Infected EYE & Lymph node drainage

[Miracoli]

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A 45-year-old man is admitted to the ED with a red, painful eye. During physical examination
it is noted that the conjunctiva of the affected eye is infected. Which of the following lymph node
groups would be first involved if the infection spread?
A. Submandibular
B. Parotid
C. Jugulodigastric
D. Submental
E. Preauricular

 

[Apoplexy__]

Ugh, this actually came up in a small group discussion back in classes, and I couldn't find a definitive answer anywhere. I'd look for the answer in whatever source you got the question from. The question hinges on the fact that the conjunctival drainage differs from most of the rest of the eye, due to differences in embryological development.

 

[001100010010011]

Don't the cornea and parotid come from the ectoderm? That's the only thing I have going on solving this question.

 

[CherryRedDracul]

Preauricular?

 

[AnastomoSteve]

http://www.cdc.gov/conjunctivitis/about/diagnosis.html

https://www.inkling.com/read/ocular...tear-film-1st/chapter-4/anatomy-and-histology

http://www.atlasophthalmology.com/a...519CAE16793EF69A0B8675A7D?node=5521&locale=en

It seems that it depends on if it is the temporal or nasal conjunctiva but a few thing I read noted that the preauricular node being swollen in viral infections.

 

[Miracoli]

BB is the given answer. I know that we see preauricular lymph node swelling in viral conjunctivitis due to adenovirus.

Here is the explanation given:
The preauricular lymph nodes are also known as the deep parotid nodes. They are located deep to the
parotid gland and drain lymph from the posterior orbit. The submandibular nodes drain the side of the cheek and lateral aspects of the nose and lips. The superfi cial parotid lymph nodes lie superficially to the parotid gland and drain the lateral angles of the eyelids, aspects of the nose, and the external acoustic meatus. The jugulodigastric nodes receive drainage from all of the superior nodes of the face and also drain the tonsils. The submental lymph nodes drain the tip of the tongue and chin.

AND from this article
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1857530/
i found this conclusion:
Nasal conjunctival melanomas tend to metastasise to SUBMANDIBULAR lymph nodes and
temporal conjunctival melanomas metastasise to the PRE‐AURICULAR or PAROTID lymph nodes.
Thanks for participation.

 

[dyspareunia]

Is this a serious question? 🙁

 

[Miracoli]

It is from gray anatomy. Happy emoticon now?

 

[001100010010011]

It is from gray anatomy. Happy emoticon now?

Only if it's from the 1858 ed.

 

[DermViser]

It would be real funny if the OP was Hanna Kern (Elizabeth Raines).