical nodes | anterior surface of the ear and external acoustic meatus; temporal and frontal regions; eyelids, lacrimal gland cheek and nose | superficial parotid nodes are up to 10 in number and may be located superficial or deep to the parotid fascia |
| pulmonary nodes | within the lung parenchyma | lymphatic vessels from the parenchyma of the lung | bronchopulmonary (hilar) nodes | lung parenchyma, bronchial tree within the lungs | pulmonary nodes are located along the larger bronchi of the lung |
| retroauricular nodes | posterior to the ear | lymphatic vessels from the ear and side of the head | superior deep cervical nodes | scalp overlying the posterior parietal region; skin of the posterior surface of the ear | retroauricular nodes are 1 or 2 nodes located at the insertion of the sternocleidomastoid m. |
| retropharyngeal nodes | posterior to pharynx in the retropharyngeal space | lymphatic vessels from the nasal and pharyngeal regions | superior deep cervical nodes | nasal fossae, paranasal sinuses, hard palate, soft palate, middle ear, oropharynx | retropharyngeal nodes are one or two in number; they are part of the deep cervical chain of nodes |
| right lymphatic duct | root of neck on the right side | formed by the union of the right jugular trunk,the right subclavian trunk, and the right bronchomediastinal trunk | junction of the right subclavian v. and right internal jugular v. | right half of the head and neck; right upper limb; right side of the chest | right lymphatic duct has a valve near its termination; the three trunks that form right lymphatic duct may drain separately into the venous system |
| subclavian trunk | along the course of the subclavian v. | apical axillary nodes; infraclavicular nodes | drains into the junction of the internal jugular v. and the subclavian v. | upper limb, most of breast, anterolateral chest wall | subclavian lymphatic trunk occasionally drains into the thoracic duct on the left side; on the right it occasionally drains into the right lymphatic duct |
| submandibular nodes | along the inferior border of the submandibular gland | submental nodes; facial nodes; lymphatic vessels from the submandibular and sublingual regions | superior deep cervical nodes; juguloomohyoid node | anterior part of tongue, lower lip, floor of the mouth, nose, cheeks, chin, gums and lower incisor teeth, lower surface of palate | submandibular nodes may be within the sheath of the submandibular gland; this group consists of from 3 to 6 nodes |
| submental nodes | under the mandible on the mylohyoid m. | lymphatic vessels from the lower face and chin | submandibular nodes, juguloomohyoid node | tip of the tongue, lower lip, floor of the mouth, chin, gums and lower incisor teeth | submental nodes are important nodes to examine in cases of oral cancer caused by the use of tobacco products |
| superficial cervical nodes | in superficial fascia and along superficial vessels of the head & neck | lymphatic vessels from superficial structures in head & neck | varies by group; ultimate destination is the jugular trunk | head & neck | several groups are designated by location: occipital, retroauricular, anterior auricular, superficial parotid, facial, submental, submandibular, external jugular, anterior jugular |
| superficial parotid nodes | superficial to the parotid gland and also deep to the parotid fascia | anterior auricular nodes | superior deep cervical nodes | anterior surface of the ear and external acoustic meatus; temporal and frontal regions; eyelids, lacrimal gland cheek and nose | superficial parotid nodes are up to 10 in number and may be located superficial or deep to the parotid fascia |
| superior deep cervical nodes | around the internal jugular v., superior to the crossing of the omohyoid m. | numerous node groups of the head and upper neck, including retropharyngeal nodes and deep parotid nodes | inferior deep cervical nodes | head and the superior part of the neck | the superior deep cervical node group has many large nodes; the jugulodigastric and juguloomohyoid nodes are members of this group |
| superior tracheobronchial nodes | superolateral to the tracheal bifurcation | bronchopulmonary (hilar) nodes | paratracheal (tracheal) nodes | lungs, middle mediastinum, posterior mediastinum | inferior tracheobronchial nodes drain lymph from the lower lobe of the left lung to the right superior tracheobronchial nodes |
