Lecture 6 - Lymphatic drainage of the thorax Flashcards
What makes up the lymphatic system?
- Network of tissues, organs, lymph vessels, nodes and lymph.
- Includes tonsils, spleen, adenoids and thymus
- 600-700 lymph nodes
Where does lymph drain into?
Upper right quadrant (head, neck, upper right limb and thorax) - right subclavian vein
Rest of the body - thoracic duct
Where does the thoracic duct drain into?
Left subclavian vein
What is lymph?
A clear and odourless substance (in most vessels) that contains WBCs, pathogens, hormones, cell debris and fats.
Where would lymph not be clear?
Can be opaque and milky if coming from the small intestine due to the fats absorbed here.
Describe the movement of lymph around the body.
- Slow and sporadic due to the lack of a pump
- Movement is maintained by action of adjacent structures (skeletal muscles and arterial pulses)
- Unidirectional flow due to presence of valves
Where will the lymph drain into at the anterior thoracic wall?
Parasternal nodes which then drain into bronchomediastinal trunks
Where will the lymph from the ribs drain into?
Intercostal nodes, with the upper half draining into the bronchomediastinal trunks and the lower half draining into the thoracic duct
Where will the diaphragm lymph drain into?
Diaphragmatic nodes that drain into the brachiocephalic vein as well as aortic and lumbar vessels
Where do the superficial nodes drain into?
Axillary or parasternal nodes
At what level does the thoracic duct begin?
L2 at the cisterns chyli, moving superiorly
What does the thoracic duct drain?
Most of the body apart from the upper right quadrant
Where does the thoracic duct drain into?
Left subclavian vein at the junction between the left subclavian vein and the left internal jugular vein
Describe the path of the thoracic duct.
Originates at L2 and pierces the diaphragm with the oesophagus at T8, ascending on the right of the midline and later crossing over to the left at T5. Sits on the vertebral column.
How is the lymph from the lung drained?
Lymph enters trachiobronchial nodes in the hilum near the bronchi. These nodes join with the parasternal and brachiocephalic veins to form the bronchomediastinal nodes.
