Paratracheal cervical nodes

At a glance

English

Paratracheal cervical nodes

Latin (TA2)

Nodi paratrachéales colli

System

Lymphatic

Region

Neck

Side

Single, on the midline

About the paratracheal cervical nodes

The paratracheal cervical nodes run in a chain on either side of the trachea in the lower neck, in the groove between the trachea and the oesophagus. They are deep anterior cervical nodes, lying behind the lower part of the thyroid gland and deep to the infrahyoid strap muscles. The pretracheal nodes, in contrast, lie in front of the trachea. The chain continues down into the upper chest along the trachea, where similar nodes form part of the mediastinal groups.

The recurrent laryngeal nerve climbs up the same groove on each side to reach the larynx, so the nodes and the nerve lie in close contact. The inferior thyroid artery crosses the area from the side, and the oesophagus lies behind.

Lymph reaches the chain from the thyroid gland, the lower larynx below the vocal folds, the cervical trachea and the cervical oesophagus. It also receives some outflow from the pretracheal and thyroid nodes. From the paratracheal nodes lymph passes to the lower deep cervical nodes along the internal jugular vein, and to nodes in the upper mediastinum.

In neck staging these nodes belong to the central compartment, level VI. Thyroid cancer, especially the papillary type, often spreads first to the paratracheal nodes, and they may be removed with the gland in a central neck dissection. Because the recurrent laryngeal nerve lies among them, this surgery carries a risk of hoarseness. Cancers of the larynx below the cords and of the upper oesophagus can also spread here.

Course and drainage

Begins at

Afferent vessels from the thyroid gland, the subglottic larynx, the cervical trachea and the cervical oesophagus, and outflow from the pretracheal and thyroid nodes.

Drains into

Efferent vessels pass to the inferior deep cervical nodes and to the upper mediastinal nodes.

Drains

Filters lymph from the thyroid, lower larynx, trachea and oesophagus in the neck. A main site of spread for thyroid cancer; removing them puts the recurrent laryngeal nerve at risk.