In Ca cervix lymphatic spread involve which of the following lymph node / nodes :

Ans. is a, b and c i.e. Obturator LN; External iliac LN; and Hypogastric LN Cervix has rich supply of lymphatics which follows the course of the uterine aery. Ca cervix follows orderly progression i.e. involves initially primary nodes in pelvis and then paraaoic nodes. Lymphatic channels of cervix drain principally into paracervical and parametrial lymph nodes. The lymphatics passing through the cardinal ligament empty into the ureteric node, which lies just lateral to the junction of the uterine aery. From the parametrial and paracervical nodes, lymph subsequently flows into the obturator lymph nodes and into the internal, external, and common iliac lymph nodes. In contrast, lymphatic channels from the posterior cervix course through the rectal pillars and the uterosacral ligaments to the rectal lymph nodes. These nodes are encountered during radical hysterectomy and removed with the uterosacral ligaments. Now some of you are going to ask -- How is hypogastric LN the correct option. Well friends, hypogastric LN is another name for internal iliac LN's. Also Know : Modes of Spread of Ca cervix : Most common is lymphatic spread. Direct spread -- To parametrium, vagina, uterus, pelvic side walls. Hematogenous spread -- Most common site are lung and liver.