Deep cervical lymph nodes

The deep cervical lymph nodes are a group of lymph nodes located along the internal jugular vein, deep to the sternocleidomastoid muscle. They form the main drainage pathway for lymph from the head and neck and are divided into superior and inferior groups. These nodes filter lymph from a wide range of areas including the scalp, face, oral cavity, pharynx, larynx, and thyroid gland.

Location

The deep cervical lymph nodes lie deep to the sternocleidomastoid muscle and run parallel to the internal jugular vein, within the carotid sheath. They extend from the base of the skull to the root of the neck. The superior group lies above the intermediate tendon of the omohyoid muscle, while the inferior group lies below it.

Classification

The deep cervical lymph nodes are traditionally divided into two main groups:

Superior Deep Cervical Lymph Nodes

• Located along the upper portion of the internal jugular vein
• Includes the jugulodigastric node—a prominent node that drains the tonsils and pharynx

Inferior Deep Cervical Lymph Nodes

• Located along the lower internal jugular vein, near the clavicle
• Includes the jugulo-omohyoid node—notable for draining the tongue

Drainage Zones

The deep cervical lymph nodes receive afferent lymphatic drainage from:

• Superficial cervical lymph nodes
• Scalp and face (via preauricular, submandibular, and submental nodes)
• Pharynx and tonsils
• Larynx, trachea, and esophagus
• Thyroid and parathyroid glands
• Oral cavity and tongue

Efferent Drainage

Efferent vessels from the deep cervical lymph nodes form the:

• Jugular lymphatic trunk:
  • Right side: Empties into the right lymphatic duct
  • Left side: Drains into the thoracic duct

Relations

• Medial: Carotid artery, vagus nerve
• Lateral: Internal jugular vein
• Anterior: Sternocleidomastoid muscle
• Posterior: Prevertebral muscles

Function

The deep cervical lymph nodes filter lymphatic fluid from critical areas of the head and neck, capturing pathogens, cancer cells, and debris. They play a central role in immune surveillance and response in this region.

Clinical Relevance

• Lymphadenopathy: Enlargement of deep cervical nodes may be seen in infections, autoimmune disorders, or malignancy
• Oral and pharyngeal cancers: These nodes are common sites for metastatic spread from cancers of the oral cavity, pharynx, larynx, and thyroid
• Neck dissections: Surgical removal of deep cervical lymph nodes is performed in head and neck cancer treatment
• Palpation: While deep, large or inflamed nodes may be palpable beneath the sternocleidomastoid muscle