This document provides an overview of lymphatic drainage in the head and neck region. It begins with embryology of the lymphatic system and describes the major lymphatic structures including lymph nodes, vessels, and ducts. It then discusses the specific lymphatic drainage patterns of different head and neck structures, such as the face, scalp, oral cavity, and tongue. Lymph from the head and neck drains primarily to the deep cervical lymph nodes and subsequently to the right lymphatic duct and thoracic duct. Applied aspects regarding clinical conditions like tonsillitis and its treatment are also summarized.

1. LYMPHATIC DRAINAGE
OF HEAD AND NECK
PRESENTED BY : BHANU PRIYA U

2. CONTENTS
 INTRODUCTION
 EMBRYOLOGY
 LYMPHATIC SYSTEM
 LYMPHATIC DRAINAGE OF HEAD & NECK
 LEVELS OF LYMPHNODES
 APPLIED ASPECTS
 CONCLUSION
 REFERENCE

3. INTRODUCTION
 The blood and lymphatic systems are the two
major circulatory systems in our body.
 One way system- lymph flows only towards
the heart.
 The lymphatic system is ubiquitous and exists
in all tissues where blood vessels are also
found
 placenta being an exception. Cornea does not
contain lymphatics
Human physiology for bds 5th edition A K Jain.

4. EMBRYOLOGY
 Lymphatic vessels arise as sac-like outgrowths from the endothelium of
veins.
 Six primary lymph sacs –
 two jugular, at the junction of the subclavian and anterior cardinal
veins
 two iliac.
 one retroperitoneal.
 one cisterna chyli .
Langman’s Medical Embryology ,12th edition, T W Sadler

6.  Numerous channels connect the sacs with each other and drain lymph
from the limbs, body wall, head, and neck.
 Two main channels, the right and left thoracic ducts, join the jugular sacs
with the cisterna chyli, and soon an anastomosis forms between these
ducts.
 The thoracic duct develops from the distal portion of the right thoracic
duct , the anastomosis, and the cranial portion of the left thoracic duct.
 The right lymphatic duct is derived from the cranial portion of the right
thoracic duct.
 Both ducts maintain their original connections with the venous system and
empty into the junction of the internal jugular and subclavian veins.
Langman’s Medical Embryology ,12th edition, T W Sadler

7. LYMPHATIC SYSTEM
1. LYMPH
2. LYMPH CAPILLARIES
3. LYMPH VESSELS
4. LYMPH DUCTS
5. LYMPH NODES
6. LYMPH TISSUES & ORGANS
Human physiology for bds 5th edition A K Jain.

8. Functions of lymphatic system
1. Returns Fluid from Tissues to Blood.
2. Hemopoiesis.
3. Returns large molecules to blood.
4. Body Defence/Immunity.
5. Absorb and Transport Fats.
Human physiology for bds 5th edition A K Jain.

9. LYMPHATIC ORGANS
Human physiology for bds 5th edition A K Jain.

10. LYMPH
 Transparent, colourless, or slightly yellow, watery
fluid.
 Resembles blood plasma ,but fewer proteins.
 Varies in composition based on site of origin
 Bone marrow , thymus , spleen- more WBC s
 Intestine- fat.
Human physiology for bds 5th edition A K Jain.

11. COMPOSITION
lymph
Water (96%) Others (4%)
Protein Lipids Carbohydrates
Coagulation
factors
Cellular
components
Na+,ca++,k+,cl-
,urea,creatinine
Human physiology for bds 5th edition A K Jain.

12. LYMPHATIC CAPILLARIES
 Lies close to blood vessels.
 Lined by single layer of endothelial cells.
 Permeable solvents &cells.
Human physiology for bds 5th edition A K Jain.

13. LYMPHATIC VESSELS
 lymphatic capillaries merge with others to
form larger lymphatic vessels.
 Resembles veins in structure.
 One way Valves.
 has lymph nodes at intervals along its
course
Human physiology for bds 5th edition A K Jain.