| supraclavicular nodes | in and around carotid sheath below level of omohyoid | superior deep cervical nodes, transverse cervical nodes, spinal accessory nodes | efferents form the jugular lymphatic trunk | head and neck | also known as: inferior deep cervical nodes |
| thoracic duct | between the esophagus anteriorly and the thoracic vertebral bodies posteriorly | formed by the union of the lumbar lymph trunks, sometimes dilated to form a cisterna chyli | junction of the left subclavian v. and the left internal jugular v. | all of the body and limbs below the respiratory diaphragm; the left side of the chest, left upper limb and the left side of the head and neck above the diaphragm | thoracic duct is the largest lymphatic vessel; it passes through the aortic hiatus on the right side of aorta; it swings to the left side of the esophagus at the T4-T5 intervertebral disc (at the level of the sternal angle) |
| tonsil, lingual | superior surface of the root of the tongue | lymphatic vessels of the tongue | superior deep cervical nodes | "guards" the entrance of the oropharynx | lingual tonsil is part of the tonsillar ring (of Waldeyer) |
| tonsil, palatine | lateral wall of the oropharynx between the palatoglossal and palatopharyngeal arches | lymphatic vessels of the posterior tongue and palatoglossal/palatopharyngeal arch region | superior deep cervical nodes, especially the jugulodigastric node | "guards" the entrance of the oropharynx | palatine tonsil is part of the tonsillar ring (of Waldeyer) |
| tonsil, pharyngeal | roof and posterior wall of the nasopharynx | lymphatic vessels of the wall of the pharynx | superior deep cervical nodes | "guards" the entrance to the nasopharynx | pharyngeal tonsil is part of the tonsillar ring (of Waldeyer); also known as: adenoids |
| tonsil, tubal | pharyngeal recess | lymphatic vessels of the torus tubarius and auditory tube | superior deep cervical nodes | "guards" the entrance to the nasopharynx | tubal tonsil is located at the pharyngeal orifice of the auditory tube |
| tracheal nodes | coursing along the lateral surface of the trachea and esophagus | superior tracheobronchial nodes | bronchomediastinal trunk | lungs, trachea, upper esophagus, the part of the larynx below the vocal folds | tracheal nodes are an important group of nodes in cases of pulmonary infection or lung cancer; also known as: paratracheal nodes |
| tracheobronchial nodes | along the trachea, around the tracheal bifurcation and primary bronchi | lymphatic vessels from the lung | bronchomediastinal lymph trunk | lungs, visceral pleura, bronchi, thoracic part of trachea, left side of heart, esophagus, posterior mediastinum | tracheobronchial nodes may be divided into five groups: paratracheal (tracheal), superior tracheobronchial, inferior tracheobronchial, bronchopulmonary (hilar), pulmonary |
| tracheobronchial nodes, inferior | inferior to tracheal bifurcation | bronchopulmonary nodes, left side inferior tracheobronchial nodes drain into right inferior tracheobronchial nodes | right superior tracheobronchial nodes | lower lobes of the lungs; middle mediastinum; posterior mediastinum | left inferior tracheobronchial nodes drain to the right side |
| tracheobronchial nodes, superior | superolateral to the tracheal bifurcation | bronchopulmonary (hilar) nodes | paratracheal (tracheal) nodes | lungs, middle mediastinum, posterior mediastinum | inferior tracheobronchial nodes drain lymph from the lower lobe of the left lung to the right superior tracheobronchial nodes |
| transverse cervical nodes | along the course of the transverse cervical blood vessels | accessory chain of nodes, sometimes the apical axillary nodes | variable: jugular lymphatic trunk, right lymphatic trunk or thoracic duct | lateral part of the neck, anterior thoracic wall, mammary gland | transverse cervical nodes are approximately 10 in number and may drain directly into the internal jugular v. or subclavian v. |
| The material presented in these tables is
contained in the book: MedCharts Anatomy by Thomas R. Gest & Jaye Schlesinger Published by ILOC, Inc., New York Copyright © 1995, unauthorized use prohibited. |
The excellent editorial assistance of Dr. Pat Tank, UAMS is gratefully acknowledged. |
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| Copyright© 2000 The University of Michigan. Unauthorized use prohibited. |
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