Main Collecting Lymphatic Channels Lymphatic Drainage of the Head and Neck

1. THE CIRCULATORY SYSTEM Chapter 12 The Lymphatic System Main Collecting Lymphatic Channels Lymphatic Drainage of the Head and Neck Lymphatic Drainage of the Upper Limb Lymphatic Drainage of the Thorax Lymphatic Drainage of the Lower Limb Lymphatic Drainage of the Abdomen and pelvis

2. generalintroduction The lymphatic system consists of lymphatic vessels and various lymphatic tissues and organs

3. The lymphatic vessels and the sinuses of the lymph nodes contain tissue fluid，which is called lymph. lymphatic capillary tissue fluid histiocyte blood capillary （vein） blood capillary （artery）

4. The composition and construction featuresoflymphatic system lymphatic vessel lymphatic capillary: the initiation is dead end,the endothelium is thin and intercellular spaces are wide。 histiocyte endothelial cell The lymphatic capillaries do not present inepithelium , cornea, lens, cartilage, brain and spinal cord

5. lymphatic vessel • superficial lymphatic vessel (located in superficial fascia) • The stems go in company with cutaneous vein • deep lymphatic vessel (located in deep fascia) • The stems go in company with deep vein there are affluent communications between the superficial and deep lymphatic vessels

6. lymphatic trunk right jugular trunk left jugular trunk right subclavian trunk left subclavian trunk right bronchomediastinal trunk left bronchomediastinal trunk right lumbar trunk left lumbar trunk intestinal trunks

7. lymphatic duct The lymphatic capillaries join to form progressively larger vessels, until finally the thoracic duct and the right lymphatic duct the thoracic duct return to left venous angle, and the right lymphatic duct return to right venous angle, a few lymphatic vessels return to renal vein、superarenal vein and inferior vena cava.

8. lymphatic tissues diffuse lymphoid tissue They main located in the lamina propria mucosae of digestive tract and respiratory tract. lymphatic nodule they include the solitary and aggregated lymphatic follicles which present in the submucosa of the small intestine , and lymphatic nodules which present in the wall of vermiform appendix.

9. lymphatic organ The lymphatic organs include the lymph nodes, tonsils , thymus and spleen. lymph node • afferent lymphatic vessel • efferent lymphatic vessel • superficial lymph node • deep lymph node • hilum of lymph node

10. lymphatic duct thoracic duct left venous angle left jugular trunk：converying lymph from the left side of the head and neck thoracic duct left subclavian trunk ：draining lymph from the left upper limb and part of the thorax on the left side left bronchomediastinal trunk ： draining lymph from Left thoracic cavity intestinal trunk, ：draining most of the lymph from the abdominal part of the alimentary canal, liver, pancreas and spleen cisterna chyli left and right 1umbar trunks ：conveying lymph from the lower limbs and the pelvic viscera

11. right lymphatic duct right venous angle right jugular trunk ： receive lymph from the right Side of head and neck right lymphatic duct right subclavian trunk ：receive lymph from the right upper limb and the right side of the thorax right bronchomediastinal trunk

12. position of lymph node and lymphatic drainage lymphatic vessels and lymph nodes of the head and neck Lymph node of the head occipital lymph node mastoid lymph node Parotid lymph node submandibular lymph node submental lymph node

13. Lymph nodes of the neck anterior cervical lymph node superficial anterior cervical lymph node deep anterior cervical lymph node prelaryngeal lymph node thyroid lymph node pretracheal lymph node paratracheal lymph node

14. lateral cervical lymph node superficial lateral cervical lymph node deep lateral cervical lymph node superior deep lateral cervical lymph node inferior deep lateral cervical lymph node supraclavicular lymph node Scalene lymph node left scalene lymph node (Virchow lymph node) retropharyngeal lymph node

15. lymphatic vessels and lymph nodes of the upper limb cubital lymph node The superficial group are also called supratrochlear lymphnodes deltopectoral lymph node

16. axillary lymph node pectoral lymph node lateral lymph node subscapular lymph node central lymph node apical lymph node

17. lymphatic vessles and lymph nodes of thorax lymph nodes of chest wall parasternal lymph node intercostal lymph node superior phrenic lymph node

