1. Lymphatic drainage of the head and neck
Tissue fluid is produced in excess by the arterial ends of the circulatory system
The excess fluid, proteins, large particulate matters, and foreign substances find their way to the lymphatic vessels to the lymph nodes located along the course of the vessels.
The fluid is filtered and foreign substances phagocytosed, and the node swell
The position of the nodes denotes the general location of infection

2. Lymphatic drainage of head & neck
Lymph nodes in the head and neck consist of a number of regional groups and terminal one.
They consist of outlying nodes (circular) which all drain into the deep cervical group (vertical) .
The outlying nodes are usually subcutaneous while others are deep and are named according to their position

3. Lymphatic drainage of head & neck
Regional :
Submental nodes:
Three to four in number, lie below the chin
Some superficial other deep to the investing deep cervical fascia
Drain a wedge of tissues in the floor of the mouth, lower incisor, gum and lip
The drain into the submandibular group or directly into the deep cervical group

4. Lymphatic drainage of head & neck
Submandibular nodes:
Half a dozen, lie on the surface of the submandibular salivary gland or embedded within it.
Drain the submental nodes, lateral part of the lower lip, upper lip and external nose, anterior 2/3 of the tongue.
Anterior half of the nasal walls, paranasal sinuses and all the teeth except lower anterior.

5. Lymphatic drainage of head & neck
Buccal node:
lies over the buccinator muscle on the facial vein
drain into the submandibular group
Preauricular nodes:
lie within the parotid gland
Drain the temporal part, lateral surface of auricle, anterior wall of external meatus, and lateral part of the eyelids
Drain into deep cervical group

6. Lymphatic drainage of head & neck
Posterior auricular nodes:
situated on the lateral of the mastoid process
receive lymph from a scalp above the auricle and the posterior border of the auditory meatus
Occipital nodes:
situated at the apex of the posterior triangle of the neck
receive lymph from the back of the scalp

7. Lymphatic drainage of head & neck
Anterior cervical nodes:
situated along the course of the anterior jugular vein
receive lymph from the skin and superficial tissues of the front of the neck.
Superficial cervical nodes:
lie along the course of the external jugular vein
receive lymph from skin over the angle of the mandible and over the apex of the parotid gland and lobe of the ear

8. Lymphatic drainage of head & neck
Retropharyngeal nodes:
lie in the retropharyngeal space, between the pharyngeal wall and the prevertebral fascia
receive lymph from the nasal pat of pharynx, auditory tube and upper cervical vertebrae
Laryngeal nodes:
in front of the larynx
Tracheal nodes:
lateral and infront of the trachea
receive from the thyroid gland

9. Lymphatic drainage of head & neck
Deep cervical nodes:
scatter in the carotid sheath, in front and behind the internal jugular vein along its course.
They lie undercover of the sternocleidomastoid muscle.
Divided into upper and lower groups and they are connected by lymphatic channels.
Receive lymph from regional nodes

10. Lymphatic drainage of head & neck
Upper group:
Receive lymph from the posterior part of the tongue, tonsil, ear, nose, sinuses, upper part of pharynx and larynx.
The Jugulo-digastric nodes lie just below the posterior belly of the digastric muscle, and is clinically palpable below angle of the mandible.
Drain the back of the tongue

11. Lymphatic drainage of head & neck
Lower group:
Receive lymph from anterior part of the face, the scalp, anterior two third of the tongue, lower part of the pharynx and larynx and thyroid gland.
The Jugulo-omohyoid nodes related to the intermediate tendon of the omohyoid muscle and is concerned with drainage of lymph from the anterior part of the tongue

12. Lymphatic drainage of head & neck
Jugular lymph trunk:
Formed by joining of lymphatic vessels at the lower end of the deep cervical lymph nodes.
On the left side, it joins the internal jugular or the subclavian veins
On the right side, it reaches the right lymphatic duct or the right brachiocephalic vein

13. Lymphatic drainage of head & neck
Lymph nodes act as a barrier against disease
They are soft, non-palpable structures
Draining infected, inflamed or areas involved in a carcinomatous changes will cause the nodes to become swollen, hard, painful and palpable
They work in groups, primary, secondary and tertiary nodes to combat disease and prevent it from reaching the major lymphatic channels

14. Lymphatic drainage of head & neck
Knowledge of the lymphatic drainage in the head and neck will assist in determining the site of the disease
Cervical metastasis in malignant diseases will require radical “Block resection” surgery to prevent recurrence.
To insure this connective tissues, muscles, glands, veins and even nerves has to be removed