Lymphatics of the Body

7/23/2019 Lymphatics of the Body

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Lymphat

ics of

theBody

-

Liste

d

Alph

abeti

callyStructure Location Afferents from Efferents to

Regions

drained Notes

accessory

nodes

posterior

triangle of

the neck,

arrangedalong the

accessory n.

occipital nodes,

retroauricular

nodes

transverse

cervical

chain of

nodes

occipital

region

and

posteriorscalp

accessory

nodes also

collect lymph

from thenape of the

neck and the

region

overlying thesupraspinato

us fossa

anteriorauricular

nodes

subcutaneous connective

tissue

anterior tothe ear

lymphatic vesselsfrom the side of the

head

superiorparotid

nodes;

superiordeep

cervical

nodes

anteriorpart of

the

parietalregion

of the

scalp;anterior

surfaceof the

ear andexternal

acoustic

meatus

anteriorauricular

nodes are 1

or 2 innumber

anterior along the lymphatic vessels inferior deep skin and anterior


2/30

jugular nodes anterior

jugular vein

from the anterior

inferior part of the

neck

cervical

nodes

mm. of

the

anteriorinfrahyo

id region

of theneck

jugular nodes

are located

between thesuperficial

layer of deep

cervicalfascia and

the

infrahyoid

mm.

anterior

mediastinal

nodes

along the

course of the

brachiocepha

lic vesselsand aorta

lymphatic vessels

from the anterior

mediastinum and

middlemediastinum

bronchomed

iastinal

trunk

thymus,

anterior

respirato

rydiaphrag

m,

pericardium, part

of the

heart

anterior

mediastinal

nodes are

from 2 to 5in number

apical axillarynodes

apex of theaxilla

lateral axillarynodes; central

axillary nodes;

subscapularaxillary nodes;

pectoral nodes;

accessorylymphatic vesselsfrom the mammary

gland; lymphatic

vesselsaccompanying the

cephalic v.

subclavianlymphatic

trunk; deep

cervicallymph

nodes

upperlimb,

most of

themammar

y gland,

some oftheanterolat

eral

chestwall,

posterior

thoracicwall and

scapular

region

apicalaxillary

nodes are !

12 innumber; this

is the highest

node groupin the axillaand all other

node groups

drain throughthese nodes;

a very

importantgroup of

nodes in

cases of

metastaticspread of

breast

cancer;connections

to deep

cervicalnodes may


3/30

result in

spread of

breast cancerthrough the

deep neck

auricular

nodes, anterior

subcutaneou

s connectivetissue

anterior to

the ear

lymphatic vessels

from the side of thehead

superior

parotidnodes;

superior

deepcervical

nodes

anterior

part ofthe

parietal

regionof the

scalp;

anterior

surfaceof the

ear and

externalacoustic

meatus

anterior

auricularnodes are 1

or 2 in

number

axillary nodes axilla cubital nodes;

lymphatic vesselsfrom the upper

limb, thoracic wall

and subscapularregion

efferents

vessels formthe

subclavian

trunk, somedrainage to

inferior deep

cervicalnodes

upper

limb,most of

the

mammary gland,

some of

theanterolateral

chest

wall,posterior

thoracic

wall andscapular

region

axillary

nodesnumber from

2" to #" and

are organi$edin five

groups based

on theirpositionwithin the

axilla% 1&

pectoralnodes, along

the lateral

border of thepectoralis

major m.; 2&

lateral nodes,

located alongthe distal

axillary v.; #&

centralnodes,

centrally

located alongaxillary v.; '&


4/30

subscapular

nodes,

located alongthe

subscapular

v. and itstributaries; 5&

apical nodes,

located at the

apex of axilla

axillary nodes,

apical

apex of the

axilla

lateral axillary

nodes; central

axillary nodes;

subscapularaxillary nodes;

pectoral nodes;

accessorylymphatic vessels

from the mammary

gland; lymphaticvessels

accompanying the

cephalic v.

subclavian

lymphatic

trunk; deep

cervicallymph

nodes

upper

limb,

most of

themammar

y gland,

some ofthe

anterolat

eralchest

wall,

posterior

thoracicwall and

scapular

region

apical

axillary

nodes are !

12 innumber; this

is the highest

node groupin the axilla

and all other

node groupsdrain through

these nodes;

a very

importantgroup of

nodes in

cases of

metastaticspread of

breastcancer;

connections

to deepcervical

nodes may

result in

spread ofbreast cancer

through thedeep neck

axillary nodes,central

in the fat ofthe axilla

lateral axillarynodes; pectoral

nodes; subscapular

nodes; lymphaticvessels from the

apicalaxillary

nodes

upperlimb,

most of

themammar

centralaxillary

nodes are '

or 5 innumber; they


5/30

mammary gland

and upper limb

y gland,

some of

theanterolat

eral

chestwall,

posterior

thoracic

wall andscapular

region

are involved

in cancer of

themammary

gland

axillary nodes,

lateral

along the

distalaxillary v.

