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The upper deep ceruical group has two qroups: 1- J.Ug.U.[g:.d.rga9tfj.q which drains the tonsils. 2- J.UgU.lq:.o..m.ehy.o.j.d which drains the tip of the tongue. The efferent from the deep ceruical LIVs goes fo . Rt. Side ) jugular duct & subclavian lymph trunk. . Lt. Side ) thoracic duct. . Tip ) sub-mental ) jugulo-omohyoid LNs.


. lt communicates with:

Other cavernous sinuses via inter-cavernous sinuses.

Pterygoid plexuses of veins (via 3 emissary veins).

It is present around the lateral pterygoid muscle.

It communicates with inferior ophthalmic vein, anterior facial vein and cavernous sinus

(via 3 emissary veins).

These veins have no valves; draining the dangerous area of face and can cause

cavernous sinus th rombosis.

It is drained by the maxillary vein.

Surgical lmportance Dangerous area of the face

- The area formed of nose & upper lip.

- Any infection even boil must not be squeezed for fear of cavernous sinus

thrombosis.

- lnfection reaches cavernous sinus either via ophthalmic emissary vein or

reaches pterygoid plexus through emissary vein in foramen lacerum.

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o Formed by the union of supra-trochlear & supra-orbital veins.

o Ends by joining anterior division of posterior facial vein to form the common facial vein,

which ends in internaljugular vein.

NB: Superior thyroid vein may end in the common facial vein 50%.

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Formed inside parotid gland by union of superficial temporal & maxillary veins.

Ends by qivino:

1) Anterior division ) ends in common facial vein.

2) Posterior division ) joins posterior auricular vein to form external jugular vein

which ends in the subclavian vein.

It connects anterior facial vein with pterygoid plexus of veins.

HEAD & NECK T

Beq inS: At the jugular foramen as a continuation of the sigmoid sinus.

EndS: By uniting with subclavian vein to form innominate vein behind the sternal end

of the clavicle.

Re latio n s

o lt lies inside the carotid sheath lateral to the internal & common carotid with

vagus nerve in between.

o Passes in.front of the thoracic duct on the left side.

o Runs alongside the chain of deep cervical LNs.

o Passes anterior to the phrenic nerve.

Tributaries

o lnferior petrosal sinus.

. Jugular lymph trunk.

. Common facialvein.

o Lingual vein.

Superior thyroid vein.

Middle thyroid vein.

It is formed by union of posterior auricular vein & retro-mandibular vein.

It crosses perpendicular to the superficial surface of the sternomastoid beneath the

platysma muscle.

It is a tributary of subclavian vein.

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I HEAD & NECK

The lymphoid tissue ring located in the pharynx and to the back of the oral cavity.

The ring consists of (from superior to inferior):

. Pharyngealtonsil.

. Tubal tonsils.

. Palatine tonsils (commonly called "the tonsils" in the vernacular, less commonly

termed "faucial tonsils").

. Lingual tonsils.

Pharyngeal tonsils (adenoid)

upper midline in the nasoPharynx

Tubal tonsils

around the openings

of the auditory tube

PalaUne tonsils

Either side of the oroPharynx

Tubaltonsils

around the openings

of the auditory tube

Palatine tonsils

Either side of the oropharynx

Lingualtonsils

Under mucosa of the posterior third of the tongue

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1- Occipital:

Midway between mastoid process & occiput. It drains the back of scalp.

2- Post-auricular:

On the mastoid process, drains the back of the ear pinna & temporal region of the

scalp.

3- Pre-auricular:

Just in front of the tragus & drains the outer surface of the pinna & sides of the

scalp.

4- Submandibular:

Drains the upper lip, angle of the mouth, lateral part of the lower lip & the tongue.

5- Submental:

Drains middle part of lower lip, tip of the tongue & floor of the mouth.

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A- Suoerficial Cervical

*a @ hrveindraining the parotid & lower part of ear.

B- Deep Cen-ical Group

#e - lJpper & lower deep ceruical LAIs are related to the internaljugular vein &

T separated from each other by omohyoid muscle.

The upper deep ceruical group has two qroups:

1- J.Ug.U.[g:.d.rga9tfj.q which drains the tonsils.

2- J.UgU.lq:.o..m.ehy.o.j.d which drains the tip of the tongue.

The efferent from the deep ceruical LIVs goes fo

. Rt. Side ) jugular duct & subclavian lymph trunk.

. Lt. Side ) thoracic duct.

. Tip ) sub-mental ) jugulo-omohyoid LNs.

. Sides ) ipsilateral submandibular LNs.

. Middle ) submandibular on both sides.

Posterior %

Deep cervical LNs (1't, retro-pharyngeal LNs ) deep cervical lymph nodes).

Upper lip

) Both submandibular LNs.

Lower lip:

.Middle part ) submental LNs.

oLateral parts ) submandibular

LNs. 

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