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Anatomy

Head and Neck

Question 140 of 180

A 18 year old presents to ED with painful swollen exudative tonsils. You diagnose acute bacterial tonsillitis. Which of the following lymph nodes receives lymphatic drainage directly from the tonsils:

Answer:

The jugulodigastric node directly receives lymphatic drainage from the palatine tonsils, tongue and pharynx.

Deep Cervical Lymph Nodes

Anatomy / Head and Neck / Neck

Last Updated: 11th April 2019

The deep cervical nodes form a chain along the internal jugular vein and are divided into upper and lower groups.

Jugulodigastric Node

The most superior node in the upper group (lying where the posterior belly of the digastric muscle crosses the internal jugular vein) is the jugulodigastric node which receives lymphatic drainage from the tonsils and tonsillar region.

Jugulo-omohyoid Lymph Node

The most superior node in the lower group (lying just inferior to the intermediate tendon of the omohyoid muscle) is the jugulo-omohyoid node which receives lymphatic drainage from the tongue.

By Henry Vandyke Carter [Public domain], via Wikimedia Commons

Deep Cervical Lymph Nodes. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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