Lymphatic System SHANDONG UNIVERSITY Liu Zhiyu 。  

The Lymphatic System Lymphatic ducts Lymphatic trunks V A Lymphatic Lymph nodes Cap Lymphatic Lymphatic-Capillary

A assistant system to the vein

Composition Lymphatic vessels Lymphatic organs Lymphatic capillary Lymph vessels Lymphatic trunks (9) Lymphatic ducts(2) thoracic duct right lymphatic duck Lymphatic organs Lymph nodes spleen thymus tonsil Lymphatic tissues

Lymphatic vessels Lymphatic capillary Features of structure: Blind end Single layer of overlapping endothelial cells More permeable than that of blood capillary Absent from avascular structures, brain, spinal cord splenic pulp and bone marrow

Lymphatic vessels Lymphatic vessel Features of structure Three layered wall similar to, but thinner than vein, More numerous valves than in vein Interposed by lymph node at interval along the course Arranged in superficial and deep sets

Lymphatic vessels Lymphatic trunks right and left jugular trunks right and left subclavian trunks right and left bronchomediastinal trunks right and left lumbar trunks intestinal trunk

Lymphatic vessels Lymphatic ducts Right lymphatic duct Formed by union of right jugular, subclavian, and bronchomediastinal trunks Ends by entering the right venous angle Receives lymph from right half of head, neck, thorax and right upper limb

Lymphatic vessels Thoracic duct Begins in front of L1 as a dilated sac, the cisterna chyli, which formed by joining of left and right lumbar trunks and intestinal trunk Enter thoracic cavity by passing through the aortic hiatus of the diaphragm and ascends along on the front of the vertebral column, between thoracic aorta and azygos vein

Lymphatic vessels Thoracic duct Travels upward, veering to the left at the level of T5 At the roof of the neck, it turns laterally and arches forwards and descends to enter the left venous angle Just before termination, it receives the left jugular, subclavian and ronchomediastinal trunks

Lymphatic vessels Thoracic duct Just before termination, it receives the left jugular, subclavian and bronchomediastinal trunks Drains lymph from lower limbs, pelvic cavity, abdominal cavity, left side of thorax, and left side of the head, neck and left upper limb

Lymph node Features Bean-shaped bodies With afferent lymph vessels (entering at the periphery) and efferent lymph vessels(emerging at the hilus) Arranged in groups, along the blood vessels or the flexural side of the joint Divided into superficial and deep groups

Lymph drainage of breast Regional Lymph Node is the lymph node where the lymph of the organ or part of the body drainge to firstly Sentinel Lymph Node(in clinic)

Lymph drainage of the body

Ⅰ.Lymph drainage of the head Lymph nodes of head Located at junction of head and neck Consist of occipital, mastoid, parotid, submandibular, submental lymph nodes Drain into deep cervical lymph nodes Submandibular lymph node lies near the submandibular gland, receive lymphatic vessels from the face, nose and mouth

Lymph drainage of neck Anterior cervical lymph nodes Superficial anterior cervical lymph nodes Deep anterior cervical lymph nodes Lateral cervical lymph node Superficial lateral cervical lymph nodes－lie along the external jugular vein Deep lateral cervical lymph nodes

Lymph drainage of neck Deep lateral cervical lymph nodes extend along the internal jugular vein from the base of skull to the root of neck divide into Superior deep lateral cervical lymph nodes Inferior deep lateral cervical lymph nodes

Lymph drainage of neck → right lymphatic duct Deep lateral cervical lymph nodes receive lymphatic vessels from head, neck, tongue, larynx, cervical parts of esophagus and trachea, thyroid gland, upper parts of the thoracic wall and breast efferent vessels form the jugular trunk →thoracic duct(left) → right lymphatic duct (right)

Lymph drainage of neck Superior deep lateral cervical lymph nodes Jugulodigastric lymph node : lies at the junction of posterior belly of digastric and internal jugular vein Inferior deep lateral cervical lymph nodes Juguloomohyoid lymph node : lies at the junction of the intermediate tendon of omohyoid and internal jugular vein Supraclavicular lymph nodes : lie along the subclavian artery

The lymphatic drainage of upper limb Lymphatic vessels Superficial lymphatic vessels Deep lymphatic vessels lymph nodes Cubital lymph nodeAxillary lymph node

