Transcript The Lymphatic System 淋巴系统

Lymphatic System
。
SHANDONG UNIVERSITY
Liu Zhiyu
Dept of Anatomy SDU
The Lymphatic System
Lymphatic ducts
Lymphatic
trunks
A
V
Cap
Lymph nodes
Lymphatic
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Lymphatic-Capillary
• A assistant system
to the vein
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Composition
 Lymphatic vessels
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Lymphatic capillary
Lymph vessels
Lymphatic trunks (9)
Lymphatic ducts(2)
thoracic duct
right lymphatic duck
 Lymphatic organs
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–

Lymph nodes
spleen
thymus
tonsil
Lymphatic tissues
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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
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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
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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
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Lymphatic vessels
Lymphatic ducts
Right lymphatic duct
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

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
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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
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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
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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
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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
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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)
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Lymph drainage
of the body
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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
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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
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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
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Lymph drainage of neck
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)
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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
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The lymphatic drainage of
upper limb
• Lymphatic vessels
– Superficial lymphatic vessels
– Deep lymphatic vessels
lymph nodes
– Cubital lymph nodeAxillary lymph node
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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.
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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
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The lymphatic drainage of thorax
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
Dept along
of Anatomy
each SDU
side of the trachea
Paratracheal lymph nodes
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
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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
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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
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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
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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
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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
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lymph drainage of lower
limb
• lymphatic vessels
– Superficial lymphatic
– Deep lymphatic
• Lymph nodes
– Superficial lymph
node
– Deep lymph node
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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.

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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.
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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.
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Spleen
 Location
 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
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Thymus
Featrues
Consists of two elongated
lobes
Is large organ in the fetus
Occupies the thoracic cavity
behind the sternum
Secrete lymphopoietin
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Clinic information
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