14. LYMPH NODES
 Lymph glands
 oval to bean shaped bodies present
along lymphatic vessels.
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

15. anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

16. LYMPH
TRUNKS

17. LYMPHATIC DUCTS
 lymphatic trunks merge together to
form two major Lymphatic Ducts
1.RIGHT LYMPHATIC DUCT
2.THORACIC DUCT
Gray’s Anatomy For Students, 4th Edition , Richard L. Drake, A Wayne Vogl, Adam W. M. Mitchell.

18. RIGHT LYMPHATIC DUCT
(ductus lymphaticus dexter)
 Lymphatic trunk on the right side unite to form right lymphatic duct.
 courses along the medial border of the Scalenus anterior at the root of the
neck
 Opens at the junction of right subclavian & right internal jugular vein.
 Drains upper right quadrant of the body.
 orifice is guarded by 2 semilunar valves, prevent the passage of venous
blood into the duct.
Gray’s Anatomy For Students, 4th Edition , Richard L. Drake, A Wayne Vogl, Adam W. M. Mitchell.

19. THORACIC DUCT
 Largest.
 Drains the rest of the body (3/4th )
 Drains all of the body below
diaphragm ,left hand ,left side of
head ,neck and thorax
 Drains into left subclavian vein.
Gray’s Anatomy For Students, 4th Edition , Richard L. Drake, A Wayne Vogl, Adam W. M. Mitchell.

20. Gray’s Anatomy For Students, 4th Edition , Richard L. Drake, A Wayne Vogl, Adam W. M. Mitchell.

21. Gray’s Anatomy For Students, 4th Edition , Richard L. Drake, A Wayne Vogl, Adam W. M. Mitchell.

22. FLOW OF LYMPH
BLOOD
VESSELS
INTERSTITIAL
FLUID
LYMPH
CAPILLARIES
LYMPH
VESSELS
LYMPHATIC
DUCTS
SUBCLAVIAN
VEIN
Gray’s Anatomy For Students, 4th Edition , Richard L. Drake, A Wayne Vogl, Adam W. M. Mitchell.

23. LYMPHATIC
DRAINAGE
OF HEAD
AND NECK
Textbook Of Anatomy Head, Neck And Brain ,2ND Edition , Vishram Singh.

24. DEEP CERVICAL LYMPH NODES
 Lymph from head and neck drains into the
deep cervical lymph nodes
 lie along and around the IJV ,deep to the
SCM
 divided into two groups by the intermediate
tendon of omohyoid.
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

26. 1. Superior group / jugulodigastric nodes
 lie above the omohyoid muscle.
 present in a triangle formed by the internal
jugular vein, posterior belly of digastric and
facial vein
 receive lymph primarily from palatine tonsils
-node of tonsil.
 The superior group drains into the inferior
group
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

27. 2. Inferior group / jugulo omohyoid node
 lie along the internal jugular
vein below the omohyoid.
 node receives lymph primarily
from the tongue (node of
tongue).
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

28. Deep cervical nodes receive afferents
from
a. Superficial cervical lymph nodes.
b. Lymph nodes related to head& neck.
c. Palatine tonsils
d. Tongue
e. Larynx above the vocal folds
Efferent from deep cervical nodes
drain into
 Form the right and left jugular lymph
trunks.
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

29. LYMPHATICS ALONG THE VISCERA
1. Infrahyoid.
2. Pre laryngeal nodes
3. Pre tracheal nodes.
4. Paratracheal.
5. Retropharyngeal nodes.
Textbook Of Anatomy Head, Neck And Brain ,2ND Edition , Vishram Singh.

31. Infrahyoid nodes: in front of thyrohyoid membrane.
Pre laryngeal nodes: in front of the cricothyroid membrane.
Pre tracheal lymph nodes: in front of trachea below the isthmus of
thyroid gland.
Paratracheal nodes: on either side of trachea and esophagus along the
recurrent laryngeal nerves.
Retropharyngeal lymph node: posterior to pharynx and in front of
prevertebral fascia in the retropharyngeal space
Textbook Of Anatomy Head, Neck And Brain ,2ND Edition , Vishram Singh.

