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淋淋淋lymphatic system

淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺

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Page 1: 淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺

淋巴系统 lymphatic system

Page 2: 淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺

目 录概 述淋巴管道

淋巴结

毛细淋巴管淋巴管

淋巴干淋巴导管

脾和胸腺

Page 3: 淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺

一、概 述 淋巴系统的组成:

淋巴管道 lymphatic ducts 淋巴组织 lymphatic tissue 淋巴器官 lymphatic organs : 包括淋巴结、脾、胸腺和扁桃体

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Page 4: 淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺

淋巴系统的功能 协助静脉系统引流组织液 产生淋巴细胞 滤过淋巴液 参与免疫应答

淋巴的构成

Page 5: 淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺

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Page 6: 淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺

二、淋巴管道 lymphatic ducts

毛细淋巴管 lymphatic capillary 构成 结构特点

淋巴管 lymphatic vessel 分类

输入淋巴管输出淋巴管 返回目录

Page 7: 淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺

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淋巴结

Page 8: 淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺

lymph node (Small oval or bean-shaped bodes Afferent vessels enter the node on

its convex surface, and efferent vessels leave the node at its concave surface - the hilum

Arranged in groups, along the blood vessels

Regional nodes is the lymph node where the

lymph of the organ or part of the body drainage to firstly

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淋巴干 lymphatic trunks

构成 九条淋巴干 :

淋巴干

成 对

不成对

颈 干 jugular trunks锁骨下干 subclavian trunks支气管纵隔干 bronchomadiastinal trunks腰 干 lumbar trunks

肠 干 intestinal trunk

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Page 10: 淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺
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返回

Page 12: 淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺

淋巴导管 lymphatic ducts

胸导管 thoracic duct构成行程注入收纳范围

右淋巴导管 right lymphatic duct构成收纳范围 返回目录

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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

Lymphatic ducts

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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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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 bronchomediastinal

trunks

Thoracic duct

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Thoracic duct

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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三、淋巴结 lymphatic node

形态:呈椭圆形或圆形,全身约 400~450 个 分群:根据位置可分为:

浅淋巴结 superficial lymphatic nodes 深淋巴结 profundal lymphatic nodes

局部淋巴结 regional lymphatic node : 指引流某一器官或部位淋巴的第一级淋巴结,临床上又称为哨位淋巴结。

返回目录

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全身各部的淋巴结 1. 头颈部淋巴结

头部淋巴结 颈部淋巴结

颈前淋巴结 颈外侧淋巴结 颈外侧浅淋巴结 颈外侧深淋巴结

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颈内静脉二腹肌淋巴结(角淋巴结)

颈内静脉肩胛舌骨肌淋巴结

锁骨上淋巴结

斜角肌淋巴结( Virchow 淋巴结)

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The lymphatic drainage of head Lymph nodes of head Located at junction of head and neck Consist of

Occipital lymph nodes Mastoid lymph nodes Parotid lymph nodes ★ Submandibular lymph nodes

lies near the submandibular gland, receive lymphatic vessels from the face, nose and mouth

submental lymph nodes Drain into deep cervical lymph

nodes

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Lymph nodes of the neckAnterior cervical ln. Superficial anterior cervical lymph

nodes Deep anterior cervical lymph nodes

Lateral cervical ln. ★ Superficial lateral cervical ln. -lie along the external jugular vein

★ Deep lateral cervical ln. - extend

along the internal jugular vein

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Lymph nodes of the neck★ Deep lateral cervical ln.

Extend along the internal jugular vein from the

base of skull to the root of neck Divided into superior deep lateral cervical ln. and

inferior deep lateral cervical ln. 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 Left jugular trunk joins the thoracic duct Right jugular trunk joins the right lymphatic

duct

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Lymph nodes of the neckSuperior deep lateral cervical

ln. Jugulodigastric ln. Lies at the junction of posterior belly of

digastric and internal jugular vein Drain the nasopharynx, palatine tonsil

and root of tongue

Inferior deep lateral cervical ln. Juguloomohyoid ln. Lies at the junction of the intermediate

tendon of omohyoid and internal jugular

vein Drain the apex of tongue

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Lymph nodes of the neckInferior deep lateral cervical ln. Supraclavicular lymph nodes

Lie along transverse cervical a. & v. palpable in the supraclavicular fossa.

The most notable supraclavicular lymph node is Virchow's node. which can contain metastasis of visceral (abdominal) tumor.

Retropharyngeal ln. Lying vertically behind the pharynx drain nasopharyngeal lymph

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2. 上肢的淋巴结 肘淋巴结 腋淋巴结

胸肌淋巴结 外侧淋巴结 肩胛下淋巴结 中央淋巴结 尖淋巴结

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Lymph nodes of upper limb Cubital lymph node lies above medial epicondyle of humerus Receive lymph vessels from forearm Axillary lymph node arranged in five groups

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Axillary lymph nodes

Axillary lymph nodes vary

in size from a pin-head to a

large bean.

They are arranged in five

groups.