Axillary lymph nodes The axillary lymph nodes mey be divided into lateral ln. pectoral ln. subscapular ln. central ln. apical ln. lateral ln. pectoral ln. subscapular ln. central ln. apical ln. subclavian trunk

The lymphatic drainage of thorax The lymphatic drainage of thoracic wall To axillary lymph nodes To parasternal lymph nodes(along internal thoracic vessels) To intercostals lymph nodes from deeper structures

The lymphatic drainage of thorax Paratracheal lymph nodes lymph nodes of the thoracic contents lymph nodes of trachea, bronchi and lungs Pulmonary lymph nodes ie in the angles of bifurcation of branching lobar bronchi Bronchopulmonary hilar lymph nodes lie in the hilus of the lung Tracheobronchial lymph nodes situated above or below the bifurcation of trachea Paratracheal lymph nodes along each side of the trachea

The lymphatic drainage of thorax Anterior mediastinal lymph node lies anterior to the large blood vessels of thoracic cavity and pericardium; the efferents unite with those of paratracheal lymph nodes, to form the right and left bronchomediastinal trunks. The left bronchomediastinal trunk terminates in thoracic duct, and right in the right lymphtic duct Posterior mediastinal lymph nodes lie along the esophagus and thoracic aorta

The lymphatic drainage of abdomen Lymphatic drainage of abdominal wall To axillary lymph node from region above umbilicus To superficial inguinal lymph node from region below umbilicus To lumbar lymph node from post wall of abdomen axillary lymph node superficial inguinal lymph node

The lymphatic drainage of abdomen Lymphatic drainage of abdominal viscera Lumbar lymph nodes Lie on posterior abdominal wall, along the abdominal aorta and inferior vena cava Receive lymph from kidneys, suprarenal glands, testes, ovarirs, fundus of uterus, ovary, and common iliac nodes Their efferent vessel form the right and left lumbar trunks

The lymphatic drainage of abdomen Celiac lymph nodes －situated around the celiac trunk Superior mesenteric lymph node situated around superior mesenteric a. Inferior mesenteric lymph node situated around inferior mesenteric a. Intestinal trunk formed by efferent vessel of celiac, superior and inferior mesenteric lymph nodes

The lymphatic drainage of pelvis Internal iliac lymph node Surround internal iliac vessels Receive lymph from pelvic viscera, perineum, buttock and back of thigh External iliac lymph nodes Lie along external iliac artery Receive lymph from lower limb and some parts of pelvic viscera

The lymphatic drainage of pelvis Sacral lymph node locate along middle sacral a. and lateral sacral a. Receive lymph from posterior pelvic wall ,rectum,prostate or uterus Common iliac lymph node Lie along common iliac artery Receive afferents from all the above nodes Efferents pass to lumbar lymph node

lymph drainage of lower limb lymphatic vessels Superficial lymphatic Deep lymphatic Lymph nodes Superficial lymph node Deep lymph node

lymph drainage of lower limb Superficial lymph node 　may be divided into two groups Upper group: below the inguinal lig. Lower group: around the terminal part of great saphenous v. Receive lymph from lower part of abdominal wall,perineum and lower limb with the exception of region drained by popliteal ln.

lymph drainage of lower limb deep lymph node 　 Locate around the proximal end of femoral v. Receive lymph from deep lymphatic vessels of lower limb and the efferentlymphatic vessels of superficial inguinal ln. Their efferent lymphatic vessels empty into external iliac ln.

lymph drainage of lower limb Popliteal ln. Embedded in the fatty connective tissue of popliteal fossa Receive superficial lymphatic vessels from posterolateral part of calf, and from deep lymphatic vessels accompanying anterior and posterior tibial a. Efferents pass to the deep inguinal ln.

Spleen Location Features Function Left epigastric region between 9th-11th rib in line of 10th rib Features Diaphragmatic surface Visceral surface - Splenic Hilum Anterior extremity Posterior extremity Superior border- Splenic Notch Inferior border Function

Thymus Featrues Consists of two elongated lobes Is large organ in the fetus Occupies the thoracic cavity behind the sternum Secrete lymphopoietin

Clinic information