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Lymph from the scalp, face, and neck drains into the superficial ring (pericervical collar) of lymph nodes: submental, submandibular, parotid, mastoid, and occipital, located at the junction of the head and neck . The lymphatic vessels of the face accompany other facial vessels. Superficial lymphatic vessels accompany veins, and deep lymphatics accompany arteries. All lymphatic vessels from the head and neck drain directly or indirectly into the deep cervical lymph nodes, a chain of nodes mainly located along the IJV in the neck. Lymph from these deep nodes passes to the jugular lymphatic trunk, which joins the thoracic duct on the left side and the IJV or brachiocephalic vein on the right side.
Superficial tissues of the thoracic wall drain in a quadrant fashion to the axillary nodes on each side. Deep wall structures drain to 3 groups of nodes: Parasternal/Internal thoracic: in the anterior intercostal space, drain territory of the anterior intercostal arteries. Intercostal: posterior intercostal space, drain territory of the posterior intercostal arteries, and end up in the thoracic or right lymphatic ducts. Diaphragmatic: anterior, posterior and around the phrenic nerves, drain the diaphragm, empty into other thoracic nodes nearby • Thoracic contents drain to 3 groups of nodes: • Brachiocephalic: lie anterior to the brachiocephalic veins, aortic arch branches, and drain the thymus, thyroid, pericardium • Posterior mediastinal: lie behind pericardium, drain oesophagus, posterior pericardium, diaphragm, empty into the thoracic duct/tracheobronchial nodes • Tracheobronchial: drain the heart, lungs, bronchi, lower trachea