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Axillary lymph nodesPectoral lymph nodes

Lying along the lower border of pectoralis minor behind the pectoralis major

Receive lymph vessels from the lateral quadrants of the breast and superficial vessels from the anterolateral abdominal wall above the level of the umbilicus

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Axillary lymph nodesLateral lymph nodes

Along medial side distal part of axillary vein

Receives lymph from upper limb

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Axillary lymph nodesSubscapular lymph

node Lying along subscapular

vessels, in front of the subscapularis

Receive superficial lymph vessels from the back, down as far as the level of the iliac crests

Efferents of above three groups pass to central lymph node

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Axillary lymph nodes

Central lymph node Lying in the center of the

axilla in the axillary fat Receive lymph from the

above three nodes Efferents pass to apical

lymph node

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Axillary lymph nodesApical lymph node infraclavicular lymph

nodes Lying at the apex of the

axilla at the lateral border of the fist rib

Receive lymph of the efferent lymph vessels from all the other axillary nodes

The efferents of the apical nodes form the subclavian trunk

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Axillary lymph nodes

Lateral ln.

Pectoral ln.

Subscapular ln.

Central ln.

Apical ln.

Efferents form subclavian trunk, the right subclavian trunk joins the right lymphatic duct; left usually drains directly into thoracic duct

Subclavian trunk

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Lymphatic drainage of thoraxThe 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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3. 胸部淋巴结 胸壁淋巴结 纵隔前淋巴结 纵隔后淋巴结 气管、支气管

和肺淋巴结

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lymph nodes of the thorax Pulmonary ln. lie in the angles of

bifurcation of branching lobar bronchi

Bronchopulmonary hilar ln. -lie in the hilums of the lung

Tracheobronchial ln. - situated above or below the bifurcation of trachea

Paratracheal ln. - along each side of the trachea

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lymph nodes of the 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 and parasternal 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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Lymph nodes of lower limbPopliteal 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 tibia a.

Efferents pass to the deep inguinal ln.

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Lymph nodes of lower limbSuperficial inguinal lymph nodes

Superior group: Lies just distal to the inguinal ligament Receive lymph vessels from anterior

abdominal wall below umbilicus, gluteal region, perineal region, external genital organs

Inferior group: Lies vertical along the terminal great

saphenous v. Receives all superficial lymph vessels of

lower limb, except for those from the posterolateral part of calf

Efferent vessels drain into the deep inguinal ln. or external iliac ln.

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Lymph nodes of lower limbDeep inguinal lymph nodes Lie medial to the femoral v. Receive deep lymph vessels of

lower limb, perineal region, and efferent vessels from the superficial inguinal ln.

Drain into the external iliac ln.

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Lymph nodes of pelvis Internal iliac lymph node

Surround internal iliac vessels Receive afferents from pelvic viscera,

perineum, buttock and back of thigh External iliac lymph nodes

Lie along external iliac artery Receive afferents from lower limb and

some parts of pelvic viscera 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 Efferent pass to lumbar lymph node

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Lymph nodes 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

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Lymph nodes of abdomenLymphatic 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, ovaries, fundus of uterus, uterine tubes, and common iliac nodes

Right and left lumbar trunks formed by efferent vessel

Paired viscera - drain to the lumbar lymph nodes

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Lymph nodes of abdomen

Right and left gastric ln. lie along the same vessels and finally to the celiac ln.

Right and left gastroomental ln. lie along the same vessels, the former drain into subpyloric ln., the latter drain into splenic ln.

Suprapyloric and subpyloric ln. receive lymphatics from pyloric part and finally to the celiac ln.

Splenic ln. receive lymphatics from fundus and left third of stomach, and finally to the celiac ln.

Celiac lymph nodes - situated around the celiac trunk

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Lymph nodes of abdomen

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 lymph nodes

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四、脾和胸腺

脾 spleen 形态 位置 功能

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Spleen Shape

The largest single mass of lymphoid tissue in the body

Reddish in color Location:

lies in the left hypochondriac region (between stomach and diaphragm) deep to the 9th to 11th rib

its long axis corresponds roughly to the 10th rib

Its lower pole extends forward only as far as the midline and cannot be palpated on clinical examination

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Spleen Two surfaces

Diaphragmatic: smooth, convex Visceral: concave, hilum of spleen

Two extremities Anterior - wider Posterior - rounder

Two border Superior - has 2-3 splenic notch,

which serve as a landmark on palpation when it is enlarge; normally it is not palpable

Inferior - rounder

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胸腺 thymus 形态 位置 功能

返回目录

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Thymus The thymus is partly in the neck and partly in the thorax. It

comprises one to three lobes, each of which consists of numerous lobules containing lymphocytes, which are important in the development and maintenance of the immune system. The cervical part of the thymus lies on the anterior and lateral sides of the trachea, whereas the thoracic part lies posterior to the superior portion of the sternum. The organ has a profuse blood supply and lymphatic drainage. The thymus reaches its greatest size at puberty and then begins to regress. Much of its substance is replaced by fat and fibrous tissue, but thymic tissue never disappears completely. Function:to develop lymph cell

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Spleen Function

Erythrocyte storagePhagocytosisCytopoiesisImmune responses

Page 52: 淋巴系统 lymphatic system. 目 录 概 述 淋巴管道 淋巴结 毛细淋巴管 淋巴管 淋巴干 淋巴导管 脾脾和胸腺胸腺