Palpation of anatomical landmark

Mastoid tip Lateral process C1 Hyoid bone Thyroid Mandible Sternocleidomastoid Clavicle

Triangle of the Neck

Internal Jugular vein

Anatomy of Lymph nodes

Nomenclature of lymph nodes Rouviere 1932

Nomenclature of lymph nodes Lindberg 1972

Nomenclature of lymph nodes Memorial Sloan-Kettering Cancer Center 1981

Additional lymph nodes group

Parapharyngeal node Retropharyngeal node Superior Mediastinal node

Specific primary site drain to specific l.n. As first echelon lymph nodes

Pattern of lymphatic drainage

Removal of lymph nodes

First echelon lymph node?

First echelon lymph node?

Primary site?

Primary site?

Primary site?

Primary site ?