lymphatic drainage of major organs
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Lymphatic Drainage of Major Organs
LYMPHATIC DRAINAGE OF GIT
lymphatic drainage
lymphatic capillaries in the interstitial space, organized into lymphatic vessels and lymph nodes [located along the course of the blood vessels and are named accordingly. e.g. left gastric nodes, splenic nodes, paraaortic nodes, coeliac nodes etc.]
All lymph of GIT drains into the cisterna chyli, thoracic duct, finally drains into the left subclavian vein.
lymphatic drainage of the oesophagus
cervical oesophagus drains into deep cervical nodes
thoracic oesophagus drains into posterior mediastinal nodes
abdominal oesophagus drains into preaortic and coeliac nodes
lymphatic drainage of the stomach
Area I superior 2/3 rd drains along Lt. and Rt. gastric vessels to aortic nodes
Area IIdrains along Rt. gastroepiploic vessel to subpyloric nodes then into aortic nodes
Area IIIdrains along short gastric, splenic vessels, superior pancreatic nodes then into aortic nodes
Subpyloric nodes
Rt. Gastric nodes
Lt. a
nd R
t. g
astroe
pipl
oic
node
s
splenic nodes
superior pancreatic nodes
Lt. gastric nodes
aortic nodes
I
II
IIIcisterna chyli
lymphatic drainage of the small intestine
drains into superior mesenteric nodes
lymphatic drainage of the large intestine
drains into the central nodes located at the origin of the superior and inferior mesenteric arteries
through epicolic, paracolic, intermediate nodes
epicolic nodes
paracolic nodes
intermediate nodes
central group of nodes
lymphatic drainage of the rectum
drain into pararectal nodes nodes along vessels supplying the rectum and
then into para-aortic nodes at the origin of the IMA
drainage is mainly upwards upper half
along superior rectal vessels to inferior mesenteric nodes
lower half along middle rectal vessels to internal iliac nodes
lymphatic drainage of the anal canal
upper canal drains into internal iliac nodes
lower part drains into superficial inguinal nodes
clinical relevance
Drainage area of particular group of lymph nodes Primary site of pathology
Spread of infection
Spread of malignant tumours (lymphatic spread)
Staging of disease ( TNM classification ) Treatment Prognosis
Lymphatic Drainage of Mediastinum
Lymphatic Drainage
50 tracheobronchial lymph nodes :Some of the largest lymph nodes in
the body.Include:
ParatrachealSuperior tracheobronchialInferior tracheobroncialBronchopulmonaryPulmonary
Lymph Drainage of Thoracic Cavity Parasternal nodes:
- Lie behind sternum along course of internal thoracic artery.- Receive lymph from thoracic wall, upper anterior abdominal wall, and diaphragm.- Also receive significant amount of lymph from mammary gland.-Drain into parasternal lymph channel.
Posterior intercostal nodes:
-Lie in posterior intercostal space between heads of ribs.
-Receive lymph from thoracic wall and paravertebral regions.-Drain into thoracic duct:
From left and lower right.-Drain into right lymphatic duct:
From upper right.
Diaphragmatic nodes:-Lie on upper surface of diaphragm.
-Receive lymph from diaphragm, pericardium, upper surface of liver.
-Drain to parasternal and posterior mediastinal nodes.
Posterior mediastinal nodes:Lie along esophagus and descending
thoracic aorta.
Brachiocephalic nodes:Lie along brachiocephalic veins.
Lymph Trunks
Bronchiomediastinal lymph trunks receive lymph from:
-Posterior mediastinal nodes-Brachiocephalic nodes-Tracheobronchial nodes-Parasternal nodes
Thoracic Duct
-Begins in abdomen on right side of midline.
-Receives most of lymph from body below diaphragm.
-Drains left side of thoracic cavity and part of right.
-Receives lymph from left internal jugular lymph trunk. CONTD
…
-Receives lymph from left subclavian lymph trunk.
-Empties into venous system at junction of:
Left internal jugular vein.Left subclavian vein.
Right Lymphatic Duct:
-Drains upper right thoracic cavity, right upper extremity, and right side of head and neck.
-Empties into venous system at junction of:
Right internal jugular vein.Right subclavian vein.
Lymphatic Drainage of Liver, Spleen & Gall Bladder
Liver
Superficial and most deep lymph vessels converge at the porta and end in the hepatic lymph nodes (eg. Cystic LN near GB neck or LN of omental foramen)
Hepatic LN’s drain into coeliac LN’s around the coeliac trunk, then thoracic duct
Some deep lymph vessels follow hepatic veins to IVC foramen in diaphragm and end in middle phrenic LN’s
Biliary Duct
Cystic LN, node of omental foramen, hepatic LN’s
Spleen
Pancreaticosplenic LN’s
Lymphatic Drainage of Male Genital Tract
Lymph Drainage of the Scrotum Lymph from the
skin and fascia, including the tunica vaginalis, drains into the superficial inguinal lymph nodes .
Lymphatic Drainage of The Testes
para-aortic lymph nodes.
Lymphatics of The Prostate
Lymph vessels terminate in internal iliac and sacral lymph nodes
Some vessels from posterior surface pass with lymph vessels from bladder to external iliac LN’s
Lymphatics of The Penis
The skin of the penis is drained into the medial group of superficial inguinal nodes.
The deep structures of the penis are drained into the internal iliac nodes.
Lymphatic Drainage of Female Genital Tract
Nodes Primary Afferent Connections
Aortic/Paraaortic Ovary, fallopian tubes, upper uterine corpus; drainage from common iliac nodes
Common Iliac Drainage from external and internal iliac nodes
External Iliac Upper vagina, cervix, upper uterine corpus; drainage from inguinal nodes
Internal Iliac Lateral Sacral Superior Gluteal Inferior Gluteal Obturator Vescical Rectal Parauterine
Upper vagina, cervix, lower uterine corpus
Inguinal Superficial Deep
Vulva, lower vagina; (rare: uterus, fallopian tubes, ovaries)
Lymphaticsof the
Female Pelvis
Lumbar lymphatictrunks
Paraaortic nodes
Common iliac nodes
Sacral nodes
Internal iliac nodes
External iliac nodes
Obturator nodes
Inguinal nodes
Parametrial nodes
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