Of the 800 lymph nodes throughout the body is almost (30% of them) 300 lymph nodes in head and neck are so often either metastasis or spreading the infection appears as sweeling of lymph nodes in head neck.
Diagnosis of a lump in the neck requires knowledge of the structure of the normal anatomy of the neck. M. Sternocleidomastoid should be palpated from the top down to ensure there any enlargement of the lymph vessels in the neck jugular.
It is also necessary to distinguish lymph node lump, lump in the thyroid is located in the midline where the thyroid gland and parotid lump which is located in the parotid area preaurikula to the inferior mandibular arch.
Knowledge of anatomy that needs to be understood to include the anatomy of the neck dissection: platisma m, m. sternokleidomastoideus, m. omohioid, m. digastrikus, m. trapezius, mandibular ramus of n. facial, brachial n, n. phrenicus, n. spinal accessory, n. hipoglosus, torachicus duct.
Figure 6. Graph Algorithms evaluation and management of lumps in the neck
Classification of the lymph nodes of the neck region according to Memorial Sloan-Kettering is divided into 6 levels according to Table 1.
Figure 7. Cervical lymph node groups and the possible location of the primary lesion
Lymph node-level Group
Submental and submandibular nodes I
II Upper jugular nodes
III Middle jugular nodes
IV Lower jugular nodes
Posterior triangle nodes V
Anterior compartment VI lymph nodes
Table 1. Classification of regional lymph nodes according to Memorial Sloan-Kettering
Lymph node metastasis in the primary tumor may be expected to follow the pattern as shown above. On oral cancer usually metastases to the submandibular triangle, is different when coming from other parts of the head of the neck are usually located in the lateral neck. If found a lump in the fossa supra clavicle then this is a metastasis from the bottom of the neck (the lungs).
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