Submandibular nodes

At a glance

English

Submandibular nodes

Latin (TA2)

Nodi submandibulares

System

Lymphatic

Region

Head

Side

Paired, left and right

About the submandibular nodes

The submandibular nodes lie beneath the jaw in the submandibular triangle, the area bounded by the lower border of the mandible and the two bellies of the digastric muscle. There are usually three to six. Most rest on the outer surface of the submandibular salivary gland, just under the investing layer of deep cervical fascia, and a few small ones may lie on the gland's deep aspect or within its capsule.

The most constant member of the group, often called the middle node of Stahr, sits on the facial artery where that vessel hooks over the lower border of the mandible. The facial vein runs close by. Further forward lie the submental nodes under the chin, and above, on the face, the small facial nodes.

The group collects lymph from a wide area of the face and mouth: the medial corner of the eye, the sides of the nose, the cheek, the upper lip and the outer parts of the lower lip, the teeth and gums, and the front of the edge of the tongue. It also receives the outflow of the facial and submental nodes. Its own outflow passes to the upper deep cervical nodes along the internal jugular vein.

Surgeons call this area level IB of the neck. Swollen, tender submandibular nodes are common with dental abscesses, gum disease and infections of the mouth and face. Cancers of the lip, tongue, floor of mouth and cheek often spread here first, so the nodes are always examined, by feeling under the jaw with the head bent forward, and are removed in neck dissection when needed. An enlarged node must be told apart from swelling of the gland itself, for example from a stone in its duct.

Course and drainage

Begins at

Afferent vessels from the medial canthus, cheek, side of the nose, upper lip, lateral lower lip, gums and the anterior margin of the tongue; also outflow from the facial and submental nodes.

Drains into

Efferent vessels drain to the superior deep cervical nodes along the internal jugular vein.

Drains

Filters lymph from much of the face, lips, gums and front of the tongue. Enlargement is common in dental and oral infection, and these nodes are an early site of spread from lip and mouth cancers.