cubital nodes;

lymphatic vesselsof the arm

central

axillarynodes,

apical

axillarynodes

upper

limb

lateral

axillarynodes

become

inflamedduring upper

limb

infections;also known

as% brachial

nodes

axillary nodes,subscapular

along thecourse of the

subscapular

vessels

lymphatic vesselsfrom the skin of the

back and back of

the neck; lymphaticvessels from themuscles of the

scapular region

centralaxillary

nodes

skin ofthe back

and back

of theneck;muscles

of the

scapularand

subscap

ularregions

subscapularaxillary

nodes are 5

or innumber; alsoknown as%

posterior

axillarynodes

bronchomedias

tinal trunk

along the

course of the

brachiocephalic v.

union of efferents

from the

paratracheal nodes,parasternal nodes

and anterior

mediastinal nodes

left% thoracic

duct; right%

rightlymphatic

duct

thoracic

wall and

viscera;medial

part of

themammar

y gland

right

bronchomedi

astinal trunkreceives

lymph from

the lowerlobe of the

left lung;

bronchomedi

astinal trunk


6/30

may drain

directly into

the venoussystem on

either side

bronchopulmo

nary nodes

hilum of the

lung

pulmonary nodes tracheobron

chial nodes

lung bronchopulm

onary nodesare also

known as%

hilar nodes

celiac nodes around theceliac trunk

hepatic nodes,gastric nodes,

pancreaticosplenic

nodes

intestinallymph trunk

liver,gall

bladder,

stomach,spleen,

pancreas

celiac nodesare from # to

in number

central axillary

nodes

in the fat of

the axilla

lateral axillary

nodes; pectoralnodes; subscapular

nodes; lymphatic

vessels from the

mammary glandand upper limb

apical

axillarynodes

upper

limb,most of

the

mammar

y gland,some of

the

anterolateral

chestwall,posterior

thoracic

wall and

scapularregion

central

axillarynodes are '

or 5 in

number; they

are involvedin cancer of

the

mammarygland

cervical nodes,

deep

in and

around

carotidsheath

posterior and

lateral to theinternal

jugular v.

lymphatic vessels

and numerous node

groups from thehead and neck

jugular

trunk

head and

neck

superior and

inferior

subdivisionsof deep

cervical

nodes aredelineated by

the crossing

of theomohyoid m.

cisterna chyli between the right and ( left thoracic all of the cisterna chyli


7/30

abdominal

aorta and the

inferior venacava anterior

to the body

of the )1 or)2 vertebra

lumbar trunks;

possibly the

intestinal trunk

duct body

below

therespirato

ry

diaphragm; all of

the

abdomin

al andpelvic

viscera

is an

enlargement

of the lowerend of the

thoracic duct;

it occurs inabout 25* of

individuals

colic nodes,

middle

along the

course of themiddle colic

vessels

peripheral nodes

located along theattachment of the

mesentery

superior

mesentericnodes

transvers

e colon

middle colic

nodes areapproximatel

y '" in

number

colic nodes,right


right colic

vessels

peripheral nodeslocated along the

marginal a.

superiormesenteric

nodes

ascending colon,

cecum

right colicnodes are

approximatel

y +" innumber

common iliac

nodes

along the

common

iliac vessels;over the

sacralpromontory

external iliac

nodes, internal iliac

nodes

lumbar

lateral

aortic& chainof nodes

lower

limb;

pelvicorgans,

perineum, lowerpart of

the

anterior

abdominal wall

common iliac

nodes are

approximately in

number

cubital nodes cubital fossa

of the upper

limb

lymphatic vessels

from the forearm

lateral

axillary

nodes

deep

tissues

of theforearm

and

hand

cubital nodes

small and are

5 or innumber

cystic node near the neckof the gall

bladder

lymphatic vesselsof the gall bladder

hepaticnodes

gallbladder

cystic nodedrains to the

node of the

omentalforamen,


8/30

then to

hepatic nodes

deep cervical

nodes

in and

aroundcarotid

sheath

posterior andlateral to the

internal

jugular v.

lymphatic vessels

and numerous nodegroups from the

head and neck

jugular

trunk

head and

neck

superior and

inferiorsubdivisions

of deep

cervicalnodes are

delineated by

the crossingof the

omohyoid m.

deep cervical

nodes, inferior

around the

internaljugular v.,

inferior tothe crossing

of theomohyoid m.

superior deep

cervical nodes;numerous node

groups of the neck

jugular

trunk

head and

neck

inferior deep

cervicalnodes are in

directcontinuity

with thesuperior deep

cervical

chain ofnodes

deep cervical

nodes, superior

around the

internal

jugular v.,superior to

the crossingof theomohyoid m.

numerous node

groups of the head

and upper neck,including

retropharyngealnodes and deepparotid nodes

inferior deep

cervical

nodes

head and

the

superiorpart of

the neck

the superior

deep cervical

node grouphas many

large nodes;thejugulodigastr

ic and

juguloomohy

oid nodes aremembers of

this group

deep inguinal

nodes

along the

medial sideof the

femoral v.

