SUPERFICIAL LYMPHATICS OF HEAD AXD NECK 649 



I. THE SUPERFICIAL LYMPHATIC VESSELS AND GLANDS OF 

 THE HEAD AND NECK 



A. The Superficial Lymphatic Vessels 



The superficial lymphatic vessels may be su])divided into the superficial 

 lymphatics of the scalp, the face, and the neck (i\<i. 398). 



1. The superficial lymphatic vessels of the scalp follow roughly the course 

 of the superficial veins. Thus there is (1) a posterior or occipital set, which course 

 downwards over the occipital bone to the occipital, or suboccipital glands as they 

 are sometimes called; (2) a postero-lateral or posterior auricular set, which course 

 downwards behind the ear, and end in the posterior auricular or sterno-mastoid 

 glands; (3) an antero-lateral or temporal set, which accompany the superficial 

 temi)oral vein in front of the ear, and end in the parotid lymphatic glands; and 

 (4) an anterior or frontal set, which course downwards over the frontal bone and 

 end in the facial lymphatics. 



2. The superficial lymphatic vessels of the face — continuous at the root of 

 the nose with tlie frontal set of lymphatics descending from the scalp — course down- 

 wards and backwards with the facial vein, receiving tributaries from the inner half 

 of the eyelids, the side of the nose, the contiguous portions of the cheek, and the 

 upper and lower lips. They end in the submaxillary lymphatic glands beneath 

 the lower jaw. The lymphatics from the outer part of the eyelids and the outer 

 part of the cheek run backwards and slightly dowuAvards to the parotid lymphatic 

 glands. 



3. The superficial lymphatic vessels of the neck form a plexus in the sub- 

 cutaneous tissues of the neck. They communicate with the superficial lymphatics 

 of the scalp and face, and with some of the superficial lymphatics of the upper 

 part of the thorax. They end in the superficial cervical chain of lymphatic glands. 



B. The Superficial Lymphatic Glands 



The superficial lymphatic glands of the head and neck may be divided into 

 two sets, a transverse and a vertical (fig. 398). 



1. The transverse occur in groups in the course of a line draAAii from the 

 occiput to the mast<jid process, and thence along the zygoma and beneath the body 

 of the lower jaw to the symphysis. They receive as afferent vessels the lymj^hatics 

 of the scalp and face. Their efferent vessels pass into the superficial and deep 

 cervical chains. 



Tiiey are named: — (1) The occipital, or suboccipital; (2) the posterior auri- 

 cular, or sterno-mastoid; (3) the parotid; (4) the buccal; and (5) the sub- 

 maxillary. 



(1 ) The occipital or suboccipital glands are situated at the back of the head, 

 beneath the skin, just below the superior curved line of the occipital bone and over 

 the insertion of the complexus muscle. They receive the lymphatic vessels from 

 the Imck of the head. Their efferent vessels discharge into the superficial lymphatic 

 glands of the neck. It is these glands which i)erha])S more esj)ecially are foimd 

 enlarged in secondary sy})liilis. 



(2) The posterior auricular or sterno-mastoid glands, situated over the 

 insertion of the sterno-mastoid nuiscle behind the ear, receive the ])osterior auri- 

 cular lymphatics. Their eft'erent vessels discharge into tlie superficial cervical 

 lympliatics. 



(S) The parotid lymphatic glands are situated Justin front of the ear over 

 the parotid salivary gland, in the sul)stance of which one or more are embedded. 

 They receive the temporal set of lymjthatic vessels, and the lymphatics from the 

 external parts of the eyelid and posterior and greater part of the cheek. They 

 discharge, partly into the sul)maxillary glands, and partly into the superficial 

 cervical chain. 



(4) The buccal lymphatic glands are situated on the surface of the buccinator. 



