lymphatic system (anatomy) Flashcards
L. system
1) L. capillaries
2) collecting vessels
3) L.nodes
4) L.organs resembling l.nodes (tonsills, l.nodules)
5) spleen
6) thymus
l.vessels and l.nodes
L.vessels: collect lymph to the large blood streams(brachiocephalic veins)
L.nodes: L.cytes, filter lymph.
L.vessels of upper limb + adjoining p of trunk
L.vessels of upper limb drain lymph into axillary l.nodes
-Divided into 1)spf and 2)deep l.vessels
1)SPF lymph vessels og 2)DEEP lymph vessels
1) SPF lymph vessels;
- Begin in digital plxuses. -Accompany spf veins
a) Lateral gr. of lymph vessels (asc. along cephalic vein)
b) Medial gr. of lymph vessels (accompanies basilic vein)
c) Anterior gr. (asc in midline of forearm)
2) DEEP lymph vessels;
- Accompany Brachial artery + all its branches
Axillary lymph nodes
Drain lymph from;
- free upper limb.
- skin of supraumblical p. of trunk(abdomen,thorax,back), including mammary gland.
- muscles conn. upper limb to trunk.
- Axillary l. nodes, divided into SPF + DEEP nodes–>
1) SPF ax. nodes; Fá lymph frá SPF lymph vessels. Eru drained into deep axillary nodes
2) Deep ax. nodes; Fá lymph frá SPF axillary l.nodes og frá DEEP lymph vessels.
*DEEP ax. lymph nodes skiptast í 5 hópa
DEEP ax. lymph nodes 5 subdivision
1) Brachial (humeral, lateral) gr.
- gets lymph from free upper limb, drained by deep+spf l.vessels
2) Pectoral (anterior) gr.
- nálægt inf. margin of Pectoralis minor m.
- gets lymph vessels from supraumblical p. of trunk (anterior + lateral surfaces), including mammary gland
3) Subscapular (posterior) gr
- hjá subscapular vessels
- drains lymph from inf. surf of back of neck
- og from dorsal side of trunk, up to iliac crest
4) Central gr.
- hjá upper margin Pectoralis minor m.
- gets lymph from fyrri þremur gr.
5) Apical gr (infraclavicular) gr.
- surrounds Axillary vein in upper p. of axillary fossa.
- gets l.vessels arising from central gr. nodes ásamt lymph from other lymph nodes + from mammary gland
–>Efferent vessels arising from Apical axillary lymph nodes, join to form Subclavian Trunk
- Right Subclav. Trunk opens into right Brachiocephalic vein(angulus venosus)
- Left Subclavian Trunk terminates in Thoracic Duct, sem opnast inní left Brachiocephalic vein(right angulus venosus)
Lymph drainage from lower limbs + adj p. of trunk
is drained into inguinal l. nodes
*Lymph vessels of free lower limb skipt í SPF gr og DEEP gr
Lymph vessels of free lower limb (spf and deep)
1) SPF l. vessels (accompany saphenous vein):
a) Medial gr;
- asc. along gr. saphenous vein
- terminates in SPF inguinal nodes
b) Lateral gr;
- asc. along lateral side of lower limb
- terminates in SPF inguinal nodes
c) Posterior gr;
- asc. along small saphenous vein
- terminates partly in popliteal nodes, partly in SPF inguinal nodes
2) DEEP l. vessels
- accompany femoral artery + its branches
* popliteal l.nodes, placed around popliteal artery
Lymph vessels of free lower limb (spf and deep)
1) SPF l. vessels (accompany saphenous vein):
a) Medial gr;
- asc. along gr. saphenous vein
- terminates in SPF inguinal nodes
b) Lateral gr;
- asc. along lateral side of lower limb
- terminates in SPF inguinal nodes
c) Posterior gr;
- asc. along small saphenous vein
- terminates partly in popliteal nodes, partly in SPF inguinal nodes
2) DEEP l. vessels
- accompany femoral artery + its branches
* popliteal l.nodes, placed around popliteal artery
Inguinal lymph nodes (spf og deep)
1) SPF inguinal l.nodes, get lymph from;
- free lower limb (spf structures skin, subQ tissue)
- gluteal reg
- infraumblical p. of anterior + lateral abd. wall (skin, subQ tissue)
- external genital organs
- uterus!
- lower p. of anal canal
- -> Lymph from SPF inguinal l.nodes, drained into external iliac l.nodes og into deep inguinal l.nodes
2) DEEP inguinal l.nodes
- hjá femoral vessels in femoral triangle near inguinal ligg.
- get lymph from deep l.vessels of lower limb(accompanying blood vessels) and from uterus
*Efferent l.vessels arising from DEEP l.nodes, terminate in external iliac l.nodes
L. ORGANS: THYMUS
- L.organ + endocrine gland
- Helstu hl.verk; diff. of l.cytes into different classes, prod. of various hormones that regulate l.cyte prod + diff. og activities in thymus and peripheral lymphoid tissue.*
- Size varies w age (stærstur um puberty, atrophy með age og replacement by fat)
- In childhood: pink-grey color, lobulated, right/left lobes conn by fibroareolar tissue.
