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Lymph Node Groups

last modified on: Mon, 05/08/2017 - 11:50

Lymph Node Groups

IA
Submental

- Between anterior belly of the digastric and hyoid
- Mets from floor of mouth, anterior oral tongue, anterior mandibular alveolar ridge, and lower lip.

IB
Submandibular

- Between anterior and posterior bellies of the digastric, the stylohyoid, and the body of the mandible.
- Radiographically, the vertical plane at the posterior aspect of the submandibular gland separates posterior IB from IIA

IIa & IIB
Upper jugular

- Upper third of IJ from the skull base (above) to the inferior border of the hyoid (below); lateral border of the sternohyoid and the stylohyoid (medial) to the posterior border of the SCM (lateral).*
- Sublevel IIA and IIB nodes are divided by the spinal accessory nerve.
- Mets from oral cavity, nasal cavity, nasopharynx, oropharynx, hypopharynx,
larynx, and parotid gland.

III
Middle jugular

- Middle third of IJ from the inferior border of the hyoid bone (above) to the inferior border of the cricoid cartilage (below); lateral border of the sternohyoid (medial) to the posterior border of the SCM (lateral).*
- Mets from oral cavity, nasopharynx, oropharynx, hypopharynx, and larynx.

IV
Lower jugular

- Lower third of IJ from the inferior border of the cricoid cartilage (above) to the clavicle (below); lateral border of the sternohyoid (medial) to the posterior border of the SCM (lateral).*
- Mets from hypopharynx, cervical esophagus, and larynx.

VA & VB
Posterior cervical

- Along lower half of CN XI and the transverse cervical artery. From the convergence of the SCM and trapezius (above) to the clavicle (below); the posterior border of the (medial),* to the anterior border of the trapezius (lateral).
- Sublevels VA and VB separated by a horizontal plane at the inferior border of the cricoid cartilage.
- Mets from the nasopharynx and oropharynx (Sublevel VA), and the thyroid gland (Sublevel VB).

VI
Anterior, visceral

- Between the hyoid bone (above) to the suprasternal notch (below), and the common carotid arteries.
- Mets from the thyroid gland, glottic and subglottic larynx, apex of the piriform sinus, and cervical esophagus.

VII
Superior mediastinal

- Top of manubrium (above) to innominate vein (below); between common carotid arteries laterally

 

* The surgical landmark that defines the lateral boundary of Levels II, III, and IV and the corresponding medial boundary of the posterior triangle (Level V) is the plane that parallels the sensory branches of the cervical plexus.