Download - Jaringan Limfe Kepala Dan Leher MO 2 Maju
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JARINGANLIMFEKEPALADANLEHERdzulhiba
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KEKURANGAN
Anatomi, topografi, fungsi dan hubungan dengan
penyakitnya
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Fungsi pembuluh limfe :
1. mengangkut cairan dari
jaringan menuju darah.
2. mengangkut lemak danbahan bahan asing
dirombak ke nodus limfe.
Pembuluh limfa bermuara di
berbagai jaringantermasuk
sirkulasi terbuka
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SISTEMLIMFATIK
Pembuluh
getah bening/ limfe
Organ-organLimfatik
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PEMBULUH GETAH BENING
Pembuluh Limfebesar
Pembuluh getahbening yg lebih
besarKapiler getah bening
PEMBULUHGETAHBENING
Kapiler getahbening
Pembuluhgetah beningyg lebih besar
PembuluhLimfe besar
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A. KAPILERGETAH
BENING Have one way minivalves allowing excess fluid to enter but not leave
Picks up bacteria and viruses as well as proteins, electrolytes andfluid (lymph nodes destroy most pathogens)
Absent from bone, bone marrow, teeth, CNS
Enter lymphatic collecting vessels
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B. PEMBULUH GETAH BENING YANG LEBIH
BESAR Similar to blood vessels (3 layers), but thin & delicate
Superficial ones in skin travel with superficialveins
Deep ones of trunk and digestive viscera travel with deep
arteries
Very low pressure
Drain into lymph nodes
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Dalam perjalanan
mencurahkan isinya kekelenjar getah bening
(Lymph Nodes)
pembuluh getahbening yang besar
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LYMPHTRUNKS/BATANGLIMPH
Lymphatic collecting vessels converge
Five major lymph trunks :
Lumbar trunks
Receives lymph from lower limbs
Intestinal trunk
Receives lymph from digestive organs
Bronchomediastinal trunks
Collects lymph from thoracic viscera
Subclavian trunksReceive lymph from upper limbs and
thoracic wall
Jugular trunks
Drain lymph from the head and neck
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LYMPHDUCTSCisterna chyli
Located at the union of lumbar andintestinal trunks
Thoracic duct
Ascends along vertebral bodies
Empties into venous circulation
Junction of left internal jugular and left
subclavian veins
Drains three quarters of the body
mengalirkan dari seluruh tubuh selain
bagian kanan
Right lymphatic duct
Empties into right internal jugular and
subclavian veins
mengalirkan dari kanan kepala dan leher,
lengan kanan dan dada kanan
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DRAINASEKGB LEHERDANKEPALADibagi 7 level
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Level Ithe submental and
submandibular nodes
Level Iathe submental nodes
Level Ibthe submandibular nodes and
gland Level IIupper jugular chain
nodes
Level IIajugulodigastric nodes
Level IIbsubmuscular recess
Level IIImiddle jugular chain nodes
Level IVlower jugular chain nodes
Level Vposterior triangle nodes
Level Va
Level Vb
Level VIanterior compartmentnodes
Level VIIparatracheal nodes
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LEVELIIUPPERJUGULARCHAINNODES
Level IIajugulodigastricnodes
deep to sternocleidomastoid(SCM) muscle,
anterior to the posteriorborder of the muscle,
posterior to the posterioraspect of the posterior bellyof digastric,
superior to the level of thehyoid,
inferior to spinal accessorynerve (CN XI)
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LEVELIIUPPERJUGULARCHAINNODES
Level IIbsubmuscular
recess;
superior to spinal
accessory nerve to the
level of the skull base
Recess : berhenti
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LEVELIIIMIDDLEJUGULARCHAINNODES
inferior to the hyoid,
superior to the level of thecricoid,
deep to SCM muscle from
posterior border of themuscle to the strapmuscles medially
Strap : mengikat/ melilit
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LEVELIVLOWERJUGULARCHAINNODES
inferior to the level of the
cricoid
superior to the clavicle
deep to SCM muscle from
posterior border of the
muscle to the strapmuscles medially
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LEVELVPOSTERIORTRIANGLENODES
Level Va
lateral to the posterioraspect of the SCM muscle
inferior and medial to
splenius capitis and
trapezius superior to the spinal
accessory nerve
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Level Vb
lateral to the posterior aspect of SCM muscle
medial to trapezius
inferior to the spinal accessory nerve superior to the clavicle
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LEVELVIANTERIORCOMPARTMENTNODES
inferior to the hyoid
superior to suprasternal notch
medial to the lateral extent of
the strap muscles bilaterally
Notch : derajat
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LEVELVIIPARATRACHEALNODES
inferior to the suprasternalnotch in the upper
mediastinum
Notch : derajat
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Patterns of spread from
primary tumor sites in
the head and neck to
cervical lymphatics are
well described The location and
incidence of metastasis
vary according to the
primary site
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Primary tumors within the
oral cavity and lip
metastasize to the nodes in
levels I, II, and III
Skip metastases may occurwith oral tongue cancers
such that involvement of
nodes in level III or IV may
occur without involvementof higher echelon nodes
(levels I & II).
Involvement : keterlibatan
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Tumors arising in the
oropharynx, hypopharynx,
and larynx most commonly
spread to the lymph nodes
of the lateral neck in levelsII, III, and IV.
Arising : timbul,
spread : lebar/ menjalar
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Isolated level V
lymphadenopathy is
uncommon with oral
cavity, pharyngeal, and
laryngeal primaries. Malignancies of the
nasopharynx and thyroid
commonly spread to level
V nodes in addition to thejugular chain nodes.
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Retropharyngeal lymph nodes are sites for
metastasis from tumors of the nasopharynx, soft
palate, and lateral and posterior walls of the
oropharynx and hypopharynx.
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Tumors of the hypopharynx, cervical esophagus,
and thyroid frequently involve the paratracheal
nodal compartment, and may extend to the
lymphatics in the upper mediastinum (level VII)
The Delphian node, a pretracheal lymph node, maybecome involved by advanced tumors of the glottis
with subglottic spread.
Involve : keterlibatan
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BOBORBAH.