Thymus relations and supply
-In anterior mediastinum, extends into neck. In children it may reach lower p. of thyroid gland.
Relations;
- anteriorly; sternum + costal cartilages, infrahyoid muscles
- posteriorly; heart in pericardium, brachiocep.veins, SVC, aortic arch+branches og trachea
- laterally; pleura og lungs
Blood supply;
Arteries–> Thymic br. of inf thyroid artery and internal thoracic artery
Veins–> Drained into inf. thyroid, brachiocephalic og internal thoracic veins
Nerve supply; Cervicothoracic ganglion(sympathetic)
og Vagus N(parasympathetic fibers)
L.ORGANS: SPLEEN
- In left hypochondriac reg.
- milli gastric fundus and diaphragm
- long axis lies in plane of 10th rib
- irregularly ovoid. 12cm long, 3-4cm thick, 7cm wide
- með diaphragm. og visceral surf
- has sup+inf margins og ant+post extremities.
*main functions; Phagocytosis Immune responses due to l.cytes Blood storage Cytopoiesis (hemopoiesis and lymphopoiesis)
SPLEEN relations and supply
diaphr. surf: diaphragm seperates it from pleural cavity(costodiaphragmatic recess)
visceral surf;
- stomach (gastric impression)
- left kidney (renal impression)
- pancreas (pancreatic impression)
- left colic flexure (colic impression)
- Hilum of spleen: splenic A + V enter spleen
- Intraperitoneal (develops in posterior mezogastrium-gr.omentum)
- conn to stomach + left kidney by gastrosplenic and gastrorenal ligg.
*accessory spleens–> in gastrosplenic lig + gr.omentum
Blood supply:
- Splenic artery (of coeliac artery)
- Splenic vein (of portal vein)
Nerve supply; abdominal autonomic plx
L.drainage of head and neck (superficial)
L.drainage of SPF tissues of head + neck—>
-most l.vessels accompany br of ext.carotid artery and corresponding veins. And they terminate in small groups of l.nodes:
1) Occipital nodes (along occipital vessels)
2) Retroauricular nodes (along posterior auricular vessels)
3) Parotid nodes (near parotid gland+temporal spf vessels)
4) Buccal nodes (along facial vessels)
5) Submandibular nodes (around facial vessels in digastric triangle)
..Submandibular nodes receive afferents from Buccal og Parotid nodes, also lymph from oral cav (tongue, teeth) + nasal cav (ventral part).
6) ))Anterior cervical nodes (along ant. jugular vein)
7) ))Superficial cervical nodes (along ext. jugular vein)
- ->Represent outlying nodes of Deep cervical l.nodes
-LYMPH IS THEN FINALLY DRAINED INTO DEEP CERVICAL L.NODES
L.drainage of head and neck (deep)
l.drainage of deep tissues of head and neck, directs to the deep cervical l.nodes
- Outlying groups of nodes:
1) Retropharyngeal: gets lymph from nasopharynx, nasal cav and auditory tube
2) Paratracheal nodes (around cervical p of trachea/esophagus): gets lymph from trachea, larynx og esophagus.
Deep cervical l.nodes
- Are the regional l.nodes of head og neck
- Get lymph from spf og deep structures of head og ncek
- lie along carotid sheath (internal jugular vein, carotid arteries)
- skipast í superior og inferior group:
1)Superior deep cervical l.nodes: close to upper p. of internal jugular vein.
*This group contains jugulodigastric node, near tendon of digastricus m. -> l.drainage of tonsils
…Efferents terminate in Inferior deep cervical nodes
2)Inferior deep cervical l.nodes: close to lower p. of internal jugular vein.
*This group contains juguloomohyoid node, near tendon of omohyoid m. -> l.drainage of tongue.
………EFFERENTS UNITE TO FORM JUGULAR TRUNK
Thoracic duct
main l.vessel conveying lymph to bloodstream.
-arises in abdomen (at 12 T v.bra), by union of right+left lumbar trunks og intestinal trunk
here dilated cisterna chyli. And here it receives lymph from abd.organs + abd wall, pelvic organs + pelvic walls og lower limbs.
Thoracic duct frh
- traverses diaphragm thru aortic hiatus
- ascends in post.mediastinum behind esophagus on right side of aorta
- turns to left behind aortic arch and subclav a.
- leaves thorax (3-4cm above clavicle)
- arches above subclav. a.
