Introduction of lymphology

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Introduction of lymphology
?????????????? 2004.2
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The Lymphatic System ????
Lymphatic ducts
Lymphatic trunks
Lymphatic-Capillary
Lymphatic
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• 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 ????

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Lymphatic capillary?????

• Lymphatic vessels ????

• 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 vessel ???

• Lymphatic vessels ????

• 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 trunks ???

• Lymphatic vessels ????

• 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 ?????
• 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?????(emergin
  g 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 node ???

• 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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?.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 node??????
• Axillary 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????lie 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

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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

axillary lymph node
superficial inguinal lymph node
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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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Superior mesenteric lymph node ???????
Celiac lymph nodes
Inferior mesenteric lymph node ???????
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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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