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Head and neck lymph nodes (CANCER LOCATIONS (Salivary Glands (uncommon,…
Head and neck lymph nodes
LYMPH DRAINAGE
from outlying lymph nodes at craniocervical junction
into terminal/
deep cervical nodes
(vertical T) associated with carotid sheath ie: internal jugular
SUPERIOR DEEP C
JUGULODIGASTRIC - a sentinel node :
swollen in
glandular fever, Hodgkins 's disease, mid-aged adults with oral and oropharynx cancer
palatine tonsil infection
treated with antibiotics
WHAT? post tongue, palatine tonsil, ear, nose, sinuses, upper pharynx and larynx, submandibular
WHERE?
jugular lymphatic trunk
joins brachiocephalic vein (R) and thoracic duct (L)
may pass into
INFERIOR DEEP C
include jugulo-omohyoid
lowest is supraclavicular nodes
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WHAT? Face, ant scalp, ant tongue, lower pharynx and larynx, thyroid gland, mediastinum incl. stomach, lung, oesophagus, pancreas (SLOP)
associated with tongue
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outlying: submental, submandibular, parotid, mastoid, occipital
clinically palpable when enlarged due to infection/cancer
superficial cervical nodes clustered along external jugular vein and anterior jugular nodes
CANCER LOCATIONS
Oral Cavity
Submental (3-4)
WHAT? - central lower lip, lower four incisor, gum, tip of tongue
WHERE? ipsilaterally to submandibular and/or bilaterally to
jugulo-omohyoid
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LOCATION? between ant bellies of digastric, sup/deep to deep C fascia
Submandibular (6)
LOCATION? superficially on or embedded in submandibular gland
WHAT? submental, lateral lower lip, all upper lip, ext nose, ant, tongue, ant half nasal walls, paranasal sinuses unilaterally due to septum
WHERE?
superior
group of deep C nodes
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Salivary Glands
uncommon, usually benign
Symptoms: swelling, numbness/ paralysis of facial muscles, pain in face, chin, neck, MUMPS (parotid gland)
has different types of cells leading to different cancers other than squamous cell carcinoma
LOCATION? Mainly in floor of mouth and near jawbone
WHERE? submandibular and
superior
deep C nodes
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Nasal Cavity
uncommon, but usually adenocarcinoma (high level exposure). squamous cell carcinoma (low level exposure).
Symptoms: One sided nose block, blood-stained mucus,, chronic sinus infection not responding to antibiotics, frequent headaches, swelling/ pain in eyes, upper teeth, denture problems
WHAT? Ant nasal cavity, sinus, nose
WHERE? submandibular, sup deep C,
retropharyngeal
nodes
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Pharynx
Symptoms: Pain/trouble in swallowing, breathing, speaking, hearing, pain in neck or throat, frequent headaches, ringing in ears
WHAT? upper / nasopharynx
WHERE? Sup deep C and
retropharyngeal
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WHAT? lower
WHERE? Inf deep C
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surrounded by Waldeyers ring of lymphoid tissue
pharyngeal/adenoid tonsil → retropharyngeal node (ABSENT IN ADULT)
tubal and palatine tonsil → jugulodigastric / tonsillar lingual → submental, submandibular node
Larynx
Symptoms: Hoarseness, swallowing and ear pain, long-lasting cough, sore throat, lump in neck
WHERE? Prelaryngeal (Delphian) and Pre-tracheal
To sup or inf deep cervical nodes along with venous drainage
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RETROPHARYNGEAL
1 median. 2 lateral
between pharynx and prevertebral layer
WHAT? posterior nasal cavity, nasopharynx, auditory tube, atlanto-occipital joint, atlanto-axial joint, may drain root of tongue
WHERE? sup and inf deep cervical
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