Lymphatic Drainage Of The Abdomen

Question 1

Lower end of the esophagus
The efferent lymph vessels of the abdominal esophagus follow the arteries and drain into the ——— nodes.

Answer 1

Lower end of the esophagus
The efferent lymph vessels of the abdominal esophagus follow the arteries into the left gastric nodes.

Question 2

The stomach
⦿ The stomach lymph vessels follow the arteries into the —— and ——nodes, the —— and ——— nodes, and the ——nodes.
⦿ All lymph from the stomach eventually passes to the —— nodes located around the root of the celiac artery.

Answer 2

⦿ The stomach
⦿ The stomach lymph vessels follow the arteries into the left and right gastric nodes, the left and right gastroepiploic nodes, and the short gastric nodes.
⦿ All lymph from the stomach eventually passes to the celiac nodes located around the root of the celiac artery.

Question 3

The duodenum
The duodenal lymph vessels follow the arteries and drain:
⦿ Upward via —— nodes to the ——
nodes and then to the —— nodes.
⦿ Downward via —— nodes to the —— nodes around the origin of the superior mesenteric artery.

Answer 3

The duodenum
The duodenal lymph vessels follow the arteries and drain:
⦿ Upward via pancreaticoduodenal nodes to the gastroduodenal
nodes and then to the celiac nodes.
⦿ Downward via pancreaticoduodenal nodes to the superior mesenteric nodes around the origin of the superior mesenteric artery.

Question 4

The jejunum and the ileum
The lymph vessels of the jejunum and ileum pass through many ——nodes and finally reach the —— nodes, which are situated around the origin of the superior mesenteric artery.

Answer 4

The jejunum and the ileum
The lymph vessels of the jejunum and ileum pass through many intermediate mesenteric nodes and finally reach the superior mesenteric nodes, which are situated around the origin of the superior mesenteric artery.

Question 5

The cecum
The lymph vessels of the cecum pass through ———nodes and finally reach the ——— nodes

Answer 5

The cecum
The lymph vessels of the cecum pass through several mesenteric nodes and finally reach the superior mesenteric nodes

Question 6

The appendix
Lymph vessels of the appendix drain into one or two nodes lying in the —— and then eventually into the —— nodes.

Answer 6

The appendix
Lymph vessels of the appendix drain into one or two nodes lying in the mesoappendix and then eventually into the superior mesenteric nodes.

Question 7

The ascending colon
Lymph vessels of the ascending colon drain into lymph nodes lying along the course of the ——— vessels and ultimately reach the ———nodes.

Answer 7

The ascending colon
Lymph vessels of the ascending colon drain into lymph nodes lying along the course of the colic blood vessels and ultimately reach the superior mesenteric nodes.
8

Question 8

Transverse Colon
⦿ The proximal two thirds drain into the ——— nodes and then into the ——— nodes;
⦿ The distal third drains into the —— nodes and then into the ———nodes.

Answer 8

Transverse Colon
⦿ The proximal two thirds drain into the middle colic nodes and
then into the superior mesenteric nodes;
⦿ The distal third drains into the colic nodes and then into the inferior mesenteric nodes.
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Question 9

Descending Colon
The lymph from the descending colon is drained to the —— lymph nodes and then to the ——— nodes around the origin of the inferior mesenteric artery.

Answer 9

Descending Colon
The lymph from the descending colon is drained to the colic lymph nodes and the inferior mesenteric nodes around the origin of the inferior mesenteric artery.

Question 10

• Liver
• The liver produces a large amount of lymph—about how many to how many of all body lymph.
• The lymph vessels leave the liver and enter several lymph nodes in the ——.
⦿ The efferent vessels pass to the —— nodes.
⦿ A few vessels pass from the bare area of the liver through the diaphragm to the ————nodes.

Answer 10

• Liver
• The liver produces a large amount of lymph—about one third to one half of all body lymph.
• The lymph vessels leave the liver and enter several lymph nodes in the porta hepatis.
⦿ The efferent vessels pass to the celiac nodes.
⦿ A few vessels pass from the bare area of the liver through the diaphragm to the posterior mediastinal lymph nodes.

Question 11

Gall Bladder
⦿ The lymph drains into a —— lymph node situated near the ——
of the gallbladder.
⦿ From here, the lymph vessels pass to the —— nodes along the course of the hepatic artery and then to the —— nodes.

Answer 11

Gall Bladder
⦿ The lymph drains into a cystic lymph node situated near the neck
of the gallbladder.
⦿ From here, the lymph vessels pass to the hepatic nodes along the course of the hepatic artery and then to the celiac nodes.

Question 12

The pancreatic lymph nodes are situated along the arteries that supply the gland.
⦿ The efferent vessels ultimately drain into the —— and ——— nodes.

