淋巴系统 lymphatic system
目 录概 述淋巴管道
淋巴结
毛细淋巴管淋巴管
淋巴干淋巴导管
脾和胸腺
一、概 述 淋巴系统的组成:
淋巴管道 lymphatic ducts 淋巴组织 lymphatic tissue 淋巴器官 lymphatic organs : 包括淋巴结、脾、胸腺和扁桃体
返回目录
图
淋巴系统的功能 协助静脉系统引流组织液 产生淋巴细胞 滤过淋巴液 参与免疫应答
淋巴的构成
返回
二、淋巴管道 lymphatic ducts
毛细淋巴管 lymphatic capillary 构成 结构特点
淋巴管 lymphatic vessel 分类
输入淋巴管输出淋巴管 返回目录
返回
淋巴结
lymph node (Small oval or bean-shaped bodes Afferent vessels enter the node on
its convex surface, and efferent vessels leave the node at its concave surface - the hilum
Arranged in groups, along the blood vessels
Regional nodes is the lymph node where the
lymph of the organ or part of the body drainage to firstly
淋巴干 lymphatic trunks
构成 九条淋巴干 :
淋巴干
成 对
不成对
颈 干 jugular trunks锁骨下干 subclavian trunks支气管纵隔干 bronchomadiastinal trunks腰 干 lumbar trunks
肠 干 intestinal trunk
返回目录
返回
淋巴导管 lymphatic ducts
胸导管 thoracic duct构成行程注入收纳范围
右淋巴导管 right lymphatic duct构成收纳范围 返回目录
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 ducts
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
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 bronchomediastinal
trunks
Thoracic duct
Thoracic duct
Drains lymph from lower limbs, pelvic cavity, abdominal cavity, left side of thorax, and left side of the head, neck and left upper limb
三、淋巴结 lymphatic node
形态:呈椭圆形或圆形,全身约 400~450 个 分群:根据位置可分为:
浅淋巴结 superficial lymphatic nodes 深淋巴结 profundal lymphatic nodes
局部淋巴结 regional lymphatic node : 指引流某一器官或部位淋巴的第一级淋巴结,临床上又称为哨位淋巴结。
返回目录
全身各部的淋巴结 1. 头颈部淋巴结
头部淋巴结 颈部淋巴结
颈前淋巴结 颈外侧淋巴结 颈外侧浅淋巴结 颈外侧深淋巴结
颈内静脉二腹肌淋巴结(角淋巴结)
颈内静脉肩胛舌骨肌淋巴结
锁骨上淋巴结
斜角肌淋巴结( Virchow 淋巴结)
The lymphatic drainage of head Lymph nodes of head Located at junction of head and neck Consist of
Occipital lymph nodes Mastoid lymph nodes Parotid lymph nodes ★ Submandibular lymph nodes
lies near the submandibular gland, receive lymphatic vessels from the face, nose and mouth
submental lymph nodes Drain into deep cervical lymph
nodes
Lymph nodes of the neckAnterior cervical ln. Superficial anterior cervical lymph
nodes Deep anterior cervical lymph nodes
Lateral cervical ln. ★ Superficial lateral cervical ln. -lie along the external jugular vein
★ Deep lateral cervical ln. - extend
along the internal jugular vein
Lymph nodes of the neck★ Deep lateral cervical ln.
Extend along the internal jugular vein from the
base of skull to the root of neck Divided into superior deep lateral cervical ln. and
inferior deep lateral cervical ln. 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 Left jugular trunk joins the thoracic duct Right jugular trunk joins the right lymphatic
duct
Lymph nodes of the neckSuperior deep lateral cervical
ln. Jugulodigastric ln. Lies at the junction of posterior belly of
digastric and internal jugular vein Drain the nasopharynx, palatine tonsil
and root of tongue
Inferior deep lateral cervical ln. Juguloomohyoid ln. Lies at the junction of the intermediate
tendon of omohyoid and internal jugular
vein Drain the apex of tongue
Lymph nodes of the neckInferior deep lateral cervical ln. Supraclavicular lymph nodes
Lie along transverse cervical a. & v. palpable in the supraclavicular fossa.
The most notable supraclavicular lymph node is Virchow's node. which can contain metastasis of visceral (abdominal) tumor.
Retropharyngeal ln. Lying vertically behind the pharynx drain nasopharyngeal lymph
2. 上肢的淋巴结 肘淋巴结 腋淋巴结
胸肌淋巴结 外侧淋巴结 肩胛下淋巴结 中央淋巴结 尖淋巴结
Lymph nodes of upper limb Cubital lymph node lies above medial epicondyle of humerus Receive lymph vessels from forearm Axillary lymph node arranged in five groups
Axillary lymph nodes
Axillary lymph nodes vary
in size from a pin-head to a
large bean.
They are arranged in five
groups.