- opens into left brachiocephalic vein, and here it receives left subclavian trunk(left upper limb), left jugular trunk(left head+neck) and left bronchomediastinial trunk(left thoracic organs+wall)
Right l.duct
lymph from right side of head, neck, upper limb and thorax drained into right l.duct (terminates in right angulus venosus) -right l.duct arises by union of: right jugular trunk right subclav.trunk right bronchomediastinal trunk
l.drainage of thorax
- Spf tissues, mammary gland, muscles conn. upper limb to thorax drained into axillary l.nodes
- Deep structures, thoracic walls, ribs, intercostal muscles, diaphragm and thoracic organs drained into Deep l.nodes of the thorax (parasternal, intercostal and diaphragmatic l.nodes)
L.drainage of thoracic wall : Parasternal l.node
-on sides of internal thoracic vessels
-receive lymph from anterior thoracic + abd.wall,
mammary gland, liver(upper surface)
–>efferents terminate in bronchomediastinal trunk
L.drainage of thoracic walls: Intercostal l.nodes
- eru near the neck of ribs
- get lymph from posterolateral thoracic wall (ribs, intercostal muscles)
- efferents open into the thoracic duct and right l.duct
L.drainage of thoracic wall: diaphragmatic l.nodes
- lie around periphery of diaphragm
- fá lymph frá diaphragm og sup.surface liver
- efferent pass into parasternal nodes and anterior+posterior mediastinal l.nodes
L.drainage of thoracic organs
-anterior mediastinal, posterior mediastinal and tracheobronchial l.nodes –> efferent empty into thoracic duct and right l.duct
Anterior mediastinal lnodes (brachiocephalic l.nodes)
- eru in front of brachiocephalic veins og br. of aortic arch
- fá lymph frá anterior mediastinum
- thymus
- thyroid gland
- pericardium
- diaphragmatic l.nodes
- ->efferents terminate into thoracic duct (and tracheobronchial l.nodes)
Tracheobronchial l.nodes
-near trachea and tracheal bifurcation og er subdivided to;
*paratracheal (on sides of trachea)
*superior tracheobronchial (above bifurcation)
*inferior tracheobronchial (below bifurcation)
og outlying lnodes;
*bronchopulmonary (in pulmonary hilum)
*pulmonary (in lung substance)
- receive lymph from;
- lungs og bronchi
- trachea
- heart
-efferent vessels unite to form bronchomediastinal trunks
Posterior mediastinal l.nodes
-around esophagus and thoracic aorta
- drain lymph from;
- esophagus
- heart
- liver
- diaphragm
- ->efferents terminate into thoracic duct
L.drainage of abdomen
-lymph from abd.wall + abd.organs drained into lumbar og pre-aortic nodes
l.drainage abdomen: Lumbar l.nodes (lateral aortic)
- lie on sides of abd.aorta og IVC
- get lymph from abd.walls
- supraren glands
- kidneys, ureters
- gonads
- -> efferents unite to form right+left Lumbar trunks
- outlying l.nodes in pelvis: common iliac l.nodes–>
- drain pelvic organs + walls + lower limbs
l.drainage abdomen: pre-aortic l.nodes
Pre-aortic l.nodes:
1) coeliac l nodes
2) superior mesenteric l.nodes
3) inferior mesenteric l.nodes
- fá lymph from alimentary canal, liver, pancreas, spleen
- –>efferents form intestinal trunk
coeliac l.nodes
- near origin of coeliac artery
- fá lymph frá organs supplied by coeliac artery (liver, gallbladder, stomach, duodenum, pancreas, spleen)
- outlying nodes:
- Hepatic l.nodes (along common and proper hepatic A)
- Gastric l.nodes (near lesser+greater curvatures og around pylorus)
- Pancreaticosplenic (along splenic A)
Superior og inferior mesenteric l.nodes
- close to origin of sup+inf mesenteric aa.
- fá lymph frá small og large intestine
- outlying nodes
- l.nodes of mesentery: drain small intestine
- ileocolic nodes: terminal p. ileum + appendix
- nodes of colon: large intestine
- superior rectal nodes: upper p. of rectum
Superior og inferior mesenteric l.nodes
- close to origin of sup+inf mesenteric aa.
- fá lymph frá small og large intestine
- outlying nodes
- l.nodes of mesentery: drain small intestine
- ileocolic nodes: terminal p. ileum + appendix
- nodes of colon: large intestine
- superior rectal nodes: upper p. of rectum
L.drainage Pelvis
- Common iliac l.nodes, along common iliac vessels:
* fá lymph frá internal og external iliac l.nodes
l.drainage pelvis: External iliac l.nodes
along ext. iliac vessels
- Fá lymph frá;
- inguinal l.nodes
- infraumblical p of anterior abd.wall
- adductor region (along obturator vessels)
- penis
- some pelvic organs:
- prostate
- urinary bladder, urethra
- uterus, vagina
—> efferents pass to the common iliac l.nodes
l. drainage pelvis: Internal iliac l.nodes
lie along internal iliac vessels
- Fá lymph from:
- Pelvic organs
- Perineum (along internal pudendal vessels)
- muscles of gluteal region (along gluteal vessels)
–> efferents pass to the common iliac l.nodes
