The lymphatics of the head and neck Fig 703

• Upper deep cervical nodes (jugulodigastric nodes): these are situated between the upper end of sternomastoid and the angle of the mandible and also deep to sternomastoid. They drain the head and the upper part of the neck, directly or indirectly (but there are no lymphatics in the cranial cavity).

• The lower deep cervical nodes (jugulo-omohyoid nodes): in the posterior triangle between the lower end of sternomastoid and the clavicle. They drain the lower part of the neck and also receive lymph from the upper deep cervical nodes, from the breast and some of the lymph from the thorax and abdomen. The efferents from this group drain into the thoracic or left lymph duct via the jugular trunk.

• Smaller groups of nodes are shown in Fig. 70.3.

• The lymph drainage of the tongue: the tip of the tongue drains into the submental nodes. The rest of the anterior two-thirds drains into the submandibular nodes, some crossing the midline and some passing directly to the upper deep cervical nodes. The posterior two-thirds drains directly into the upper deep cervical nodes.

• The lymph drainage of the larynx: above the vocal cords the larynx drains into the infrahyoid nodes and thence to the upper deep cervical group. Below the cords, drainage is to the paratracheal and inferior deep cervical nodes.

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