deep to thefascia lata

and inguinal

ligament

superficial inguinal

nodes, poplitealnodes

external

iliac nodes

lower

limb,external

genitalia

, lowerpart of

the

anteriorabdomin

al wall

the deep

inguinal nodein the

femoral canal

is called thenode or

gland& of

-louet


9/30

deep parotid

nodes

on the lateral

side of the

pharyngealwall, deep to

the parotid

gland

lymphatic vessels

from the ear

superior

deep

cervicalnodes

external

acoustic

meatus,auditory

tube,

middleear

deep parotid

nodes are

part of thedeep cervical

chain of

nodes

external iliac

nodes

along the

external iliac

vessels


nodes; deep

inguinal nodes;inferior epigastric

nodes

common

iliac nodes

lower

limb;

externalgenitalia

; lower

part of

theanterior

abdomin

al wall

external iliac

nodes are /

to 1" innumber

externaljugular nodes

along theexternal

jugular v.

lymphatic vesselsfrom the side of the

head

superiordeep

cervical

nodes

inferiorpart of

the ear

and theparotid

region

there are oneor two nodes

in this group

facial nodes along the

course of thefacial a. and

v.

lymphatic vessels

from the face

submandibu

lar nodes

eyelids,

nose,cheek

and lips

facial nodes

are groupedinferior to

the orbit; atthe angle ofthe mouth

and over the

mandible

gastric nodes,left

on the lessercurvature of

the stomach,

along the

course of theleft gastric

vessels

lymphatic vesselsfrom the lesser

curvature of the

stomach

celiac nodes lessercurvatur

e of the

stomach

left gastricnodes are 1"

to 2" in

number

gastric nodes,

right

on the lesser

curvature ofthe stomach,

along the

course of theright gastric

lymphatic vessels

from the lessercurvature of the

stomach

celiac nodes lesser

curvature of the

stomach

right gastric

nodes are 2to # in

number


10/30

vessels

gastro!omental

nodes, left

on the

greater


along the left

gastro!omental

vessels

lymphatic vessels

from the greater

curvature of thestomach

splenic

nodes

left half

of the

greatercurvatur

e of the

stomach

left gastro!

omental

nodes are 1or 2 in

number

gastro!omental

nodes, right

on the

greatercurvature of

the stomach,

along theright gastro!

omentalvessels

lymphatic vessels

from the greatercurvature of the

stomach

pyloric

nodes

greater

curvature of the

stomach

right gastro!

omentalnodes are

to 12 in

number

hepatic nodes along thecourse of the

common

hepatic a.

right gastric nodes,pyloric nodes

celiac nodes liver andgall

bladder;

extrahep

aticbiliary

apparatu

s;respirato

rydiaphragm; head

of

pancreas

andduodenu

m

hepatic nodesdrain a

portion of the

respiratory

diaphragmbecause of

the common

embryonicorigin of the

diaphragmand the liverseptum

transversum&

hilar nodes at hilum of

lung

pulmonary nodes tracheobron

chial nodes

lung also known

as%bronchopulm

onary nodes

ileocolic nodes along the

origin andterminal end

of the

ileocolicvessels

peripheral nodes


mesentery

superior

mesentericnodes

ileum,

cecum,appendi

x

ileocolic

nodes locatednear the

ileocecal

junction maybe divided


11/30

into two

subsidiary

groups% cecalnodes and

appendicular

nodes

iliac nodes,common

along thecommon

iliac vessels;

over thesacral

promontory

external iliacnodes, internal iliac

nodes

lumbarlateral

aortic& chain

of nodes

lowerlimb;

pelvic

organs,perineu

m, lower

part of

theanterior

abdomin

al wall

common iliacnodes are

approximatel

y innumber

iliac nodes,external

along theexternal iliac

vessels

superficial inguinalnodes; deep

inguinal nodes;

inferior epigastricnodes

commoniliac nodes

lowerlimb;

external

genitalia; lower

part of

theanterior

abdomin

al wall

external iliacnodes are /

to 1" in

number

iliac nodes,internal

along theinternal iliac

vessels

lymphatic vesselsfrom the pelvic

viscera

commoniliac nodes,

external

iliac nodes

pelvis,perineu

m and

gluteal

region

internal iliacnodes are '

to / in

number

inferior deep

cervical nodes

around the

internal

jugular v.,

inferior tothe crossing

of the

omohyoid m.

superior deep

cervical nodes;

numerous node

groups of the neck

jugular

trunk

head and

neck

inferior deep

cervical

nodes are in

directcontinuity

with the

superior deepcervical

chain of

nodes

inferiormesenteric

around theroot of the


lumbarchain of

distal10# of

inferiormesenteric


12/30

nodes inferior

mesenteric a.

marginal a. nodes,

superior

mesentericnodes

the

transvers

e colon,descendi

ng

colon,sigmoid

colon,

rectum

nodes may

number as

high as ";an important

node group

in cases ofcancer of the

colon and

rectum

inferiortracheobronchi

al nodes

inferior totracheal

bifurcation

bronchopulmonarynodes, left side

inferior

tracheobronchial

nodes drain intoright inferior

tracheobronchial

nodes

rightsuperior

tracheobron

chial nodes

lowerlobes of

the

lungs;

middlemediasti

num;

posteriormediasti

num

left inferiortracheobronc

hial nodes

drain to the

right side

infraclavicular

nodes

along the

cephalic v. inthe

deltopectoral

groove

lymphatic vessels

from the superficialupper limb

apical

axillarynodes

skin and

superficial fascia

of the

upperlimb

infraclavicul

ar nodes maybecome

inflamed

duringinfections of

the

superficialtissues of theupper limb

inguinal nodes,

deep

along the

medial side

of thefemoral v.

