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Lymphatic Drainage of the Head and Neck anatomy
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Lymphatic Drainage of the Head and Neck anatomy
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Lymphatic Drainage of the Head and NeckThe lymphatic system functions to drain tissue fluid, plasma proteins and other
cellular debris back into the blood stream, and is also involved in immune defence.
Once this collection of substances enters the lymphatic vessels, it is known as lymph.
Lymph is subsequently filtered by lymph nodes and directed into the venous system.
This article will explore the anatomy of lymphatic drainage throughout the head and
neck, and how this is relevant clinically. We will also look at Waldeyer’s ring, the
collection of lymphatic tissue surrounding the superior pharynx.
Lymphatic Vessels
The lymphatic vessels of the head and neck can be divided into two major groups;
superficial vessels and deep vessels.
Superficial Vessels
The superficial vessels drain lymph from the scalp, face and neck into the superficial
ring of lymph nodes at the junction of the neck and head.
Deep Vessels
The deep lymphatic vessels of the head and neck arise from the deep cervical lymph
nodes. They converge to form the left and right jugular lymphatic trunks:
Left jugular lymphatic trunk – combines with the thoracic duct at the root of the
neck. This empties into the venous system via the left subclavian vein.
Right jugular lymphatic trunk – forms the right lymphatic duct at the root of the
neck. This empties into the venous system via the right subclavian vein.
Lymph Nodes
The lymph nodes of the head and neck can be divided into two groups; a superficial
ring of lymph nodes, and a vertical group of deep lymph nodes.
Superficial Lymph Nodes
The superficial lymph nodes of the head and neck receive lymph from the scalp, face
and neck. They are arranged in a ring shape; extending from underneath the chin, to
the posterior aspect of the head. They ultimately drain into the deep lymph nodes.
, Occipital: There are usually between 1-3 occipital lymph nodes. They are located in
the back of the head at the lateral border of the trapezius muscle and collect lymph
from the occipital area of the scalp.
Mastoid: There are usually 2 mastoid lymph nodes, which are also called the post-
auricular lymph nodes. They are located posterior to the ear and lie on the insertion
of the sternocleidomastoid muscle into the mastoid process. They collect lymph
from the posterior neck, upper ear and the back of the external auditory meatus
(the ear canal).
Pre-auricular: There are usually between 1-3 pre-auricular lymph nodes. They are
located anterior to the auricle of the ear, and collect lymph from the superficial areas
of the face and temporal region.
Parotid: The parotid lymph nodes are a small group of nodes located superficially to
the parotid gland. They collect lymph from the nose, the nasal cavity, the external
acoustic meatus, the tympanic cavity and the lateral borders of the orbit. There are
also parotid lymph nodes deep to the parotid gland that drain the nasal cavities and
the nasopharynx.
Submental: These lymph nodes are located superficially to the mylohoid muscle.
They collect lymph from the central lower lip, the floor of the mouth and the apex
of the tongue.
Submandibular: There are usually between 3-6 submandibular nodes. They are
located below the mandible in the submandibular triangle and collect lymph from
the cheeks, the lateral aspects of the nose, upper lip, lateral parts of the lower lip,
gums and the anterior tongue. They also receive lymph from the submental and
facial lymph nodes.
Facial: This group comprises the maxillary/infraorbital, buccinator and
supramandibular lymph nodes. They collect lymph from the mucous membranes of
the nose and cheek, eyelids and conjunctiva.
Superficial Cervical: The superficial cervical lymph nodes can be divided into the
superficial anterior cervical nodes and the posterior lateral superficial cervical lymph
nodes. The anterior nodes lie close to the anterior jugular vein and collect lymph
from the superficial surfaces of the anterior neck. The posterior lateral nodes lie
close to the external jugular vein and collect lymph from superficial surfaces of the
neck.
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