Answer 12

The pancreatic lymph nodes are situated along the arteries that supply the gland.
⦿ The efferent vessels ultimately drain into the celiac and superior mesenteric lymph nodes.

Question 13

Spleen
The lymph vessels of the spleen emerge from the hilum and pass through a few lymph nodes along the course of the —— artery and then drain into the —— nodes.

Answer 13

Spleen
The lymph vessels of the spleen emerge from the hilum and pass through a few lymph nodes along the course of the splenic artery and then drain into the celiac nodes.

Question 14

Kidney
The lymph of the kidneys go to the —— lymph nodes around the origin of the renal artery.

Answer 14

Kidney
The lymph of the kidneys go to the lateral aortic lymph nodes around the origin of the renal artery.

Question 15

Ureter
The lymph of the ureters drains to the ——nodes and the —— nodes.

Answer 15

Ureter
The lymph of the ureters drains to the lateral aortic nodes and the iliac nodes.

Question 16

Suprarenal gland
The lymph from the suprarenal glands drains into the ———nodes.

Answer 16

Suprarenal gland
The lymph from the suprarenal glands drains into the lateral aortic nodes.

Question 17

The lymph nodes are closely related to the aorta and form a —— and a right and left —— (also called —— or ——) chain.

Answer 17

The lymph nodes are closely related to the aorta and form a preaortic and a right and left lateral aortic (Para-aortic or lumbar) chain.

Question 18

The preaortic lymph nodes lie around the origins of the ——, —— & —— arteries.
⦿ They are referred to as the ——, ——, and —— lymph nodes, respectively.

Answer 18

The preaortic lymph nodes lie around the origins of the celiac, superior & inferior mesenteric arteries.
⦿ They are referred to as the celiac, superior, and inferior mesenteric lymph nodes, respectively.

Question 19

Pre aortic nodes drain the lymph from the gastrointestinal tract, extending from the ——— to ———, and from the ——, ——, ——, and ———.

Answer 19

These nodes drain the lymph from the gastrointestinal tract, extending from the lower one third of the esophagus to halfway down the anal canal, and from the spleen, pancreas, gallbladder, and greater part of the liver.

Question 20

The efferent lymph vessels from the preaortic nodes form the large ———.

Answer 20

The efferent lymph vessels from the preaortic nodes form the large intestinal lymph trunk.

Question 21

The ——— (also called the —— or ——) lymph nodes drain lymph from the kidneys and suprarenals; from the testes in the male and from the ovaries, uterine tubes, and fundus of the uterus in the female; from the deep lymph vessels of the abdominal walls; and from the common iliac nodes.
⦿ The efferent lymph vessels form the —— and —— trunks.

Answer 21

The lateral aortic (para-aortic or lumbar) lymph nodes drain lymph from the kidneys and suprarenals; from the testes in the male and from the ovaries, uterine tubes, and fundus of the uterus in the female; from the deep lymph vessels of the abdominal walls; and from the common iliac nodes.
⦿ The efferent lymph vessels form the right and left lumbar trunks.

Question 22

⦿ The thoracic duct begins in the abdomen as an elongated lymph sac, the ———.
⦿ The cisterna chyli lies just below the diaphragm in front of the —— lumbar vertebrae and on the which side of the aorta.

Answer 22

⦿ The thoracic duct begins in the abdomen as an elongated lymph sac, the cisterna chyli.
⦿ The cisterna chyli lies just below the diaphragm in front of the first two lumbar vertebrae and on the right side of the aorta.

Question 23

The cisterna chyli receives the ———, the —— and ——trunks, and some small lymph vessels that descend from the ———.

Answer 23

The cisterna chyli receives the intestinal trunk, the right and left lumbar trunks, and some small lymph vessels that descend from the lower part of the thorax.

Question 24

Portal vein
——. long (—inches)
Formed behind the —— of the pancreas.
Formed by the union of the —— and ——, behind the —— of the pancreas.
Drains blood from the ————.
.

Answer 24

⦿ ⦿
⦿
Five cm. long (2 inches)
Formed behind the neck of the pancreas.
Formed by the union of the splenic and superior mesenteric veins, behind the neck of the pancreas.
Drains blood from the gastrointestinal tract.
(From the lower1/3rd of esophagus to halfway down the anal canal).
It also drains, the spleen, the pancreas, and the gall bladder.

Question 25

Portal Vein
It ascends behind the —— part of the duodenum
⦿ Then it lies in the free margin of the ——, behind the —— and the ——.
⦿ In the liver it breaks up into liver ——, from which blood passes to the inferior vena cava through the two —— veins.

Answer 25

It ascends behind the 1st part of the duodenum
⦿ Then it lies in the free margin of the lesser omentum, behind the hepatic artery and the bile duct.
⦿ In the liver it breaks up into liver sinusoids, from which blood passes to the inferior vena cava through the two hepatic veins.

