Intro to Lymphatics

Question 1

What parts of the body are drained by the right lymphatic duct? What is drained by the thoracic duct?

Answer 1

Right lymphatic drains right side of head, neck, right upper limb, right side of thorax
Rest is by thoracic duct

Question 2

What is the name of the bulging of the duct where the thoracic duct begins?

Answer 2

Cysterna chili

Question 3

When does the thoracic duct cross on its ascent up?

Answer 3

Begins crossing to the eft at T5, reaching left border of esophagus at sternal angle

Question 4

Which node do the upper limbs converge on?

Which node do the lower limbs converge on?

Answer 4

Upper limbs converge on axillary nodes

Lower limbs converge on inguinal nodes

Question 5

Where do the efferent vessels from inguinal nodes pass into abdomen and drain into?

Answer 5

External iliac nodes

Question 6

From what structures do the superficial inguinal nodes receive?

Answer 6

• anterior and posterior surfaces of the trunk below the umbilicus
• the perineum including the lower half of the anal canal, the lower portion of the vagina, and all external genitalia of both sexes (except testes, and except ovaries)
• the superficial lymph vessels of the lower limbs

Question 7

From what structures do the deep inguinal nodes receive?

Answer 7

Receive all the lymph from the superficial nodes and deep structures of the lower limb

Question 8

Where does the fluid in the deep inguinal nodes go to?

Answer 8

Ascend through femoral canal and drain into external iliac nodes

Question 9

What are the final nodes draining the head and neck? Where are they?

Answer 9

Lie along carotid sheath and are the deep cervical nodes

Question 10

What drains the final nodes located in the carotid sheath?

Answer 10

Jugular trunk

Question 11

Where does the lymph from lung/pleura, bronchi, trachea, and heart converge? Where does the lymph from these nodes go? Where do they empty from there?

Answer 11

Lymph from these areas converge on the bronchomediastinal lymph nodes
Efferents from these nodes unite into bronchomediastinal trunks
Left jugular, subclavian, and bronchomediastinal trunks empty into thoracic duct
Right jugular, subclavian and bronchomediastinal trunks empty into right lymphatic duct

Question 12

What is received by the thoracic duct?

Answer 12

Left jugular, subclavian, and bronchomediastinal trunks

Question 13

What is received by the right lymphatic duct?

Answer 13

right jugular, subclavian, and bronchomediastinal trunks

Question 14

What are the 3 groups of the pre-aortic nodes?

Answer 14

Celiac nodes (drains foregut)
superior mesenteric node (drains midgut)
inferior mesenteric node (drains hindgut)

Question 15

What do the efferents from the pre-aortic nodes form? What lymphatic structure does this contribute to?

Answer 15

Intestinal trunk which contributes to the formation of the cysterna chili

Question 16

What drains into the para-aortic nodes? What do these nodes give rise to?

Answer 16

Drains kidneys, suprarenal glands, and gonads. Upper nodes form the lumbar trunks

Question 17

What is the first node that ovarian or testicular cancers would travel to?

Answer 17

Para-aortic nodes (lumbar nodes)

Question 18

What are the two nodes that the breasts drain into

Answer 18

75% of lymph travel to axillary (most pectoral) nodes

Most of remaining lymph drains towards upper abdominal nodes and some goes to opposite breast

Question 19

Where do the fundus and body of the uterus drain? Where do the lower body and cervix drain to?

Answer 19

Fundus and body drain mostly to lymphatics from uterine tube and ovary passing to lumbar (para-aortic) nodes. Some go to superficial inguinal nodes

Lower body and cervix drain to internal, external, common iliac nodes, and sacral nodes (basically everywhere; common site of carcinoma)

Question 20

Where does the upper 3/4 of the vagina drain? Bottom 1/4?

Answer 20

Upper 3/4 = internal iliac nodes

Lower 1/4 = superficial inguinal nodes