UAMS Department of Neurobiology and Developmental Sciences - Lymphatics of the Head and Neck

Gross Anatomy


Lymphatics of the Head and Neck - Listed Alphabetically

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.


Some of the material presented in these tables is contained in the book:
MedCharts Anatomy by Thomas R. Gest and Jaye Schlesinger
Published by ILOC, Inc., New York. Copyright 1995.

The content of these tables has been edited for use in this course by Patrick W. Tank, Ph.D.
Copyright 2009, Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences.
Unauthorized use is prohibited.




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