Question 26

TRIBUTARIES OF PORTAL VEIN
.

Answer 26

TRIBUTARIES OF PORTAL VEIN
⦿ 1- Splenic. ⦿ 2- Superior
mesenteric. ⦿ 3- Left gastric.
⦿ 4- Right gastric. ⦿ 5- Cystic.

Question 27

SUPERIOR MESENTERIC VEIN
⦿ Ascends in the ———.
⦿ In the —— side of the superior mesenteric artery.
⦿ It passes in front of —— part of the duodenum.
⦿ Tributaries:

Answer 27

SUPERIOR MESENTERIC VEIN
⦿ Ascends in the root of the mesentery.
⦿ In the right side of the superior mesenteric artery.
⦿ It passes in front of 3rd part of the duodenum.
⦿ Tributaries:
⦿ 1- Jejunal & Ilial veins.
⦿ 2-Iliocolic.
⦿ 3-Right colic.
⦿ 4-Middle colic.
⦿ 5- Inferior pancreaticoduodenal
⦿ 6- Right gastroepiploic

Question 28

SPLENIC VEIN
⦿ Runs in the ——- ligament.
⦿ Runs below the —— artery, behind the —— of the pancreas.
⦿ Tributaries:

Answer 28

SPLENIC VEIN
⦿ Runs in the spleniorenal ligament.
⦿ Runs below the splenic artery, behind the body of the pancreas.
⦿ Tributaries:
⦿ 1- Short gastric.
⦿ 2- Left gastroepiploic.
⦿ 3- Inferior mesenteric.
⦿ 4- Pancreatic veins.

Question 29

Inferior mesenteric vein
⦿ Ascends in the ——wall, in the — side of the inferior mesenteric artery.
⦿ It joins the —— vein behind the —— of the pancreas.
⦿ Tributaries:
.

Answer 29

⦿ Ascends n the posterior abdominal wall, in the left side of the inferior mesenteric artery.
⦿ It joins the splenic vein behind the body of the pancreas.
⦿ Tributaries:
⦿ 1- Superior rectal vein.
⦿ 2- Sigmoid veins.
⦿ 3- Left colic vein.

Question 30

PORTO-SYSTEMIC ANASTOMOSIS
⦿ Normally, portal blood passes to the ——, then it drained into the ——.
⦿ Other smaller communications are exist between the portal and systemic systems.
⦿ These communications become important when the normal route faces a resistant, e.g. —— or ——.

Answer 30

⦿ Normally, portal blood passes to the liver, then it drained into the IVC.
⦿ Other smaller communications are exist between the portal and systemic systems.
⦿ These communications become important when the normal route faces a resistant, e.g. portal hypertension or liver cirrhosis.

Question 31

SITES OF PORTO-SYSTEMIC ANASTOMOSIS
⦿ 1- In the submucosa of the lower 1/3rd of esophagus between esophageal branches of——— (portal) and esophageal branches of ——( systemic).
⦿ These veins become dilated, tortuous and engorged with blood forming ——.

Answer 31

SITES OF PORTO-SYSTEMIC ANASTOMOSI
⦿ 1- In the submucosa of the lower 1/3rd of esophagus between esophageal branches of left gastric vein (portal) and esophageal branches of azygos vein ( systemic).
⦿ These veins become dilated, tortuous and engorged with blood forming esophageal varices.
S

Question 32

SITES OF PORTO- SYSTEMIC ANASTOMOSIS
⦿ 2- Halfway down the anal canal, between the —— (portal) and —— & ——veins (systemic).
⦿ These veins become dilated tortuous, and engorged with blood forming ——

Answer 32

SITES OF PORTO- SYSTEMIC ANASTOMOSIS
⦿ 2- Halfway down the anal canal, between the superior rectal vein (portal) and middle & inferior rectal veins (systemic).
⦿ These veins become dilated tortuous, and engorged with blood forming piles

Question 33

SITES OF PORTO- SYSTEMIC ANASTOMOSIS
⦿ 3- Paraumbilical veins: which connects the ———— with the ———
⦿ These veins appear engorged with blood radiating from the umbilicus and called ———.

Answer 33

⦿ 3- Paraumbilical veins: which connects the left branch of portal vein with he superficial veins of the anterior abdominal wall.
⦿ These veins appear engorged with blood radiating from he umbilicus and called caput Medusae.

Question 34

SITES OF PORTO- SYSTEMIC ANASTOMOSIS

4- The veins of the ascending & descending colon, duodenum, pancreas and bare area of liver (which are retroperitoneal) and drained by portal vein may anastomosis with veins on the ——— (e.g. ——-).

Answer 34

4- The veins of the ascending & descending colon, duodenum, pancreas and bare area of liver (which are retroperitoneal) and drained by portal vein may anastomosis with vines on the posterior abdominal wall (e.g. Lumbar veins, systemic).