Level IV: lower internal jugular (deep cervical) chain medially: medial border of the common carotid artery.anteriorly: anterior border of the sternocleidomastoid muscle.inferiorly: inferior border of the cricoid cartilage.superiorly: inferior border of the hyoid bone.
Level III: middle internal jugular (deep cervical) chain level IIb: posterior to and separable by a fat plane from the internal jugular vein.level IIa: inseparable from or anterior to the posterior edge of the internal jugular vein includes jugulodigastric nodal group.medially: medial border of the internal carotid artery.posterolaterally: posterior border of the sternocleidomastoid muscle.anteriorly: posterior border of the submandibular gland.inferiorly: inferior border of the hyoid bone.superiorly: base of the skull at the jugular fossa.Level II: upper internal jugular (deep cervical) chain
level Ib (submandibular nodes): posterolateral to the anterior belly of the digastric muscles.level Ia (submental nodes): anteromedial between the anterior bellies of both digastric muscles.posteriorly: posterior border of the submandibular gland.inferiorly: inferior border of the hyoid bone.superiorly: mylohyoid muscle and mandible.The following is a synthesis of radiologically useful boundaries for each level. Differing definitions exist across specialties 1-4. If your swollen gland is due to cancer, your doctor can refer you to the appropriate specialist for treatment.The lymph nodes in the neck have historically been divided into at least six anatomic neck lymph node levels for the purpose of head and neck cancer staging and therapy planning. If you have a bacterial infection, your doctor might give you antibiotics. Swollen glands caused by a virus don't need treatment. If the results suggest cancer, you may need to have a biopsy of the gland. In some situations, your doctor might order blood tests or a scan. If you have a simple infection, you may not need any medical tests. If you see your doctor about your swollen glands, he or she will ask you questions about your symptoms, and examine you. In young people cancer is even less likely. Out of 100 people with swollen glands, only one, if any, is likely to have cancer. bacterial infection, such as tonsillitis.An infection on your leg can cause swollen glands in the groin. For example, if you have a sore throat from a virus, you may get swollen neck glands. Having swollen glands usually means your immune system is fighting an infection in the swollen area. There are many different causes of swollen glands. Glands in many different parts of the body can become swollen, but you’re more likely to feel them in your neck, in your armpits or in your groin. Lymph nodes filter impurities from the lymph, which is a type of body fluid. They are part of the lymphatic system, which fights infection. If you’re not sure why you have swollen glands, if they are painful or getting bigger, or if you are feeling unwell, it's a good idea to see your doctor. If you have swollen glands because of a virus, they usually get better without treatment. Glands become swollen for different reasons.