1.2.2. Lymphatics of the Upper Limb

Question 1

Where do all lymphatic vessels in the upper limb drain to?

Answer 1

The Axillary Lymph Nodes

Question 2

What are the 5 groups of Axillary Lymph Nodes?

Answer 2

1. Anterior (Pectoral) Group
2. Posterior (Subscapular) Group
3. Apical Group
4. Central Group
5. Lateral (Humeral) Group

Question 3

Where do the superficial lymphatic vessels of the upper limb arise?

Answer 3

Lymphatic Plexuses in the skin of the hand

Question 4

Where do the Lymphatic Plexuses travel?

Answer 4

They ascend up the arm, in close proximity to the major superficial veins

Question 5

Where do the Superficial Lymphatic Vessels shadowing the Basilic vein enter?

Answer 5

The Cubital Lymph Nodes

Question 6

Where are the Cubital Lymph Nodes located?

Answer 6

1. Medial to the Basilic Vein

2. Proximal to the Medial Epicondyle of the Humerus

Question 7

Where do the Superficial Lymphatic Vessels ascending from the Cubital Lymph Nodes terminate?

Answer 7

These continue up the arm and terminate in the Lateral Group of Axillary Lymph Nodes

Question 8

Where do the Superficial Lymphatic Vessels shadowing the Cephalic Vein travel?

Answer 8

They cross the proximal part of the Arm and Shoulder

Question 9

1. Where do the Superficial Lymphatic Vessels shadowing the Cephalic Vein terminate?
2. What are the exceptions?

Answer 9

1. The Apical Group of Axillary Lymph Nodes

2. Some enter more superficial Deltopectoral Lymph Nodes

Question 10

What do the Deep Lymphatic Vessels of the Upper Limb follow?

Answer 10

They follow the Major Deep Veins of the Upper Limb:

1. Radial
2. Ulnar
3. Brachial

Question 11

Where do the Deep Lymphatic Vessels of the Upper Limb terminate?

Answer 11

Humeral Axillary Lymph Nodes

Question 12

What is the function of the Deep Lymphatic Vessels of the Upper Limb (including the Humeral Axillary Lymph Nodes)?

Answer 12

To drain Lymph from:

1. Joint Capsules
2. Periosteum
3. Tendons
4. Muscles

Question 13

Where is the Anterior (Pectoral) Group of Axillary Lymph Nodes located?

Answer 13

Medial Wall of the Axilla

Question 14

Where does the Anterior (Pectoral) Group of Axillary Lymph Nodes receive Lymph from?

Answer 14

Primarily from the Anterior Thoracic Wall (including most of the breast)

Question 15

Where is the Posterior (Subscapular) Group of Axillary Lymph Nodes located?

Answer 15

Along the Posterior Axillary Fold, and Subscapular Blood Vessels

Question 16

Where does the Posterior (Subscapular) Group of Axillary Lymph Nodes receive Lymph from?

Answer 16

1. Postreior Thoracic Wall

2. Subscapular Region

Question 17

Where is the Lateral (Humeral) Group of Axillary Lymph Nodes located?

Answer 17

1. In the Lateral Wall of the Axilla

2. Posterior to the Axillary Vein

Question 18

Where does the Lateral (Humeral) Group of Axillary Lymph Nodes receive Lymph from?

Answer 18

Majority of the Lymph drained from the Upper Limb (Deep Lymphatic Vessels drain into here)

Question 19

Where is the Central Group of Axillary Lymph Nodes located?

Answer 19

Near the base of the Axilla:

1. Deep to the Pectoralis Minor
2. Close to the 2nd part of the Axillary Artery

Question 20

Where does the Central Group of Axillary Lymph Nodes receive Lymph from?

Answer 20

Efferent Vessels from the:

1. Anterior (Pectoral) Group of Axillary Lymph Nodes
2. Posterior (Subscapular) Group of Axillary Lymph Nodes
3. Lateral (Humeral) Group of Axillary Lymph Nodes

Question 21

Where is the Apical Group of Axillary Lymph Nodes located?

Answer 21

In the Apex of the Axilla - close to the Axillary Vein and 1st part of the Axillary Artery

Question 22

Where does the Apical Group of Axillary Lymph Nodes receive Lymph from?

Answer 22

1. Efferent Vessels of the Central Axillary Lymph Nodes (therefore all Axillary Lymph Node Groups)
2. Lymphatic Vessels accompanying the Cephalic Vein

Question 23

Where do the Efferent Vessels of the Apical Group of Axillary Lymph Nodes travel?

Answer 23

Through the Cervico-Axillary Canal

Question 24

What do the Efferent Vessels of the Apical Group of Axillary Lymph Nodes converge with?

Answer 24

The Subclavian Lymphatic Trunk

Question 25

What does the Right Subclavian Lymphatic Trunk go on to form?

Answer 25

The Right Lymphatic Duct

Question 26

Where does the Right Lymphatic Duct drain?

Answer 26

It enters the Right Venous Angle (Junction of Internal Jugular and Subclavian Veins) directly

Question 27

Where does the Left Subclavian Lymphatic Trunk drain?

Answer 27

Directly into the Thoracic Duct

Question 28

Which group of Lymph Nodes will be involved if the Lymphatic Spread of an infection begins in the little finger?

Answer 28

The Axillary Lymph Nodes

Question 29

Which group of Lymph Nodes will be involved if the Lymphatic Spread of an infection begins in the Scapular region?

Answer 29

The Axillary Lymph Nodes

Question 30

Which group of Lymph Nodes will be involved if the Lymphatic Spread of an infection begins in Medial part of the Breast (close to the Sternum)?

Answer 30

The Internal Thoracic (Internal Mammary) Lymph Nodes

Question 31

Which group of Lymph Nodes will be involved if the Lymphatic Spread of an infection begins in Lateral part of the Breast (close the the Axilla)?

Answer 31

The Axillary Lymph Nodes

Question 32

1. Which group of Lymph Nodes will be involved if the Lymphatic Spread of an infection begins around the Umbilicus (due to an infected tattoo)?
2. Why?

Answer 32

1. a) The Axillary Lymph Nodes
2. b) The Superficial Inguinal Lymph Nodes
3. The umbilicus is the boundary for which lymph above drains into the Axillary, and below drains into the Superficial Inguinal Lymph Nodes - so it can spread both ways