32. Supraclavicular nodes
 lower part of posterior triangle
 Left supraclavicular lymph nodes is called
VIRCHOW’S nodes.
 Swelling of left Supraclavicular nodes due
cancer of stomach, colon.
Textbook Of Anatomy Head, Neck And Brain ,2ND Edition , Vishram Singh.

33. SUPERFICIAL CERVICAL LYMPH
NODES
1. Submental nodes
 4 in number
 In submental triangle
 Afferents from : tip of tongue , floor of
mouth, chin, central part of lower lip.
 Efferent from : submandibular node &
jugulo omohyoid node
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

34. 2. Submandibular nodes
 3 in number
 In submandibular triangle.
 AFFERENTS :- centre of
forehead, medial angle of
eye, side of nose, cheek,
angle of mouth, anterior 2/3rd
of tongue, gums, submental
lymph nodes , frontal &
maxillary sinuses
 EFFERENT: Deep cervical
lymph nodes.
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

35. 3. Parotid/Preauricular lymph nodes
 Superficial group lie over the gland
 Deep group within the gland
 AFFERENTS :-
1. Forehead.
2. Temporal region
3. Auricle, lateral surface
4. External acoustic meatus, anterior wall
5. Eyelids, lateral half
 EFFERENT :- Deep cervical nodes
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

36. 5. Occipital nodes
 Situated at the apex of occipital
triangle along the occipital artery
 AFFERENT :- Posterior part of
scalp
 EFFERENT :- Supraclavicular
nodes.
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

37. 6. Buccal nodes
 Lie on the buccinator
muscle , along the facial
vein.
 upward extension of
submandibular nodes
 AFFERENT – part of cheek
& lower eyelid
 Efferent :- deep cervical
nodes
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

38. WALDEYER’S LYMPHATIC RING
 submucosal ring of aggregated masses of lymphoid tissue called tonsils, which surround
the commencement of air and food passages.
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

39. lymph from lymphoid
tissue of this ring
drains into
pericervical chain and
deep cervical chain,
which constitutes the
external ring of
Waldeyer.
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

40. PALATINE TONSIL
 In tonsillar fossae
 b/w palatoglossal
&palatopharyngeal arches
 Efferent pass to jugulodigastric
node
 No afferents
anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand

41. Textbook Of Anatomy Head, Neck And Brain ,2ND Edition , Vishram Singh.

42. CLINICAL ANATOMY
 Tonsils are larger in children, regress after puberty.
TONSILLITIS
 inflammation of tonsils.
 Two types – acute & chronic
 Acute – viral & bacterial
 Chronic – complication of acute
 Clinical features- recurrent sore throat, halitosis , cough , difficulty in breathing
Textbook Of Anatomy Head, Neck And Brain ,2ND Edition , Vishram Singh.

43. PERITONSILLAR ABSCESS/QUINSY
 When tonsillar infection spreads to tonsillar bed.
 Radiating pain to ear & side of neck
 Spasm of pterygoid muscles- trismus
 Swelling of soft palate
Textbook Of Anatomy Head, Neck And Brain ,2ND Edition , Vishram Singh.

44. TREATMENT- TONSILLECTOMY
 Pt in supine position with head extended ; sand bag under shoulder
 Mouth gag is used to open and fix the jaw including the tongue.
 Packing of larynx to prevent aspiration.
 Tonsils grasped with tonsil holding forceps and stretched medially.
 Mucosa incised over upper pole, anterior pillar& posterior pillar
 Bluntly dissect tonsil from its bed
 Lower pole is separated with a snare
 Bleeding vessel is ligated/cauterised
SRB’s Manual Of Surgery Third Edition- Sriram Bhat M

45.  Bleeding from tonsillar fossa after tonsillectomy: occurs due to
damage of paratonsillar vein. blood clots should be removed in order to
check bleeding. If not removed, they interfere with the retraction of the
vessel walls by preventing the contraction of the surrounding muscles.
 Postoperative edema of tonsillar bed after tonsillectomy can affect the
glossopharyngeal nerve.
Textbook Of Anatomy Head, Neck And Brain ,2ND Edition , Vishram Singh.

