Lymph Pathways

Question 1

Lateral aspect of the sole of the foot and the skin of the heel and lower calf

Answer 1

Popliteal- deep nodes

Question 2

Skin of the posterior thigh

Answer 2

Directs to the front of the leg and drains into the superficial inguinal nodes

Question 3

Skin over the lower abdomen ( below the navel- lumbar line)

Answer 3

Superficial inguinal nodes

Question 4

Skin of the right arm

Answer 4

Drains into the axillary nodes

Question 5

Skin of the left thumb

Answer 5

Cubital nodes, left venous angle where it empties into the left subclavian vein

If no swelling in thumb when thers edema in arm, bypasses axilla via radial pathway along cephalic vein to infra supra clavicular

Question 6

Skin over the breast

Answer 6

Axillary nodes

Question 7

Anterior intercostal spaces

Answer 7

Parasternal nodes to Thoracic duct

Question 8

Medial portions of the mammary gland

Answer 8

The two medial quadrants drain into the retrosternal and parasternal nodes, thoracic duct

Question 9

Skin of the posterior thorax

Answer 9

Drain lymph into the right and left axillary nodes

Question 10

Posterior intercostal spaces

Answer 10

Drains lymph into the intercostal lymph nodes, which are located along the spinal column and usually empty into the thoracic duct

Question 11

Skin of anterior thorax

Answer 11

Transport it via the infraclavicular lymph nodes to the venous angle or retrograde to the thoracic duct or cisterna chyli

Question 12

Skin of the upper back above the spine of the scapular

Answer 12

Drain into the left and right axillary nodes

Question 13

The lips

Answer 13

Submandibular lymph nodes , cervical lymph nodes, emptying in the venous angle

Question 14

Skin of the right eyelid

Answer 14

Periauricular ( in front of ear at parotid)
Submandibular both are drawn into the deep cervial nodes
emptying from there into the venous angle.

Question 15

The scalp

Answer 15

Through occipital lymph nodes along the nuchal line, to the superficial and deep cervical lymph nodes, emptying from there into the venous angle

Question 16

The mesentery of the small intestine

Answer 16

intestinal trunk, to the cisterna chyli, joining into the thoracic duct

Question 17

Urogenital organs

Answer 17

Iliac lymph nodes, into the right and left lumbar trunk to the cisterna chyli

Question 18

The rectum

Answer 18

The lymphatic vessels of the upper half of the rectum ascends with the superior rectal blood vessels to reach the pararectal nodes and pass into the inferior mesenteric nodes. The lymphatic vessels of the lower half of the rectum up to the upper half of the anus travels via the middle rectal blood vessels to reach the internal iliac nodes. Others pierce the levator ani and accompany the internal pudendal and inferior rectal blood vessels to reach the internal iliac nodes. These nodes have efferents, which drain into the common iliac nodes and then the lateral aortic nodes. The lateral aortic nodes drain into lumbar nodes, which drain into the abdominal confluence of the lymphatic trunks or cisterna chyli. The cisterna chyli drains into the thoracic duct.

Question 19

The lower concave surface of the liver

Answer 19

Drains to the nodes of the hepatic hilum

Question 20

The testes

Answer 20

Iliac nodes , to lumbar trunks

Question 21

Skin of external genitals

Answer 21

Superficial inguinal nodes to deep inguinal nodes

Question 22

The heart

Answer 22

Via Bronchomediastinal trunk to left and right venous angle, to left and right lymphatic duct

Question 23

Right lobes of the lung

Answer 23

Transported to right venous angle via the right bronchomediastinal trunk and the right lymphatic duct

Question 24

Lower Left lobe of the lung

Answer 24

Follow left Bronchus via hilar nodes cross at the carina and join right Broncho mediastinal trunk to thoracic duct

Question 25

The brain and spinal nerves

Answer 25

No lymph vessels in the brain or spinal cord so…
Cranial nerves lead the prelymph towards the ethmoid bone ( sieve like structure) 40-50% exits the skull with the olfactory nerve.
The rest is received by the nasopharyngeal area,and travels to the deep cervical nodes.

Question 26

Sciatic pathway

Answer 26

Drains part of the back of the upper leg and empties into the iliac or the lumbar nodes of the abdomen, passing by the inguinal nodes. ( this is very important for patients with lymph stasis in the inguinal area.)

Question 27

Paraspinal nodes…

Answer 27

Posterior intercostal pathways
Deep underneath the muscles
Capture any infected material near the pleural lining of the lung
Increase drainage from pleura( not when acute)

Question 28

Upper portion of liver drains to…

Answer 28

Mediastinal nodes

Only thing in the diaphragm that doesnt drain into the abdominals