18. lymph nodes of the organs located in thoracic cavity anterior mediastinal lymph nodes, posterior mediastinal lymph nodes lymph nodes of trchea ,bronchi and lung pulmonary lymph nodes bronchopulmonary lymph node （pulmonary hilar lymph node） tracheobronchial lymph node paratracheal lymph node

19. lymphatic vessles and lymph nodes of lower limb popliteal lymph node inguinal lymph node superficial inguinal lymph node deep inguinal lymph node

20. lymphatic vessels and lymph nodes of the pelvis sacral lymph node internal iliac lymph node external iliac lymph node common iliac lymph node

21. lymphatic vessels and lymph nodes of abdomen lymph node of the abdominal wall lumbar lymph node Left sidediaphragm truck Right side liver truck

22. lymph nodes of organs located in abdominal cavity Lymph nodes accompany celiac truck and its branches left and right gastric lymph nodes left and right gastroomental lymph nodes pyloric lymph nodes hepatic lymph nodes pancreatic lymph nodes splenic lymph nodes →celiac lymph node

23. Lymph nodes accompany superior mesenteric arteries and their branches mesenteric lymph node ileocolic lymph node right colic lymph node middle colic lymph node →superior mesenteric lymph node Lymph nodes accompany inferior mesenteric artery left colic lymph node sigmoid lymph node superior rectal lymph node →inferior mesenteric lymph node

24. Lymphatic Drainage of some organs lymphatic drainage of the lung Superficial lymphatic vessels of the lung are located in the deep face of the visceral pleura Deep lymphatic vessels of the lung flow to the pulmonary lymph nodes and the bronchopulmonary lymph nodes Communication present between the superficial and deep lymphatic vessels。 pulmonary lymph node →bronchopulmonary lymph nodes → tracheobronchial lymph node and paratracheal lymph node lymphatic vessels from the lower lobe flow to the lymph nodes which located in pulmonary ligament Lymphatic vessels from the lower part of the superior lobe of the left lung and some lymphatic vessels from the lower lobe →upper group of the right tracheobronchial lymph node and right paratracheal lymph node

25. Lymphatic Drainage of the esophagus Lymph of cervical part esophagus→paratracheal lymph node and inferior deep lateral cervical lymph node。 Lymph of thoracic part esophagus→posterior mediastinal lymph node， lymph of the superior segment of thoracic part→paratracheal lymph nodes and tracheobronchial lymph node lymph of the inferior segment of thoracic part →left gastric lymph node lymphatic vessels of epicardia→left gastric lymph node A few of lymphatic vessels of esophagus→thoracic duct

26. Lymphatic Drainage of the rectum The lymphatic vessels of the anal canal above the dentate line ： accompany the superior rectal artery ,then ascending to enter the superior rectal lymph nodes； accompany the inferior rectal aryery,then enter the internal iliac lymph nodes accompany the anal artery and then follow the pudental artery to enter the internal iliac lymph nodes, part of lymphatic vessles follow the Vessles of sacro-lateral ， then enter the sacral lymph nodes. The lymphatic vessels of the anal canal under the dentate line enter the superficial inguinal lymph nodes.

27. Lymphatic drainage of the uterus lymphatic vessels located in the superior aspect of fundus of uterus and body of uterus: follow the ovarian blood vessels and ascend to terminate mainly in the lumbar lymph nodes. accompany the round ligament , pass the inguinal canal，and reach the superficial inguinal lymph nodes. lymphatic vessels located in inferior part of the uterus and cervical of the uterus： follow blood vessels of the uterus and reach the external and internal iliac lymph nodes ; Pass cardinal ligament of uterus and reach the obturator lymph nodes ；follow the sacrouterine ligament , go backward and reach the sacral lymph nodes.

28. Lymphatic drainage of the breast The lymph of the breast mainly reach the axillary lymph nodes lymphatic vessels located in lateral and central part of the breast reach the pectoral lymph nodes； superior lymphatic vessels reach apical lymph nodes and supraclavicular lymph nodes; medial part lymphatic vessels reach parasternal lymph nodes.

29. the spleen The spleen is the largest lymphatic organ. It functions in storing blood, haematogenesis, disposing effete red cells and immunologic response. the spleen lies deep to the left ninth, tenth and eleventh ribs hilum of spleen splenic artery splenic vein splenic notches