Medial Retropharyngeal Lymph Node

The large medial retropharyngeal lymph node lies medial to the mandibular gland and sternomastoideus muscle, between the wing of the atlas and the larynx. Coursing along its medial surface is the terminal portion of the common carotid artery, as well as the hypoglossal, vagus, and sympathetic nerves and the internal jugular vein. This node drains deep structures of the head, including the tongue, palatine tonsil, salivary glands, and deep parts of the external ear, and also receives lymph from the other nodes in the head. It also receives afferents from the larynx and esophagus in the upper part of the neck. Its efferents form the tracheal lymph trunk. It cannot be palpated (Fig. 11.47/3).