deep to the

fascia lataand inguinal

ligament


nodes, popliteal

nodes

external

iliac nodes

lower

limb,

externalgenitalia

, lower

part ofthe

anterior

abdominal wall

the deep

inguinal node

in thefemoral canal

is called the

node orgland& of

-louet

inguinal nodes,

superficial

in the

superficial

fasciaparallel to

the inguinal

lymphatic vessels

from the superficial

lower limb,superficial

abdominal wall,

external

iliac nodes;

deepinguinal

nodes

lower

abdomin

al wall;external

genitalia

superficial

inguinal

nodes are 12!2" in

number; they


13/30

ligament and

along the

terminal partof the greater

saphenous v.

perineum ;

superfici

al partsof the

lower

limb

become

inflamed

duringinfections of

the lower

limb; theymay become

inflamed

during

infections ofthe external

genitalia

intercostal

nodes

near the

heads of theribs

lymphatic vessels

from the intercostalspace

cisterna

chyli0thoracic duct,

jugulosubcla

vian duct

intercost

al spaceand

posterol

ateralthoracic

wall

usually two

nodes occurin each

intercostal

space

internal iliac

nodes

along the

internal iliacvessels

lymphatic vessels

from the pelvicviscera

common

iliac nodes,external

iliac nodes

pelvis,

perineum and

gluteal

region

internal iliac

nodes are 'to / in

number

intestinallymphatic

trunk

left side ofthe

abdominalaorta orbetween the

abdominal

aorta and the

inferior venacava near the

level of the

superiormesenteric

artery

union of efferentlymphatic vessels

from the celiacnodes and superiormesenteric nodes

left lumbartrunk or the

cisternachyli0thoracic duct

largeand

smallintestines


carries lymphthat is rich infat; drains

into the left

lumbar trunk

+"*&,cisterna chyli

25*& or

right lumbartrunk 5*&

jugular

lymphatictrunk

carotid

sheath inroot of neck

deep cervical nodes left% thoracic

duct near itstermination;

right% right

lymphaticduct or

junction of

head (

neck

jugular trunk

carries mostof the lymph

from the

head andneck


14/30

right

subclavian

and rightinternal

jugular vv.

jugular nodes,

anterior

along the

anteriorjugular vein

lymphatic vessels

from the anteriorinferior part of the

neck

inferior deep

cervicalnodes

skin and

mm. ofthe

anterior

infrahyoid region

of the

neck

anterior

jugular nodesare located

between the

superficiallayer of deep

cervical

fascia and

theinfrahyoid

mm.

jugular nodes,

external

along the

externaljugular v.

lymphatic vessels

from the side of thehead

superior

deepcervical

nodes

inferior

part ofthe ear

and the

parotidregion

there are one

or two nodesin this group

jugulodigastric

node

anterolateral

to internal

jugular v.where it is

crossed byposteriorbelly of the

digastric

superior deep

cervical nodes

inferior deep

cervical

nodes

oral

cavity,

tongue,palatine

tonsil

a member of

the superior

deep cervicalnode group;

importantnode topalpate

during

physical

exam

juguloomohyoi

d node

lateral to

internal

jugular v.

where it iscrossed by

superior

belly ofomohyoid

superior deep

cervical nodes

inferior deep

cervical

nodes

subment

al region

and tip

oftongue;

head (

neckabove

this

level

an important

node to

examine in

cases of oralcancer

caused by

use oftobacco

products

juxtavisceralnodes

adjacent tothe cervical

cervical viscera superiordeep

esophagus,

four groupsof


15/30

viscera cervical

nodes,

inferior deepcervical

nodes

larynx,

trachea

andthyroid

gland

juxtavisceral

nodes are

recogni$ed%infrahyoid,

prelaryngeal,

pretrachealand

paratracheal

lateral aortic

nodes

along the

inferior venacava and

abdominal

aorta from

the aorticbifurcation

to the aortic

hiatus of thediaphragm

common iliac


posterior

abdominal wall and

viscera

efferents

form onelumbar

trunk on

each side

lower

limb;pelvic

organs;

perineu

m;anterior

and

posteriorabdomin

al wall;

kidney;supraren

al gland;

respirato

rydiaphrag

m

also known

as% lumbarnodes; the

intestinal

trunk drains

into to theleft lumbar

trunk; the

lumbartrunks unite

to form the

thoracicduct0cisterna

chyli

lateral axillarynodes along thedistalaxillary v.

cubital nodes;lymphatic vesselsof the arm

centralaxillarynodes,

apical

axillarynodes

upperlimb lateralaxillarynodes

become

inflamedduring upper

limb

infections;also known

as% brachial

nodes

left gastricnodes

on the lessercurvature of

the stomach,


left gastric

vessels

lymphatic vesselsfrom the lesser

curvature of the

stomach

celiac nodes lessercurvatur

e of the

stomach

left gastricnodes are 1"

to 2" in

number


16/30

left gastro!

omental nodes

on the

greater


along the left

gastro!omental

vessels

lymphatic vessels

from the greater


splenic

nodes

left half

of the

greatercurvatur

e of the

stomach

left gastro!

