The lymphatic vessels of the head and neck can be divided into two major groups superficial vessels and deep vessels. In this article, we shall look at the anatomy of the lymphatic drainage of the head and neck - the lymph vessels, nodes and their clinical relevance. The lymphatic system is a network of vessels and nodes which acts to drain lymphatic fluid from the tissues and return it to the circulation. The posterior lateral nodes lie close to the external jugular vein and collect lymph from superficial surfaces of the neck. The anterior nodes lie close to the anterior jugular vein and collect lymph from the superficial surfaces of the anterior neck. Superficial Cervical: The superficial cervical lymph nodes can be divided into the superficial anterior cervical nodes and the posterior lateral superficial cervical lymph nodes.They collect lymph from the mucous membranes of the nose and cheek, eyelids and conjunctiva. Facial: This group comprises the maxillary/infraorbital, buccinator and supramandibular lymph nodes.They also receive lymph from the submental and facial lymph 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. Submandibular: There are usually between 3-6 submandibular nodes.They collect lymph from the central lower lip, the floor of the mouth and the apex of the tongue. Submental: These lymph nodes are located superficially to the mylohoid muscle.There are also parotid lymph nodes deep to the parotid gland that drain the nasal cavities and the nasopharynx. They collect lymph from the nose, the nasal cavity, the external acoustic meatus, the tympanic cavity and the lateral borders of the orbit. Parotid: The parotid lymph nodes are a small group of nodes located superficially to the parotid gland.They are located anterior to the auricle of the ear, and collect lymph from the superficial areas of the face and temporal region. Pre-auricular: There are usually between 1-3 pre-auricular lymph nodes.They collect lymph from the posterior neck, upper ear and the back of the external auditory meatus (the ear canal). They are located posterior to the ear and lie on the insertion of the sternocleidomastoid muscle into the mastoid process. Mastoid: There are usually 2 mastoid lymph nodes, which are also called the post-auricular 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. Occipital: There are usually between 1-3 occipital lymph nodes.They ultimately drain into the deep lymph nodes. They are arranged in a ring shape extending from underneath the chin, to the posterior aspect of the head. The superficial lymph nodes of the head and neck receive lymph from the scalp, face and neck. 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.
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