Dept of Anatomy SDU

Introduction of lymphology

山东大学医学院人体解剖教研室2004.2

Dept of Anatomy SDU

The Lymphatic System 淋巴系统

A

Cap

V

Lymphatic-CapillaryLymphatic

Lymphatic trunks

Lymphatic ducts

Lymph nodes

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• A assistant system to the vein

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Composition Lymphatic vessels 淋巴管道

– Lymphatic capillary 毛细淋巴管– Lymph vessels 淋巴管 – Lymphatic trunks (9) 淋巴干 – Lymphatic ducts(2) 淋巴导管 thoracic duct 胸导管 right lymphatic duck 右淋巴导管

Lymphatic organs 淋巴器官– Lymph nodes 淋巴结– spleen 脾– thymus 胸腺– tonsil 扁桃体 ,

Lymphatic tissues 淋巴组织

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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 淋巴管道

Lymphatic capillary毛细淋巴管

Dept of Anatomy SDU

Lymphatic vessel 淋巴管

Features of structure Three layered wall similar

to, but thinner than vein, More numerous valves tha

n in vein Interposed by lymph node

at interval along the course Arranged in superficial and

deep sets

Lymphatic vessels 淋巴管道

Dept of Anatomy SDU

Lymphatic trunks 淋巴干

right and left jugular trunks ( 颈干 ) right and left subclavian trunks （锁骨下干） right and left bronchomediasti

nal trunks （支气管纵隔干） right and left lumbar trunks （腰干） intestinal trunk （肠干）

Lymphatic vessels 淋巴管道

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Right lymphatic duct 右淋巴导管 Formed by union of right jugular, subclavia

n, and bronchomediastinal trunks Ends by entering the right venous angle 右

静脉角 Receives lymph from right half of head, neck,

thorax and right upper limb

Lymphatic ducts 淋巴导管

Lymphatic vessels 淋巴管道

Dept of Anatomy SDU

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

c, the cisterna chyli 乳糜池 , 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 淋巴管道

Dept of Anatomy SDU

• 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 淋巴管道

Thoracic duct 胸导管

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Thoracic duct 胸导管

• 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 淋巴管道

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Lymph node 淋巴结Features Bean-shaped bodies With afferent lymph vessels

输入淋巴管 (entering at the periphery) and efferent lymph vessels 输出淋巴管 (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 局部淋巴结 is the lymph node where the lymph of the organ or part of the body drainge to firstly

• Sentinel Lymph Node前哨淋巴结 (in clinic)

Lymph node 淋巴结

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Lymph drainage of the body

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Ⅰ.Lymph drainage of the head头部的淋巴引流

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 下颌下淋巴结 lies near the submandibular gland, receive lymphatic vessels from the face, nose and mouth

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Lymph drainage of neck颈部的淋巴引流

• Anterior cervical lymph nodes 颈前淋巴结– Superficial anterior cervical lymp

h nodes

– Deep anterior cervical lymph nodes

• Lateral cervical lymph node 颈外侧淋巴结– 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 颈外侧深淋巴结

• extend along the internal jugular vein from the base of skull to the root of neck

• divide into Superior deep lateral cervical l

ymph nodes 颈外侧上深淋巴结

Inferior deep lateral cervical lymph nodes 颈外侧下深淋巴结

Lymph drainage of neck颈部的淋巴引流

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Deep lateral cervical lymph nodes 颈外侧深淋巴结

• 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颈部的淋巴引流

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• Superior deep lateral cervical lymph nodes 颈外侧上深淋巴结– Jugulodigastric lymph node 颈内静

脉二腹肌淋巴结 : lies at the junction of posterior belly of digastric and internal jugular vein

• Inferior deep lateral cervical lymph nodes 颈外侧下深淋巴结– Juguloomohyoid lymph node 颈内静

脉肩胛舌骨肌淋巴结 : lies at the junction of the intermediate tendon of omohyoid and internal jugular vein

– Supraclavicular lymph nodes 锁骨上淋巴结 : lie along the subclavian artery

Lymph drainage of neck颈部的淋巴引流

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The lymphatic drainage of upper limb 上肢的淋巴引流

• Lymphatic vessels– Superficial lymphatic vessels 浅淋巴管 伴随浅静脉 注入滑车上淋巴结和腋淋巴结– Deep lymphatic vessels 深淋巴管 伴随深静脉 注入腋淋巴结