omental

nodes are 1or 2 in

number

lumbar nodes along the

inferior venacava and

abdominal

aorta from

the aorticbifurcation

to the aortic

hiatus of thediaphragm

common iliac


posterior

abdominal wall and

viscera

efferents

form onelumbar

trunk on

each side

lower

limb;pelvic

organs;

perineu

m;anterior

and

posteriorabdomin

al wall;

kidney;supraren

al gland;

respirato

rydiaphrag

m

also known

as% lateralaortic nodes;

the intestinal

trunk drains

into to theleft lumbar

trunk; the

lumbartrunks unite

to form the

thoracicduct0cisterna

chyli

lumbar trunk between thelumbarvertebral

bodies and

inferior venacava right&

or aorta left&

at the upperend of the

lumbar chain

of nodes

lumbar lateralaortic& nodes; theintestinal trunk

joins the left

lumbar trunk

thoracicduct0cisternachyli

leftlumbartrunk !

left side

of thebody

below

therespirato

ry

diaphrag

m, gut;right

lumbar

trunk !right

side of

bodybelow

lumbartrunks uniteto form the

lower end of

the thoracicduct; an

enlargement

of the lowerend of the

thoracic duct

called the

cisternachyli& occurs

in about 25*

ofindividuals,

and when it

is present,the lumbar


17/30

the

diaphrag

m

trunks drain

into it

mediastinalnodes, anterior


brachiocepha

lic vesselsand aorta

lymphatic vesselsfrom the anterior

mediastinum and

middlemediastinum

bronchomediastinal

trunk

thymus,anterior

respirato

rydiaphrag

m,

pericardium, part

of the

heart

anteriormediastinal

nodes are

from 2 to 5in number

mediastinalnodes,

posterior

along a$ygossystem of

veins andesophagus

viscera of theposterior

mediastinum andchest wall

thoracicduct,

inferiortracheobron

chial nodes,superior

tracheobron

chial nodes

posteriormediasti

num,posterior

aspect ofthe heart

and

pericardium,

posterior

part ofthe

respirato

rydiaphragm

posteriormediastinal

nodes drainprimarily to

the thoracicduct

mesenteric

nodes

along the

vasa recta

and branchesof the

superior

mesenteric a.between the

leaves of

peritoneumforming the

mesentery

peripheral nodes

located along the

attachment of themesentery

superior

mesenteric

nodes

small

intestine

mesenteric

nodes may

number asmany as 2"";

an important

node groupin cases of

intestinal

cancer

mesenteric

nodes, inferior

around the

root of theinferior

mesenteric a.

peripheral nodes

located along themarginal a.

lumbar

chain ofnodes,

superior

distal

10# ofthe

transvers

inferior

mesentericnodes may

number as


18/30

mesenteric

nodes

e colon,

descendi

ngcolon,

sigmoid

colon,rectum

high as ";

an important

node groupin cases of

cancer of the

colon andrectum

mesenteric

nodes, superior

along the

course of the

superiormesenteric a.

mesenteric nodes,

ileocolic nodes,

right colic nodes,middle colic nodes

celiac

nodes,


gut and

viscera

suppliedby the

superior

mesenter

ic a.

superior

mesenteric

nodes areimportant in

the spread of

cancer from

the small andlarge

intestine

middle colic

nodes

along the

course of themiddle colic

vessels

peripheral nodes


mesentery

superior

mesentericnodes

transvers

e colon

middle colic

nodes areapproximatel

y '" in

number

occipital nodes superiornuchal line,

along the

course of theoccipital a.

and v.

lymphatic vesselsfrom the posterior

head and neck

accessorynodes

occipitalpart of

the scalp

and thesuperior

neck

occipitalnodes are 2

or # nodes

locatedbetween the

attachmentsof thesternocleido

mastoid m.

and the

trape$ius m.

pancreaticoduo

denal nodes

along the

pancreaticod

uodenal

arcade ofvessels

lymphatic vessels

from the duodenum

and pancreas

pyloric

nodes

duodenu

m and

head of

thepancreas

lymph from

the pancreas

is drained in

threedifferent

directions%

pancreaticoduodenal

nodes,

pancreaticosplenic nodes,

superior


19/30

mesenteric

nodes

pancreaticospl

enic nodes

along the

splenicvessels

lymphatic vessels

from the pancreasand greater

curvature of the

stomach

celiac nodes neck,

bodyand tail

of the

pancreas; left

half of

thegreater

curvatur

e of the

stomach

lymph from

the pancreasis drained in

three

differentdirections%

pandreaticod

uodenalnodes,

pancreaticos

plenic nodes,

superiormesenteric

nodes

paracardial

nodes

around the

esophagogastric junction

lymphatic vessels

of the fundus andcardia of the

stomach

left gastric

nodes

fundus

andcardia of

the

stomach

paracardial

nodes are 5or in

number

pararectalnodes


superior

rectal vessels

lymphatic vesselsfrom the rectum

and anal canal

inferiormesenteric

nodes

rectumand anal

canal

pararectalnodes are

small lymph

nodes thatare not well

locali$ed

parasternal

nodes

lateral border

of sternum,along the

course of the

internalthoracic

vessels

anterior phrenic

nodes, lymphaticvessels from the

anterior thoracic

wall

larger

lymphaticvessels in

the root of

the neck

medial

side ofthe

mammar

y gland;medial

part of

the

anteriorchest

wall and

muscles

parasternal

nodesconstitute an

important

drainagepattern in

cases of

cancer of the

mammarygland; one or

two

parasternalnodes may

be found in

the anteriorend of

intercostal


20/30

spaces 1!;