46. LYMPHATIC DRAINAGE OF FACE
 SUB MENTAL NODES
 SUB MANDIBULAR NODES
 PAROTID LYMPH NODES
LYMPHATIC DRAINAGE OF THE SCALP
 OCCIPITAL
 MASTOID
 PAROTID
Gray’s Anatomy For Students, 4th Edition , Richard L. Drake, A Wayne Vogl, Adam W. M. Mitchell.

47. LYMPHATIC DRAINAGE OF ORBIT
PAROTID
SUBMANDIBULAR
LYMPHATIC DRAINAGE OF EAR
PAROTID
MASTOID
Gray’s Anatomy For Students, 4th Edition , Richard L. Drake, A Wayne Vogl, Adam W. M. Mitchell.

48. LYMPHATIC DRAINAGE OF TEETH
 MANDIBULAR INCISORS- SUBMENTAL
 OTHERS- SUBMANDIBULAR LYMPH NODES
LYMPHATIC DRAINAGE OF NASAL CAVITY
 ANTERIOR HALF - SUBMANDIBULAR LYMPH NODES
 POSTERIOR HALF - RETROPHARYNGEAL LYMPH
NODES.
Gray’s Anatomy For Students, 4th Edition , Richard L. Drake, A Wayne Vogl, Adam W. M. Mitchell.

49. LYMPHATIC DRAINAGE OF TONGUE
1. Apical vessels: tip and inferior surface of the
tongue into submental lymph nodes.
2. Marginal vessels: marginal portions of the
anterior two-third of the tongue—unilaterally into
submandibular lymph nodes.
3. Central vessels: central portion of the
anterior two-third of the tongue into the deep
cervical lymph nodes.
4. Basal vessels: root of the tongue and
posterior one-third of the tongue bilaterally into
upper deep cervical lymph nodes,
Textbook Of Anatomy Head, Neck And Brain ,2ND Edition , Vishram Singh.

50. LEVELS OF LYMPH NODES
(American head and neck society & the American academy of otolaryngology)
IA- submental lymph nodes
IB- submandibular lymph nodes
II A &II B -upper jugular lymph nodes
III- middle jugular lymph nodes
IV- lower jugular lymph nodes
V A & V B -posterior triangle lymph nodes
VI- anterior ( Central) compartment lymph nodes
VII- superior mediastinal
Quick Reference Guide To TNM Staging Of Head And Neck Cancer And Neck Dissection Classification – 4th Edition, American Academy
Of Otolaryngology - Head And Neck Surgery Foundation.

51. Quick Reference Guide To TNM Staging Of Head And Neck Cancer And Neck Dissection Classification – 4th Edition, American Academy
Of Otolaryngology - Head And Neck Surgery Foundation.

52. LEVEL I LYMPH NODES
I A - between the anterior belly of the digastric muscles and hyoid bone.
II A- bounded by the anterior and posterior bellies of the digastric muscle
and the inferior border of the body of the mandible.
lymph nodes adjacent to the submandibular salivary gland and along the
facial artery are included in this group.
Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

53. LEVEL II LYMPH NODES
 Upper jugular
 around the upper portion of the internal jugular vein and the
upper part of the spinal accessory nerve.
 extending from the base of the skull up to the bifurcation of the
carotid artery or the hyoid bone.
 Lymph nodes anterior to the spinal accessory nerve are
designated level IIA, and those posterior to it are designated
level IIB.
Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

54. LEVEL III LYMPH NODES
 Mid jugular group, which includes lymph nodes around the
middle third of the internal jugular vein from the hyoid bone up
to the inferior border of cricoid cartilage.
LEVEL IV LYMPH NODES
includes lymph nodes around the lower third of the internal
jugular vein from the inferior border of cricoid cartilage up to the
clavicle
Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

