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Lymph node levels of the neck

Lymph node levels of the neck
Level I  
  • below myohyoid muscle and above the lower margin of the hyoid bone 
  • anterior to the posterior border of the submandibular glands
    • level Ia : sub mental - between the anterior bellies of the digastric muscle
    • level Ib : sub mandibular - posterolateral to the anterior belly of digastric
Level II
  • jugulodigastric 
  • base of skull to lower margin of hyoid bone
  • anterior to the posterior border of sternocleidomastoid (SCM)
  • posterior to the posterior border of the submandibular glands
    • level IIa : anterior, lateral, or medial to the vein or posterior to the internal jugular vein and inseparable from it.
    • level IIb : posterior to the internal jugular vein and have a fat plane separating the nodes and the vein 
Level III
  • middle jugular nodes
  • lower margin of hyoid to lower margin of cricoid cartilage
  • anterior to the posterior border of SCM
  • lateral to the medial margin of the CCA / ICA
Level IV
  • low jugular nodes 
  • lower margin of cricoid cartilage to level of the clavicle
  • anterior and medial to an oblique line drawn through the posterior edge of the sternocleidomastoid muscle and the posterolateral edge of the anterior scalene muscle4
  • lateral to the medial margin of the CCA
Level V
  • posterior triangle nodes
    • level Va :  superior half, posterior to levels II and III
    • level Vb :  inferior half, posterior to level IV
Level VI
  • prelaryngeal / pretracheal / Delphian node
  • from inferior margin of hyoid to manubrium
  • in front of levels III and IV
Level VII 
  • superior mediastinal 
  • between CCAs, below top of manubrium

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