also known

as% sternalnodes

paratracheal

nodes

coursing

along the

lateralsurface of

the trachea

andesophagus

superior

tracheobronchial

nodes

bronchomed

iastinal

trunk

lungs,

trachea,

upperesophag

us, the

part ofthe

larynx

below

thevocal

folds

paratracheal

nodes are an

importantgroup of

nodes in

cases ofpulmonary

infection or

lung cancer;

also knownas% tracheal

nodes

parotid nodes,

deep

on the lateral

side of thepharyngeal

wall, deep to

the parotidgland

lymphatic vessels

from the ear

superior

deepcervical

nodes

external

acousticmeatus,

auditory

tube,middle

ear

deep parotid

nodes arepart of the

deep cervical

chain ofnodes

parotid nodes,

superficial

superficial to

the parotidgland and

also deep tothe parotidfascia

anterior auricular

nodes

superior

deepcervical

nodes

anterior

surfaceof the

ear andexternalacoustic

meatus;

temporal

andfrontal

regions;

eyelids,lacrimal

gland

cheekand nose

superficial

parotid nodesare up to 1"

in numberand may belocated

superficial or

deep to the

parotid fascia

pectoral nodes along the

lateral border

of thepectoralis

major m.

lymphatic vessels

from the mammary

gland andanterolateral

thoracic wall

central

axillary

nodes

anterolat

eral

thoracicwall and

muscles;

an important

group of

nodes toexamine

during a


21/30

along the

course of the

lateralthoracic

vessels

most of

the

mammary gland

breast

physical

exam; alsoknown as%

anterior

axillarynodes

phrenic nodes on the

thoracic

surface ofthe

respiratory

diaphragm

lymphatic vessels

from the

diaphragm, liverand thoracic wall

lumbar

nodes,

posteriormediastinal

nodes

superior

surface

of theliver,

respirato

ry

diaphragm

phrenic

nodes drain

twostructures

that are very

closely

related indevelopment

al origin ! the

liver anddiaphragm

septum

transversum&; three

subgroups of

phrenic

nodes arerecogni$ed%

anterior,

middle and

posterior

popliteal nodes in the

popliteal

fossa alongthe popliteal

vessels

lymphatic vessels

that accompany the

anterior tibial ,posterior tibial and

fibular vessels

deep and

superficial

inguinalnodes

leg and

foot

5 or nodes

located in the

fat of thepopliteal

fossa

posterior

mediastinalnodes

along a$ygos

system ofveins and

esophagus

viscera of the

posteriormediastinum and

chest wall

thoracic

duct,inferior

tracheobron

chial nodes,superior

tracheobron

chial nodes

posterior

mediastinum,

posterior

aspect ofthe heart

and

pericardium,

posterior

part of

the

posterior

mediastinalnodes drain

primarily to

the thoracicduct


22/30

respirato

ry

diaphragm

pulmonary

nodes

within the

lung

parenchyma

lymphatic vessels

from the

parenchyma of thelung

bronchopul

monary

hilar& nodes

lung

parench

yma,bronchia

l tree

withinthe

lungs

pulmonary

nodes are

located alongthe larger

bronchi of

the lung

pyloric nodes near the

terminationof the

gastroduodenal a.

pancreaticoduodena

l nodes

hepatic

nodes

head of

pancreasand

duodenum; right

half ofgreater

curvatur

e ofstomach

pyloric nodes

are to / innumber

retroauricular

nodes

posterior to

the ear

lymphatic vessels

from the ear and

side of the head

superior

deep

cervicalnodes

scalp

overlyin

g theposterior

parietalregion;skin of

the

posterior

surfaceof the

ear

retroauricular

nodes are 1

or 2 nodeslocated at the

insertion ofthesternocleido

mastoid m.

retropharyngea

l nodes

posterior to

pharynx inthe

retropharyng

eal space

lymphatic vessels

from the nasal andpharyngeal regions

superior

deepcervical

nodes

nasal

fossae,paranasa

l

sinuses,hard

palate,

softpalate,

middle

retropharyng

eal nodes areone or two in

number; they

are part ofthe deep

cervical

chain ofnodes


23/30

ear,

orophary

nx

right colicnodes


right colic

vessels


marginal a.

superiormesenteric

nodes

ascending colon,

cecum

right colicnodes are

approximatel

y +" innumber

right gastric

nodes

on the lesser

curvature of

the stomach,along the

course of the

right gastricvessels

lymphatic vessels

from the lesser


celiac nodes lesser

curvatur

e of thestomach

right gastric

nodes are 2

to # innumber

right gastro!omental nodes

on thegreater


along the

right gastro!

