Chapter two The lymphatic system

Section one Introduction

I . Composition:
lymphatic vessels ,
lymphatic tissue,
lymphatic organs
 II. The lymphatic vessels
1. Lymphatic capillary
2. Lymphatic vessels
3. Trunks : nine trunks →
• right and left jugular trunks,
• right and left subclavian trunks,
• right and left bronchomediastinal trunks,
• right and left lumbar trunks,
• intestinal trunk
4. Lymphatic ducts:
right lymphatic duct and thoracic duct
III. The lymphatic tissue
IV. The lymphatic organs
Include lymph nodes, thymus,spleen and tonsils.
1. Lymph nodes
a Mophology : bean-shaped matter. The afferent and
efferent lymph vessels enter and leave the nodes.
b Groups: superficial and deep lymph nodes
c Regional lymph node
 Section two The lymphatic ducts
1. The thoracic duct(left lymphatic duct)
a. Coures :arise from the cisterna chyli and ends by
opening into the left venous angle.

b. Collecting lymph vessels:

six trunks. About three-quarters of the body

2. The right lymphatic duct

three trunks. About upper right quadrant of the body.
 Section three The lymphatic drainage

I. The lymphatic drainage of head

1. Location :
around the adjoining part of the head and neck.
2. Lymph nodes
 II. The lymphatic drainage of neck

1. Anterior cervical lymph node

2. Lateral cervical lymph node

a. Superficial lateral cervical lymph nodes:
lie along external jugular v.

b. Deep lateral cervical lymph nodes:

lie along internal jugular v.
1) Superior deep lateral cervical lymph nodes
• retropharyngeal lymph nodes :nasopharyngeal
cancer
• jugulodigastric lymph nodes
• juguloomohyoid lymph nodes

2) Inferior deep lateral cervical lymph nodes

• supraclavicular lymph nodes ( left →Virchow lymph
nodes ) : stomach cancer or esophageal cancer
• Efferents form jugular trunk
 III. The lymphatic drainage of upper limb

1. Supratrochlear lymph nodes

2. Infraclavicular nodes
3. The axillary lymph nodes
• anterior group(pectoral lymph nodes)
• lateral group
• posterior group(subscapular group)
• central group
• apical group: efferents form the subclavian trunk
IV. The lymphatic drainage of thorax
1. Lymph nodes of thoracic wall
a. parasternal lymph nodes
b. intercostal lymph nodes
2. Lymph nodes of thoracic viscera
a. anterior mediastinal lymph nodes
b. posterior mediastinal lymph nodes
c. lymph nodes of trachea, bronchus and lungs
• pulmonary lymph nodes
• bronchopulmonary lymph nodes
• tracheobronchial lymph nodes
• paratracheal lymph nodes: efferents unite with
parasternal lymph nodes to form bronchomediastinal
trunk
V. The lymphatic drainage of abdomen
1.Lymph nodes of the abdominal wall
2.Lymph nodes of the abdominal viscera
• paired viscera: lumbar lymph nodes
• unpaired viscera: celiac lymph nodes , superior
mesenteric lymph nodes and inferior mesenteric
lymph nodes
VI. The lymphatic drainage of pelvis
1.The common iliac lymph nodes
2.The internal iliac lymph nodes
3.The external iliac lymph nodes
VII. The lymphatic drainage of lower limb
1 Popliteal lymph nodes
2 Superficial inguinal lymph nodes
3 Deep inguinal lymph nodes
 Section four The spleen

1. Location : in the left hypochondriac region, between

the ninth rib and the eleven rib
2. Formation : splenic notch on the superior border
3. Accessory spleen