CorpusHuman Anatomy
Lymphatic & ImmuneLymph node group

Cervical lymph nodes

Nodi lymphoidei cervicales

Also known as: neck lymph nodes, deep cervical nodes, jugulodigastric node, tonsillar node, jugulo-omohyoid node, submandibular nodes, submental nodes, neck levels I–VI

The lymph nodes of the head and neck: a superficial "collar" at the junction of head and neck and the deep cervical chain along the internal jugular vein, through which all lymph from the head and neck ultimately passes.

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Overview

Lymph from the head and neck drains first to a ring of superficial nodes at the junction of head and neck — occipital, retroauricular (mastoid), parotid (pre-auricular), submandibular and submental — and to superficial cervical nodes along the external jugular vein. All of these, together with direct vessels from deep structures (pharynx, larynx, thyroid, tongue), drain to the deep cervical nodes strung along the internal jugular vein within and around the carotid sheath. This chain is the final common pathway: its inferior efferents form the jugular trunk, which joins the thoracic duct on the left or the right lymphatic duct on the right.

Two deep nodes are named. The jugulodigastric (tonsillar) node lies just below the posterior belly of digastric where it crosses the internal jugular vein, near the angle of the mandible; it drains the palatine tonsil and posterior tongue and is the node enlarged in tonsillitis. The jugulo-omohyoid node lies where omohyoid crosses the vein and drains the tongue, including its tip.

For head and neck cancer, surgeons and radiologists use levels I–VII: I (Ia submental, Ib submandibular), II (upper jugular, skull base to hyoid), III (middle jugular, hyoid to cricoid), IV (lower jugular, cricoid to clavicle), V (posterior triangle), VI (central/anterior compartment: pre- and paratracheal, prelaryngeal "Delphian" node) and VII (superior mediastinum).

Location

Neck: superficial groups at the junction of head and neck and along the external jugular vein; deep chain along the internal jugular vein deep to sternocleidomastoid, from the skull base to the root of the neck.

Parts & subdivisions

  1. Occipital nodes
    Over the occiput near the trapezius attachment; drain the posterior scalp. Enlarged in scalp infection, head lice and rubella.
  2. Retroauricular (mastoid) nodes
    Over the mastoid process; drain the posterior scalp, posterior auricle and external acoustic meatus.
  3. Parotid (pre-auricular) nodes
    On and within the parotid gland; drain the lateral face, anterior scalp, eyelids, auricle and external meatus.
  4. Submandibular nodes
    Beside the submandibular gland; drain most of the face (upper lip, lateral lower lip, cheek, nose, medial eye), anterior nasal cavity, teeth and gums, anterior tongue sides and floor of mouth.
  5. Submental nodes
    Below the chin between the anterior bellies of digastric; drain the tip of the tongue, central lower lip, chin and anterior floor of mouth.
  6. Superficial cervical nodes
    Along the external jugular vein on sternocleidomastoid; drain the skin of the neck and the parotid region.
  7. Deep cervical nodes
    Superior and inferior groups along the internal jugular vein, including the jugulodigastric and jugulo-omohyoid nodes; receive all head and neck lymph. Inferior deep nodes extend into the supraclavicular fossa.

Anatomy

Lymphatic drainage

Superficial groups → deep cervical nodes → jugular trunk → thoracic duct (left) or right lymphatic duct (right).

Relations

The deep chain lies along the internal jugular vein in the carotid sheath region, deep to sternocleidomastoid; the accessory nerve (CN XI) crosses the posterior triangle superficially among level V nodes.

Function

  • Filter lymph from the scalp, face, oral and nasal cavities, pharynx, larynx, thyroid and neck.
  • Mount immune responses to the many antigens entering via the upper aerodigestive tract.

Clinical significance

Cervical lymphadenopathy

Commonest in children with upper respiratory and dental infections. Tender jugulodigastric nodes accompany tonsillitis; posterior triangle nodes suggest EBV (infectious mononucleosis), rubella or scalp infection; a firm, painless, persistent neck node in an adult (especially a smoker or drinker) is metastatic squamous-cell carcinoma until proven otherwise — examine the upper aerodigestive tract before biopsy. Tuberculous cervical adenitis (scrofula) causes matted nodes and cold abscesses.

Neck dissection and accessory-nerve injury

Lymph-node biopsy or dissection in the posterior triangle risks the superficially placed accessory nerve, causing trapezius weakness, shoulder droop and difficulty abducting above 90°.

Mnemonics

Superficial collar (posterior → anterior)

"Old Rats Prefer Soft Sugar" — Occipital, Retroauricular, Parotid, Submandibular, Submental.

Compiled from standard anatomy and physiology references — see the Lymphatic & Immune System sources. For education only; not medical advice.