55. LEVEL V
 Posterior triangle group
 Lower portion of spinal accessory nerve
 bounded by the triangle formed by the clavicle, the posterior border of the
sternocleidomastoid muscle, and the anterior border of the trapezius muscle.
 divided into two levels by a plane at the level of the inferior border of the cricoid
cartilage.
 Level V A is superior to this plane, and level VB is inferior to it.
Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

56. LEVEL VI
 Central compartment
 Hyoid bone to suprasternal notch.
 And between carotid sheaths.
LEVEL VII
 superior mediastinal group
 lymph nodes in the anterosuperior mediastinum and tracheoesophageal
groove
 extending from the suprasternal notch to innominate artery.
Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

57. EXAMINATION OF LYMPHNODES
LOOK FOR
1. LOCATION
2. SIZE
3. CONSISTENCY
4. NUMBER

58. ORDER OF EXAMINATION
1. UPPER HORIZONTAL CHAIN
2. EXTERNAL JUGULAR CHAIN
3. INTERNAL JUGULAR CHAIN
4. SPINAL ACCESSORY CHAIN
5. TRANSVERSE CERVICL CHAIN
6. ANTERIOR JUGULAR CHAIN
7. JUXTAVISCERAL CHAIN

66. PATTERNS OF NECK METASTASIS
 For primary tumors in the oral cavity, the regional lymph nodes at highest
risk for early dissemination by metastatic cancer are limited to levels I, II,
and III.
Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

67.  For tumors on the lateral aspect of the oropharynx, hypopharynx, and
larynx first-echelon lymph nodes at highest risk are levels II, III, and IV on
the ipsilateral side.
Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

68. Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

69. Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

70. Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

71. Cutaneous malignant tumors of the scalp
 A line joining the helix of one ear to the helix of the opposite ear in a
coronal plane separates the watershed areas of the scalp.
 Tumors anterior to this line in general metastasize to preauricular,
periparotid,& levels I to IV.
 Posterior to this line metastasize to the suboccipital and postauricular &
posterior triangle of the neck and the deep jugular chain (levels II to V).
Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

72. CLINICAL
STAGING OF
CERVICAL
LYMPH NODES
(N STAGING)
American Joint Committee on
Cancer and the International
Union Against Cancer
Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal G. Patel, Bhuvanesh Singh.

73. Neck Dissection Classification
A. Radical Neck Dissection
 standard basic procedure for cervical lymphadenectomy
 removal of all ipsilateral cervical lymph node groups
 Levels I through V
 spinal accessory nerve, internal jugular vein, and sternocleidomastoid
 inferior border of the mandible superiorly to the clavicle inferiorly
 from the lateral border of the sternohyoid muscle, hyoid bone, and
contralateral anterior belly of the digastric muscle medially; to the anterior
border of the trapezius muscle laterally.
Quick Reference Guide To TNM Staging Of Head And Neck Cancer And Neck Dissection Classification – 4th Edition, American Academy
Of Otolaryngology - Head And Neck Surgery Foundation.

74. B. Modified Radical Neck
Dissection
RND + preservation of one or
more non lymphatic structures
(SAN , IJV & SCM).
RND
Quick Reference Guide To TNM Staging Of Head And Neck Cancer And Neck Dissection Classification – 4th Edition, American Academy
Of Otolaryngology - Head And Neck Surgery Foundation.

75. C. Selective Neck Dissection
preservation of one or more of the lymph nodes
Anterior Neck Dissection—Includes Level VI .
Supra omohyoid Neck Dissection—Includes Levels IA & IB, Level IIA or Levels IIA & IIB, and
Level III
Lateral Neck Dissection—Includes Level IIA or Levels IIA & IIB, Level III, and Level IV
Posterolateral Neck Dissection—Includes Levels II, III, IV, & V
D. Extended Radical Neck Dissection
RND + removal of one or more additional lymph node groups or non lymphatic structures
Quick Reference Guide To TNM Staging Of Head And Neck Cancer And Neck Dissection Classification – 4th Edition, American Academy
Of Otolaryngology - Head And Neck Surgery Foundation.