omentalvessels

lymphatic vesselsfrom the greater


pyloricnodes

greatercurvatur

e of thestomach

right gastro!omental

nodes are to 12 in

number

right

lymphatic duct

root of neck

on the right

side

formed by the

union of the right

jugular trunk,theright subclavian

trunk, and the right

bronchomediastinaltrunk

junction of

the right

subclavianv. and right

internal

jugular v.

right

half of

the headand

neck;

rightupper

limb;

rightside of

the chest

right

lymphatic

duct has avalve near its

termination;

the threetrunks that

form right

lymphaticduct may

drain

separately

into thevenous

system

sacral nodes along the

course of thelateral sacral

aa.

lymphatic vessels

from the pelvicviscera

common

iliac nodes

prostate

gland,uterus,

vagina,

rectum,posterior

sacral nodes

are 2 or # innumber


24/30

pelvic

wall

spleen in the

abdominalcavity below

the left dome

of thediaphragm,

anterior to

the leftkidney

splenic brs. of the

splenic a.

splenic v. filters

blood byphagocy

tosis;

produces ( 3!

lymphoc

ytes

spleen

containsnodules of

lymphatic

tissue

sternal nodes lateral border

of sternum,


internalthoracic

vessels

anterior phrenic

nodes, lymphatic

vessels from theanterior thoracic

wall

larger

lymphatic

vessels inthe root of

the neck

medial

side of

themammar

y gland;medial

part ofthe

anterior

chestwall and

muscles

sternal nodes

constitute an

importantdrainage

pattern incases of

cancer of themammary

gland; one or

two sternalnodes may

be found in

the anteriorend of

intercostal

spaces 1!;also knownas%

parasternal

nodes

subclaviantrunk


subclavian v.

apical axillarynodes;

infraclavicular

nodes

drains intothe junction

of the

internaljugular v.

and the

subclavianv.

upperlimb,

most of

breast,anterolat

eral

chestwall

subclavianlymphatic

trunk

occasionallydrains into

the thoracic

duct on theleft side; on

the right it

occasionallydrains into

the right

lymphatic

duct


25/30

submandibular

nodes

along the

inferior

border of thesubmandibul

ar gland

submental nodes;

facial nodes;

lymphatic vesselsfrom the

submandibular and

sublingual regions

superior

deep

cervicalnodes;

juguloomoh

yoid node

anterior

part of

tongue,lower

lip, floor

of themouth,

nose,

cheeks,

chin,gums

and

lowerincisor

teeth,

lower

surfaceof palate

submandibul

ar nodes may

be within thesheath of the

submandibul

ar gland; thisgroup

consists of

from # to

nodes

submental

nodes

under the

mandible onthe

mylohyoid

m.

lymphatic vessels

from the lower faceand chin

submandibu

lar nodes,juguloomoh

yoid node

tip of the

tongue,lower

lip, floor

of the

mouth,chin,

gums

and

lowerincisor

teeth

submental

nodes areimportant

nodes to

examine in

cases of oralcancer

caused by the

use of

tobaccoproducts

subscapularaxillary nodes


subscapular

vessels

lymphatic vesselsfrom the skin of the

back and back of

the neck; lymphaticvessels from the

muscles of the

scapular region

centralaxillary

nodes

skin ofthe back

and back

of theneck;

muscles

of the

scapularand

subscap

ularregions

subscapularaxillary

nodes are 5

or innumber; also

known as%

posterior

axillarynodes

superficial

cervical nodes

in superficial

fascia and

along

lymphatic vessels

from superficial

structures in head

varies by

group;

ultimate

head (

neck

several

groups are

designated


26/30

superficial

vessels of

the head (neck

( neck destination

is the

jugulartrunk

by location%

occipital,

retroauricular, anterior

auricular,

superficialparotid,

facial,

submental,

submandibular, external

jugular,

anteriorjugular

superficial

inguinal nodes

in the

superficial

fasciaparallel to

the inguinal

ligament andalong the

terminal part

of the greater

saphenous v.

lymphatic vessels

from the superficial

lower limb,superficial

abdominal wall,

perineum

external

iliac nodes;

deepinguinal

nodes

lower

abdomin

al wall;external

genitalia

;superfici

al parts

of the

lowerlimb

superficial

inguinal

nodes are 12!2" in

number; they

becomeinflamed

during

infections of

the lowerlimb; they

may become

inflamed

duringinfections of

the externalgenitalia

superficial

parotid nodes

superficial to

the parotid

gland andalso deep to

the parotid

fascia

anterior auricular

nodes

superior

deep

cervicalnodes

anterior

surface

of theear and

external

acoustic

meatus;temporal

and

frontalregions;

eyelids,

lacrimalgland

superficial

parotid nodes

are up to 1"in number

and may be

located

superficial ordeep to the

parotid fascia


27/30

cheek

and nose

superior deep

cervical nodes

around the

internaljugular v.,

superior to

the crossingof the

omohyoid m.

numerous node

groups of the headand upper neck,

including

retropharyngealnodes and deep

parotid nodes

inferior deep

cervicalnodes

head and

thesuperior

part of

the neck

the superior

deep cervicalnode group

has many

large nodes;the

jugulodigastr

ic andjuguloomohy

oid nodes are

members of

this group

superior

mesentericnodes

along the

course of thesuperior

mesenteric a.

