B19 - General features of the lymphatic system, lymphonodi capitis et cervicis

Question 1

General features of the lymphatic system

1. Draw the main lymphatic vessels
2. Name the important lymphatic vessels

Answer 1

• Cisterna chyli (abdomen, exists of two main vessels)
  
  • Trunci lumbales (follows abdominal aorta and drains parietal wall of abdomen)
  • Trunci visceralis (follows visceral branches of aorta abdominis)
• Ductus thoracicus (drains the thorax, opens near v. cava cranialis)
• Ductus lymphaticus dexter (drains the thorax (little bit), head, neck)
  
  • Ductus trachealis dexter
  • Ductus trachealis sinistra

Question 2

General features of the lymphatic system

Draw the division of lymph nodes

Answer 2

Question 3

General features of the lymphatic system

General about lymphatic vessels

Answer 3

• Arteries/veins → interstitial fluid space → lymphatic capillaries → lymph vessels → lymph ducts → v. jugularis / v. cava cranialis
• Proteins pass throught the capillary walls of arteries and veins into the interstitial fluid space, and then taken up by blind-ending lymphatic capillaries
• Lymphatic capillaries form plexuses within most body tissues, from which larger lymph vessels take their origin
• Lymph vessels opens into v. jugularis or v. cava cranialis
• Lymph vessels are interrupted by lymph nodes
• Ø CNS
• Ø valves in lymph capillaries
• Valves in lymph vessels
  
  • ​More valves than veins
  • Thinner walls than veins
• Afferent lymph vessels: capillary region → lymph node
• Efferent lymph vessels: leave the lymph node

Lymph centers:

• Car, ru: fewer, but induvidually large lymph nodes
• Su, eq: larger number of small lymph nodes

Question 4

Give the lymphatic centers of the head and the neck

Answer 4

Head:

1. Lc. parotideum
2. Lc. mandibulare
3. Lc. retropharyngeum

Neck:

1. Lc. cervicalis profundus
2. Lc. cervicalis superficialis

Figure: drainage of the head

Question 5

Head

Lc. parotideum

Answer 5

1. Ln. parotideus superficialis
   
   • ​Between gl. parotideus and ​m. masseter
2. Ln. parotideus profundus
   
   • ​​Inside gl. parotideum

• Drain:
  
  • Dorsal half of head
  • Orbit
  • Masticatory muscles

Question 6

Head

Lc. madibulare

Answer 6

1. Ln. mandibularis
   
   • ​​V. facialis

• Drain:
  
  • Oral cavity
  • Salivary glands
  • Intermandibular space
  • Masticatory muscles
• Location:
  
  • Ca: found in skinfold
  • Su: combined with 2 lymphatic centers

Question 7

Head

Lc. retropharyngeum

Answer 7

1. Ln. retropharyngeum medialis
   
   • ​​Fossa atlantis
2. Ln. retropharyngeum lateralis (ø Ca)
   
   • Eq: drain gutteral pouch

• Drain:
  
  • Deep parts of head
  • Pharynx
  • Larynx
  • Cranial thrachea
  • Esophagus
  • Eq: gutteral pouch
• Location:
  
  • Behind the pharynx

Question 8

Neck

Lc. cervicalis profundus

Answer 8

1. Ln. cervicalis profundus cranialis
   
   • ​Close to larynx
2. Ln. cervicalis profundus medialis
   
   • ​​Thoracic inlet
   • Sometimes absent
3. Ln. cervicalis profundus caudalis
   
   • ​​Bifucation of trachean between rib 2-5

• Drains:
  
  • Deep structures of cervical region:
    
    • Trachea
    • Esophagus
    • Thyroid gland
    • Thymus
• Drain into lymphatic duct → thoracic duct

Question 9

Neck

Lc. cervicalis superficialis

Answer 9

1. Ln. cervicalis superficialis dorsalis
2. Ln. cervicalis superficialis medius
3. Ln. cervicalis superficialis ventralis

• Efferent vessels pass to lc. cervicalis profundum
• Location:
  
  • Cranial to shoulder joint
  • Close to v. prescapularis
  • Covered by m. brachiocephalicus and m. omotransversarius
• Ca: 1 ln
• Fe: 2 ln
• Su:
  
  • Ln. cervicalis superficialis dorsalis
  • Ln. cervicalis superficialis medialis
  • Ln. cervicalis superficialis ventralis