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Lymphatic System SHANDONG UNIVERSITY Liu Zhiyu. 。. A. V. Cap. Lymph nodes. The Lymphatic System. Lymphatic ducts. Lymphatic trunks. Lymphatic. Lymphatic-Capillary. A assistant system to the vein. Composition. Lymphatic vessels Lymphatic capillary Lymph vessels - PowerPoint PPT Presentation
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Dept of Anatomy SDU
Lymphatic System
SHANDONG UNIVERSITYLiu Zhiyu
。
Dept of Anatomy SDU
The Lymphatic System
A
Cap
V
Lymphatic-CapillaryLymphatic
Lymphatic trunks
Lymphatic ducts
Lymph nodes
Dept of Anatomy SDU
• A assistant system to the vein
Dept of Anatomy SDU
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
Dept of Anatomy SDU
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
Lymphatic capillary
Dept of Anatomy SDU
Lymphatic vessel
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
Lymphatic vessels
Dept of Anatomy SDU
Lymphatic trunks
right and left jugular trunks right and left subclavian trunks
right and left bronchomediasti
nal trunks
right and left lumbar trunks
intestinal trunk
Lymphatic vessels
Dept of Anatomy SDU
Right lymphatic duct Formed by union of right jugular, subclavia
n, 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
Lymphatic vessels
Dept of Anatomy SDU
Thoracic duct• Begins in front of L1 as a dilated sa
c, 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
Lymphatic vessels
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
Thoracic duct
Dept of Anatomy SDU
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
Lymphatic vessels
Dept of Anatomy SDU
Lymph node Features Bean-shaped bodies With afferent lymph vessels
(entering at the periphery) and efferent lymph vessels(emerging at the hilus)
Arranged in groups, along the blood vessels or the flexural side of the joint
Divided into superficial and deep groups
Dept of Anatomy SDU
• 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)
Lymph drainage of breast
Dept of Anatomy SDU
Lymph drainage of the body
Dept of Anatomy SDU
Ⅰ.Lymph drainage of the head
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 lies near the submandibular gland, receive lymphatic vessels from the face, nose and mouth
Dept of Anatomy SDU
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
Dept of Anatomy SDU
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
Lymph drainage of neck
Dept of Anatomy SDU
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)
Lymph drainage of neck
Dept of Anatomy SDU
• 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 al
ong the subclavian artery
Lymph drainage of neck
Dept of Anatomy SDU
The lymphatic drainage of upper limb
• Lymphatic vessels– Superficial lymphatic vessels– Deep lymphatic vessels
lymph nodes– Cubital lymph nodeAxillary lymph node
Dept of Anatomy SDU
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
Dept of Anatomy SDU
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
Dept of Anatomy SDU
The lymphatic drainage of thorax
lymph nodes of the thoracic contents
lymph nodes of trachea, bronchi and lungs
• Pulmonary lymph nodes ie 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
Paratracheal lymph nodes
Dept of Anatomy SDU
• 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
The lymphatic drainage of thorax
Dept of Anatomy SDU
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
Dept of Anatomy SDU
Lymphatic drainage of abdominal viscera
• Lumbar lymph nodes – 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
Dept of Anatomy SDU
• 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
The lymphatic drainage of abdomen
Dept of Anatomy SDU
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
Dept of Anatomy SDU
The lymphatic drainage of pelvis
Sacral lymph node 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• Lie along common iliac artery• Receive afferents from all the abo
ve nodes• Efferents pass to lumbar lymph n
ode
Dept of Anatomy SDU
lymph drainage of lower limb
• lymphatic vessels– Superficial lymphatic– Deep lymphatic
• Lymph nodes– Superficial lymph
node– Deep lymph node
Dept of Anatomy SDU
lymph drainage of lower limb
Superficial lymph node may be divided into two group
s
– 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.
Dept of Anatomy SDU
lymph drainage of lower limb
deep lymph node – Locate around the proximal e
nd of femoral v.– Receive lymph from deep ly
mphatic vessels of lower limb and the efferentlymphatic vessels of superficial inguinal ln. Their efferent lymphatic vessels empty into external iliac ln.
Dept of Anatomy SDU
– Popliteal ln.• Embedded in the fatty connecti
ve 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.
lymph drainage of lower limb
Dept of Anatomy SDU
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
Dept of Anatomy SDU
Thymus
Featrues Consists of two elongated l
obesIs large organ in the fetusOccupies the thoracic cavity
behind the sternumSecrete lymphopoietin
Dept of Anatomy SDU
Clinic information
Dept of Anatomy SDU