Lymph Drainage of Limbs Flashcards
where do axillary lymph nodes receive drainage from?
- upper limb
- adjacent shoulder and neck regions
- breast
- post. and ant. thoracic wall
- ant. wall (above umbilicus)
- skin of back (above iliac crests)
what are the 5 groups of axillary lymph nodes?
- lateral (humeral)
- anterior (pectoral)
- posterior (subscapular)
- central
- apical
to which lymph nodes does the anterior thoracic wall and breast drain?
anterior (pectoral)
where is the lateral lymph node located?
lateral wall of axilla, medial and posterior to axillary vein
where is the anterior lymph node located?
medial wall of axilla near inf. border of pec. minor
where is the posterior lymph node located?
posterior axillary fold
where is the central lymph node located?
deep to pec. minor within axilla
where is the apical lymph node located?
apex of axilla
why is breast cancer most likely to metastasise to anterior (pectoral) lymph nodes?
- 75% of lymph from breast/mammary gland drains there
- palpation of these nodes common in breast exams
what care must be taken when breast cancer in nodes is biopsied or removed?
care not to damage long thoracic nerve - damage results in ‘winged’ scapula
where do lateral/humeral nodes receive lymph from??
majority of upper limb (except cephalic vessels)
where do anterior/pectoral nodes receive lymph from?
anterior thoracic wall and breast
where do posterior/subscapular nodes receive lymph from?
posterior thoracic wall and scapula
where do central nodes receive lymph from?
- lateral/humeral nodes
- ant./pectoral nodes
- post./ subscapular nodes
where do apical nodes receive lymph from?
- central nodes
- cephalic vessels
where do apical axillary nodes drain to?
to the suprasclavicular nodes and eventually to the subclavian lymph trunk (SLT)
where does the SLT drain to?
- venous system at junction between internal jugular and subclavian veins
- may also drain to thoracic duct on left)
where do lymph vessels of great saphenous drain?
> superficial inguinal lymph nodes
deep inguinal nodes
external iliac nodes
where do lymph vessels of small saphenous drain?
> popliteal lymph nodes
> deep inguinal nodes
what type of vessels drain the medial side of the dorsum and sole of the foot?
medial superficial vessels, accompanying great saphenous vein
where do medial superficial vessels accompanying great saphenous vein drain to?
> superficial inguinal nodes
> deep inguinal nodes
what type of vessels drain the lateral side of dorsum of foot?
lateral superficial vessels, accompanying small saphenous vein
where do lateral superficial vessels accompanying small saphenous vein drain to?
> popliteal nodes
> deep inguinal nodes
where do superficial inguinal nodes lie?
- “T” along inguinal ligament and saphenous vein
- outside femoral triangle
- superficial to fascia lata
- along great saphenous
where do the superficial nodes receive lymph from?
- ant. abdominal wall (below umbilicus)
- skin of back (below iliac crests)
- perineum
- gluteal region (via sup. and inf. gluteal nodes)
- sup. lower limb
where are the deep inguinal nodes located?
medial to femoral vein, in femoral triangle
where do deep nodes receive lymph from?
- lower limb (accompanying fem. vessels, incl. from popliteal nodes)
- most drainage from superficial inguinal nodes
- external genitalia
where do the deep and superficial inguinal nodes drain to?
external iliac nodes accompanying femoral vein
where does lymph from external iliac nodes drain to?
> common iliac nodes
lateral lumbar nodes
cisterna chyli and thoracic duct
what is the femoral sheath?
continuation of abdominal transversalis fascia
what does the femoral sheath contain?
- femoral artery, vein and canal
- not nerve
where is a common site for femoral hernia?
- femoral sheath
- femoral ring
what is the function of the femoral canal?
- allows for expansion of femoral vein upon increased venous return
- sometimes contains deep inguinal nodes
what is the femoral ring?
- an opening of femoral canal at abdominal side
- weak area of anterior abdominal wall
what are the femoral ring boundaries?
anterior: - med. part of inguinal ligament medial: - lacunar ligament lateral: - septum between femoral canal and vein posterior: - pectineus muscle and fascia (sup. ramus of pubis)
what is the femoral canal?
- a short and conical space between medial wall of femoral sheath and femoral vein
- contains deep inguinal lymph nodes