mesenteric nodes,

ileocolic nodes,right colic nodes,

middle colic nodes

celiac

nodes,intestinal

lymph trunk

gut and

viscerasupplied

by thesuperior

mesenter

ic a.

superior

mesentericnodes are

important inthe spread of

cancer from

the small andlarge

intestine

superior

tracheobronchial nodes

superolateral

to thetracheal

bifurcation

bronchopulmonary

hilar& nodes

paratracheal

tracheal&nodes

lungs,

middlemediasti

num,posteriormediasti

num

inferior


drain lymphfrom thelower lobe of

the left lung

to the right

superiortracheobronc

hial nodes

supraclavicular

nodes

in and

aroundcarotid

sheath below

level ofomohyoid

superior deep

cervical nodes,transverse cervical

nodes, spinal

accessory nodes

efferents

form thejugular

lymphatic

trunk

head and

neck

also known

as% inferiordeep cervical

nodes

thoracic duct between the

esophagus

anteriorlyand the

formed by the

union of the lumbar

lymph trunks,sometimes dilated

junction of

the left

subclavianv. and the

all of the

body

andlimbs

thoracic duct

is the largest

lymphaticvessel; it


28/30

thoracic

vertebral

bodiesposteriorly

to form a cisterna

chyli

left internal

jugular v.

below

the

respiratory

diaphrag

m; theleft side

of the

chest,

leftupper

limb and

the leftside of

the head

and neck

abovethe

diaphrag

m

passes

through the

aortic hiatuson the right

side of aorta;

it swings tothe left side

of the

esophagus at

the '!5intervertebral

disc at the

level of thesternal angle&

thymus root of the

neck and

superior

mediastinumposterior to

sternum

none parasternal

nodes

essential

for

normal

development of

the

immune

systemmaturati

on

thymus

involutes at

puberty and

is mostlyreplaced by a

mass of fat

tonsil, lingual superiorsurface of

the root of

the tongue

lymphatic vesselsof the tongue

superiordeep

cervical

nodes

4guards4the

entrance

of theorophary

nx

lingual tonsilis part of the

tonsillar ring

ofaldeyer&

tonsil, palatine lateral wall

of theoropharynx

between the

palatoglossaland

palatopharyn

geal arches

lymphatic vessels

of the posteriortongue and

palatoglossal0palato

pharyngeal archregion

superior

deepcervical

nodes,

especiallythe

jugulodigast

ric node

4guards4

theentrance

of the

oropharynx

palatine

tonsil is partof the

tonsillar ring

ofaldeyer&


29/30

tonsil,

pharyngeal

roof and

posterior

wall of thenasopharynx

lymphatic vessels

of the wall of the

pharynx

superior

deep

cervicalnodes

4guards4

the

entranceto the

nasophar

ynx

pharyngeal

tonsil is part

of thetonsillar ring

of

aldeyer&;also known

as% adenoids

tonsil, tubal pharyngeal

recess

lymphatic vessels

of the torustubarius and

auditory tube

superior

deepcervical

nodes

4guards4

theentrance

to the

nasophar

ynx

tubal tonsil is

located at thepharyngeal

orifice of the

auditory tube

tracheal nodes coursing

along thelateral

surface ofthe trachea

and

esophagus

superior

tracheobronchialnodes

bronchomed

iastinaltrunk

lungs,

trachea,upper

esophagus, the

part of

thelarynx

below

thevocal

folds

tracheal

nodes are animportant

group ofnodes in

cases of

pulmonaryinfection or

lung cancer;

also knownas%

paratracheal

nodestracheobronchial nodes

along thetrachea,

around the

tracheal

bifurcationand primary

bronchi

lymphatic vesselsfrom the lung

bronchomediastinal

lymph trunk

lungs,visceral

pleura,

bronchi,

thoracicpart of

trachea,

left sideof heart,

esophag

us,posterior

mediasti

num


may be

divided into

five groups%paratracheal

tracheal&,


hial, inferior

tracheobronchial,

bronchopulm

onary hilar&,pulmonary

tracheobronchi

al nodes,

inferior to

tracheal

bronchopulmonary

nodes, left side

right

superior

lower

lobes of

left inferior

tracheobronc


30/30

inferior bifurcation inferior

tracheobronchial

nodes drain intoright inferior

tracheobronchial

nodes

tracheobron

chial nodes

the

lungs;

middlemediasti

num;

posteriormediasti

num

hial nodes

drain to the

right side

tracheobronchi

al nodes,superior

superolateral

to thetracheal

bifurcation

bronchopulmonary

hilar& nodes

paratracheal

tracheal&nodes

lungs,

middlemediasti

num,

posterior

mediastinum

inferior


drain lymph

from the

lower lobe ofthe left lung

to the right


hial nodes

transverse

cervical nodes

along the

course of thetransverse

cervical

blood vessels

accessory chain of

nodes, sometimesthe apical axillary

nodes

variable%

jugularlymphatic

trunk, right

lymphatictrunk or

thoracic

duct

lateral

part ofthe neck,

anterior

thoracicwall,

mammar

y gland

transverse

cervicalnodes are

approximatel

y 1" innumber and

may drain

directly intothe internaljugular v. or

subclavian v.

Lymphatics of the Body

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Transcript of Lymphatics of the Body