• lymph nodes– Cubital lymph node 滑车上淋巴结– Axillary lymph node 腋淋巴结

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Axillary lymph nodes 腋淋巴结The axillary lymph nodes mey b

e divided into

lateral ln. 外侧淋巴结 pectoral ln. 胸肌淋巴结 subscapular ln. 肩胛下淋巴

结 central ln. 中央淋巴结 apical ln. 尖淋巴结lateral ln.pectoral ln.subscapular ln.

central ln. apical ln. subclavian trunk

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The lymphatic drainage of thorax胸部的淋巴引流

The lymphatic drainage of thoracic wall

• To axillary lymph nodes• To parasternal lymph nodes

胸骨旁淋巴结 (along internal thoracic vessels)

• To intercostals lymph nodes 肋间淋巴结 from deeper structures

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The lymphatic drainage of thorax胸部的淋巴引流

lymph nodes of the thoracic contents

lymph nodes of trachea, bronchi and lungs

• Pulmonary lymph nodes 肺淋巴结 lie in the angles of bifurcation of branching lobar bronchi

• Bronchopulmonary hilar lymph nodes 支气管肺门淋巴结－ lie in the hilus of the lung

• Tracheobronchial lymph nodes气管支气管淋巴结－ situated above or below the bifurcation of trachea

• Paratracheal lymph nodes 气管旁淋巴结－ along each side of the trachea

Paratracheal lymph nodes

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• Anterior mediastinal lymph node 纵隔前淋巴结 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 支气管纵隔干 . The left bronchomediastinal trunk terminates in thoracic duct, and right in the right lymphtic duct

• Posterior mediastinal lymph nodes 纵隔后淋巴结 lie along the esophagus and thoracic aorta

The lymphatic drainage of thorax胸部的淋巴引流

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The lymphatic drainage of abdomen 腹部的淋巴引流

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 腰淋巴结– 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 腹部的淋巴引流

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• Celiac lymph nodes 腹腔淋巴结 － situated around the celiac trunk

• Superior mesenteric lymph node 肠系膜上淋巴结 － situated around superior mesenteric a.

• Inferior mesenteric lymph node 肠系膜下淋巴结 － situated around inferior mesenteric a.

• Intestinal trunk 腹腔干 － formed by efferent vessel of celiac, superior and inferior mesenteric lymph nodes

The lymphatic drainage of abdomen 腹部的淋巴引流

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The lymphatic drainage of pelvis 盆部的淋巴引流

Internal iliac lymph node 髂内淋巴结

• Surround internal iliac vessels• Receive lymph from pelvic viscer

a, perineum, buttock and back of thigh

External iliac lymph nodes 髂外淋巴结

• Lie along external iliac artery• Receive lymph from lower limb a

nd some parts of pelvic viscera

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The lymphatic drainage of pelvis 盆部的淋巴引流

Sacral lymph node 骶淋巴结 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 髂总淋巴结

• 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下肢的淋巴

• lymphatic vessels– Superficial lymphatic– Deep lymphatic

• Lymph nodes– Superficial lymph no

de• 腹股沟浅淋巴结

– Deep lymph node• 腹股沟深淋巴结

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lymph drainage of lower limb下肢的淋巴

Superficial lymph node 腹股沟浅淋巴结　 may be divided into two groups

– Upper group: below the inguinal lig. 腹股沟韧带

– Lower group: around the terminal part of great saphenous v. 大隐静脉

– Receive lymph from lower part of abdominal wall,perineum 会阴 and lower limb with the exception of region drained by popliteal ln. 腘淋巴结

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lymph drainage of lower limb下肢的淋巴

deep lymph node 腹股沟深淋巴结　

– 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. 腹股沟浅淋巴结

– Their efferent lymphatic vessels empty into external iliac ln. 髂外淋巴结

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– Popliteal ln. 腘淋巴结• Embedded in the fatty connecti

ve tissue of popliteal fossa

• Receive superficial lymphatic vessels from posterolateral part of calf 小腿 , and from deep lymphatic vessels accompanying anterior and posterior tibial a.

• Efferents pass to the deep inguinal ln. 腹股沟深淋巴结

lymph drainage of lower limb下肢的淋巴

Dept of Anatomy SDU

Dept of Anatomy SDU

Celiac lymph nodes

Superior mesenteric lymph node 肠系膜上淋巴结

Inferior mesenteric lymph node 肠系膜下淋巴结

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Dept of Anatomy SDU

Spleen 脾 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

Dept of Anatomy SDU

Dept of Anatomy SDU

Thymus 胸腺

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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