jaringan limfe kepala dan leher mo 2 maju

8/12/2019 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.

jaringan limfe kepala dan leher mo 2 maju

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