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Lymphatics Anatomy

Introduction to the Lymphatic System

What is the primary function of the lymphatic system? drains excess fluid from body's tissue and returns it to the bloodstream; also includes tissues and organs that provide immunological responses (thymus gland, spleen, aggregates of lymphatic tissue in respiratory and digestive tract, and lymph nodes)
Describe the origin of interstitial fluid and lymph @ Capillaries: arterial side: hydrostatic pressure exceeds osmotic pressure-->fluid out of vessels; some of it returns at venous end; rest of fluid removed by lymphatic capillaries-->lymphatics
Lymphatics conducting lymph into a cluster of lymph nodes are called _____ lymphatics; lymphatics draining lymph from lymph nodes are called _____ lymphatics. afferent, efferent
The lymph reaches the bloodstream at the junctions of the _____ and the _____ veins by way of the ______ duct and the ______ duct. Internal jugular, subclavian, right lymphatic, thoracic
In general terms, the ______ duct drains the head and neck, the right upper limb and the right side of the thorax (including right lung); all the rest of the body is drained by the _____ duct. right lymphatic; thoracic
* Describe the path and location of the thoracic duct begins as dilated sac (cysterna chili), behind the right of aorta (L1, L2); ascends via aortic hiatus on right of aorta and left of azygous v.; @ T5 crosses to left and reaches left of esophagus at level of sternal angle; empties @ l. SubcV and l. IJV
Where does the right lymphatic duct empty? At the junction of the right internal jugular and the right subclavian veins
What nodes do the lymphatic vessels of the upper limbs empty into? Axillary nodes
What nodes do the lymphatics of the lower limbs empty into? Inguinal nodes
The lymphatic vessels from the wall of the thorax and abdomen for the most part drain into the ____ and ____ nodes. Some vessels pierce the body wall to run to deeper nodes, particularly in the anterior wall of the _____. Axillary and inguinal, thorax
Where is the watershed between the inguinal and axillary drainage areas? A line around the trunk at the level of the umbilicus
What are the main vessels carrying lymph from the axilla? Where do they pass? The subclavian trunk; pass proximally alongside the subclavian artery and vein
Where do the efferent vessels from the inguinal nodes pass through? Where do they drain? Into abdomen; into external iliac nodes
Where are the superficial inguinal nodes located? Where do they receive lymph from? In superficial fascia below inguinal lig.; anterior and posterior surfaces of trunk below umbilicus, perineum including lower 1/2 of anal canal, vagina, and all of externa genitalia of both sexes (not testes), and superficial lymph vessels of lower limb
* * Where are the deep inguinal nodes? What structures do they drain? Receive ALL the lymph from the superficial nodes and from the deep structures of lower limb; efferent vessels ascend via femoral canal and drain into external iliac nodes.
Where are the final nodes draining the neck and head located? What is the main vessel draining these nodes? What do they drain (superficial or deep)? Alongside carotid sheath; known as deep cervical nodes; jugular trunk; drain skin and superficial fascia AND deeper structures
Lymph from the lungs, pleura, bronchi, trachea, and heart converge on the _____ lymph nodes. Bronchomediastinal
The efferents unite to form the ____ trunks. bronchomediastinal
Which trunks empty into the thoracic duct? Left jugular, subclavian, bronchomediastinal trunks
Which trunks join the right lymphatic duct? THE RIGHT JUGULAR, subclavian, bronchomediastinal
How are the major lymph node groups in the abdomen arranged? Along blood vessels; groups include pre-aortic and para-aortic nodes
How are the pre-aortic nodes arranged? Where are they? What do they drain? What the efferents from these nodes form? Along front of aorta in 3 groups: celiac nodes (foregut), superior mesenteric nodes (midgut), inferior mesenteric nodes (hindgut); intestinal trunk (contributes to cysterna chili)
How are the para-aortic nodes arranged? Where are they? What do they drain? What the efferents from these nodes form? Along borders of aorta; drain kidneys, suprarenal glands, gonads; receive efferents from common iliac nodes; upper nodes give rise to lumbar trunks that contribute to cysterna chili
What nodes drain the pelvis? Internal iliac nodes (organs supplied by internal iliac arteries EXCEPT gonads, uterine tube, fundus, upper body of uterus, which drain into para-aortic/lumbar nodes); external iliac nodes-->common iliac nodes-->lumbar nodes
Lymph nodes of the axilla receive and filter lymph from the ____ limb and from the ____ and _____ aspects of the trunk as far as the ______ and the _____ crest. upper; anterior and posterior; umbilicus; iliac
How are the axillary nodes typically subdivided? By the territories they drain and their location
What are the five groups of axillary nodes? Brachial (lateral), subscapular (posterior), pectoral (anterior), central, apical (subclavian)
Describe the location and drained region of the brachial group Lie along medial side of axillary vein; receive most of lymph from upper lymph
Describe the location and drained region of the subscapular group Lie in front of subscapularis muscle; from scapular region and back
Describe the location and drained region of the pectoral group along lower border of pectoralis minor behind pec major; receive from thoracic wall and anterior abdominal wall
Describe the location and drained region of the central group Lie in center of axilla in axillary fat; receive lymph from above three groups (brachial, subscapular, and pectoral)
Describe the location and drained region of the apical group Lie in apex of axilla at lateral border of first rib; receive efferents from other axillary nodes; efferents from apical group form the subclavian lymph trunk
Describe Drainage of breast: what node groups drain most of it? most goes laterally and upward to axillary (mostly pec) nodes and suprascapular and infraclavicular nodes; remaining lymph goes to parasternal (intern. thoracic) along intrnl thoracic vessels; some drains down to upper abdmnl nodes, some to other breast
Describe the drainage of the uterus: fundus and body; lower body and cervix (most frequent site of carcinoma) Few to superficial inguinal nodes, most unite with lymphatics from uterine tube and ovary passing to lumbar (para-aortic) nodes; internal, external, and common iliac nodes, sacral nodes
Describe the drainage of the vagina, testes, and ovaries Upper 3/4s: internal iliac nodes; lower 1/4: superficial inguinal nodes; para-aortic (lumbar) nodes
Created by: karkis77



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