77. LYMPHATIC DISORDERS
1. Acute Lymphangitis
 caused by Streptococcus pyogenes
 spreads to the draining lymphatics and
lymph nodes (lymphadenitis) where an
abscess may form.
 progress to bacteraemia or septicaemia.
 t/t - intravenous antibiotics
2. Lymphoedema
as abnormal limb swelling secondary to
defective lymphatic drainage.
SRB’s Manual Of Surgery Third Edition- Sriram Bhat M

78. 3. LYMPHOMAS
Neoplastic condition
 Types – Hodgkin & non
Hodgkin lymphoma.
 HODGKIN’S LYMPHOMA -
most common
 NON HODGKIN LYMPHOMA –
more aggressive
 Inner waldeyer’s ring involved.
 Poor prognosis.
SRB’s Manual Of Surgery Third Edition- Sriram Bhat M

79. 4. BURKITT’S LYMPHOMA
 EBV –aetiology
 Common in jaw –either upper/lower
 Treatment-radiotherapy & chemotherapy
5.TUBERCULOUS LYMPHADENITIS
-Mycobacterium tuberculosis
-cold abscess
Common in jugulodigastric(54%) & posterior triangle
lymph nodes
SRB’s Manual Of Surgery Third Edition- Sriram Bhat M

80. LYMPHADENOPATHY-INVESTIGATIONS
 BLOOD EXAMINATION
 FNAC
 BIOPSY
 IMAGING –
1. ULTRASOUND
2. CT
3. MRI
4. PET
5. NANOPARTICLE MRI
6. LYMPHANGIOGRAPHY
7. LYMPHSCINTIGRAPHY

81. ULTRASOUND
 NORMAL – FLATTENED
HYPOECHOICH STRUCTURE WITH
VARYING AMOUNT OF FAT – CIGAR
SHAPED
MALIGNANT LYMPHNODES –
ENLARGED NODES, ROUNDED WITH
PERIPHERAL /MIXED VASCULARITY
,HYPERECHOICH &SEPTATION

82. CT SCAN
NORMAL
 <1cm in size
 Smooth,well defined ,homogenous
LYMPHADENOPATHY

83. MRI SCAN
NORMAL
LYMPHADENOPATHY

84. POSITRON EMISSION TOMOGRAPHY

85. MR LYMPHANGIOGRAM
Contrast dye will then be injected into the vessel, making the vessels more visible
under imaging.

86. LYMPHOSCINTIGRAPHY
 injecting tiny amounts of radioactive
particles (Technetium-99m sulfur-
colloid) at the site of the primary
cancer
 identify the first sentinel lymph nodes

87. CONCLUSION
Situation of lymph nodes in neck, their areas of
drainage are of clinical importance since
removal of lymph nodes in neck is the
management of cancers in head and neck
region.

88. REFERENCE
i. Gray’s Anatomy For Students, 4th Edition , Richard L. Drake, A Wayne Vogl, Adam W. M.
Mitchell.
ii. Textbook Of Anatomy Head, Neck And Brain ,2ND Edition , Vishram Singh.
iii. Human Anatomy – Head And Neck , 7th Edition Vol 3 , B D Chaurasia.
iv. Anand’s Human Anatomy for Dental Students, 3rd Edition-Mahindra Kumar Anand
v. Quick Reference Guide To TNM Staging Of Head And Neck Cancer And Neck
Dissection Classification – 4th Edition, American Academy Of Otolaryngology - Head And
Neck Surgery Foundation.
vi. SRB’s Manual Of Surgery Third Edition- Sriram Bhat M
vii. Oral Anatomy , 3RD Edition - Harry Sicher.
viii. Human physiology for bds 5th edition A K Jain.
ix. Jatin Shah’s Head And Neck Surgery And Oncology 4th Edition -Jatin P. Shah, Snehal
G. Patel, Bhuvanesh Singh.
x. Langman’s Medical Embryology ,12th edition- T W Sadler

89. THANK YOU