Axillary lymph nodesPectoral lymph nodes
Lying along the lower border of pectoralis minor behind the pectoralis major
Receive lymph vessels from the lateral quadrants of the breast and superficial vessels from the anterolateral abdominal wall above the level of the umbilicus
Axillary lymph nodesLateral lymph nodes
Along medial side distal part of axillary vein
Receives lymph from upper limb
Axillary lymph nodesSubscapular lymph
node Lying along subscapular
vessels, in front of the subscapularis
Receive superficial lymph vessels from the back, down as far as the level of the iliac crests
Efferents of above three groups pass to central lymph node
Axillary lymph nodes
Central lymph node Lying in the center of the
axilla in the axillary fat Receive lymph from the
above three nodes Efferents pass to apical
lymph node
Axillary lymph nodesApical lymph node infraclavicular lymph
nodes Lying at the apex of the
axilla at the lateral border of the fist rib
Receive lymph of the efferent lymph vessels from all the other axillary nodes
The efferents of the apical nodes form the subclavian trunk
Axillary lymph nodes
Lateral ln.
Pectoral ln.
Subscapular ln.
Central ln.
Apical ln.
Efferents form subclavian trunk, the right subclavian trunk joins the right lymphatic duct; left usually drains directly into thoracic duct
Subclavian trunk
Lymphatic drainage of thoraxThe lymphatic drainage of
thoracic wall To axillary lymph nodes To parasternal lymph nodes (along
internal thoracic vessels) To intercostals lymph nodes from
deeper structures
3. 胸部淋巴结 胸壁淋巴结 纵隔前淋巴结 纵隔后淋巴结 气管、支气管
和肺淋巴结
lymph nodes of the thorax Pulmonary ln. lie in the angles of
bifurcation of branching lobar bronchi
Bronchopulmonary hilar ln. -lie in the hilums of the lung
Tracheobronchial ln. - situated above or below the bifurcation of trachea
Paratracheal ln. - along each side of the trachea
lymph nodes of the 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 and parasternal 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
Lymph nodes of lower limbPopliteal 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 tibia a.
Efferents pass to the deep inguinal ln.
Lymph nodes of lower limbSuperficial inguinal lymph nodes
Superior group: Lies just distal to the inguinal ligament Receive lymph vessels from anterior
abdominal wall below umbilicus, gluteal region, perineal region, external genital organs
Inferior group: Lies vertical along the terminal great
saphenous v. Receives all superficial lymph vessels of
lower limb, except for those from the posterolateral part of calf
Efferent vessels drain into the deep inguinal ln. or external iliac ln.
Lymph nodes of lower limbDeep inguinal lymph nodes Lie medial to the femoral v. Receive deep lymph vessels of
lower limb, perineal region, and efferent vessels from the superficial inguinal ln.
Drain into the external iliac ln.
Lymph nodes of pelvis Internal iliac lymph node
Surround internal iliac vessels Receive afferents from pelvic viscera,
perineum, buttock and back of thigh External iliac lymph nodes
Lie along external iliac artery Receive afferents from lower limb and
some parts of pelvic viscera 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 Efferent pass to lumbar lymph node
Lymph nodes 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
Lymph nodes of abdomenLymphatic 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, ovaries, fundus of uterus, uterine tubes, and common iliac nodes
Right and left lumbar trunks formed by efferent vessel
Paired viscera - drain to the lumbar lymph nodes
Lymph nodes of abdomen
Right and left gastric ln. lie along the same vessels and finally to the celiac ln.
Right and left gastroomental ln. lie along the same vessels, the former drain into subpyloric ln., the latter drain into splenic ln.
Suprapyloric and subpyloric ln. receive lymphatics from pyloric part and finally to the celiac ln.
Splenic ln. receive lymphatics from fundus and left third of stomach, and finally to the celiac ln.
Celiac lymph nodes - situated around the celiac trunk
Lymph nodes of abdomen
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 lymph nodes
四、脾和胸腺
脾 spleen 形态 位置 功能
返回目录
Spleen Shape
The largest single mass of lymphoid tissue in the body
Reddish in color Location:
lies in the left hypochondriac region (between stomach and diaphragm) deep to the 9th to 11th rib
its long axis corresponds roughly to the 10th rib
Its lower pole extends forward only as far as the midline and cannot be palpated on clinical examination
Spleen Two surfaces
Diaphragmatic: smooth, convex Visceral: concave, hilum of spleen
Two extremities Anterior - wider Posterior - rounder
Two border Superior - has 2-3 splenic notch,
which serve as a landmark on palpation when it is enlarge; normally it is not palpable
Inferior - rounder
胸腺 thymus 形态 位置 功能
返回目录
Thymus The thymus is partly in the neck and partly in the thorax. It
comprises one to three lobes, each of which consists of numerous lobules containing lymphocytes, which are important in the development and maintenance of the immune system. The cervical part of the thymus lies on the anterior and lateral sides of the trachea, whereas the thoracic part lies posterior to the superior portion of the sternum. The organ has a profuse blood supply and lymphatic drainage. The thymus reaches its greatest size at puberty and then begins to regress. Much of its substance is replaced by fat and fibrous tissue, but thymic tissue never disappears completely. Function:to develop lymph cell
Spleen Function
Erythrocyte storagePhagocytosisCytopoiesisImmune responses