Dept of Anatomy SDU

Lymphatic System

SHANDONG UNIVERSITYLiu Zhiyu

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Dept of Anatomy SDU

The Lymphatic System

A

Cap

V

Lymphatic-CapillaryLymphatic

Lymphatic trunks

Lymphatic ducts

Lymph nodes

Dept of Anatomy SDU

• A assistant system to the vein

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Composition Lymphatic vessels

– Lymphatic capillary– Lymph vessels– Lymphatic trunks (9) – Lymphatic ducts(2)

thoracic duct right lymphatic duck

Lymphatic organs – Lymph nodes – spleen

– thymus

– tonsil Lymphatic tissues

Dept of Anatomy SDU

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 capillary

Dept of Anatomy SDU

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

Dept of Anatomy SDU

Lymphatic trunks

right and left jugular trunks right and left subclavian trunks

right and left bronchomediasti

nal trunks

right and left lumbar trunks

intestinal trunk

Lymphatic vessels

Dept of Anatomy SDU

Right lymphatic duct Formed by union of right jugular, subclavia

n, and bronchomediastinal trunks Ends by entering the right venous angle Receives lymph from right half of head, neck,

thorax and right upper limb

Lymphatic ducts

Lymphatic vessels

Dept of Anatomy SDU

Thoracic duct• Begins in front of L1 as a dilated sa

c, 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

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• 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

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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

Lymphatic vessels

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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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• 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 breast

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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, pa

rotid, 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

Dept of Anatomy SDU

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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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

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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

Dept of Anatomy SDU

• 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 al

ong the subclavian artery

Lymph drainage of neck

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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.

central ln. apical ln. subclavian trunk

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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 along each side of the trachea

Paratracheal lymph nodes

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• 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 thorax

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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

axillary lymph node

superficial inguinal lymph node

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Lymphatic drainage of abdominal viscera

• Lumbar lymph nodes – Lie on posterior abdominal wall, alo

ng 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

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• 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 abdomen

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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 l

ateral sacral a. Receive lymph from posterior pel

vic wall ,rectum,prostate or uterus

Common iliac lymph node• Lie along common iliac artery• Receive afferents from all the abo

ve nodes• Efferents pass to lumbar lymph n

ode

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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 group

s

– 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 e

nd of femoral v.– Receive lymph from deep ly

mphatic 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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– Popliteal ln.• Embedded in the fatty connecti

ve 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.

lymph drainage of lower limb

Dept of Anatomy SDU

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 l

obesIs large organ in the fetusOccupies the thoracic cavity

behind the sternumSecrete lymphopoietin

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Clinic information

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