Lymphatics of Retroperitonium and Pelvic Wall; Supracolic and Infracolic Organs Flashcards
Lymph nodes of the Retroperitoneum
- Pre-Aortic Lymph Nodes
- Right and Left Lateral Aortic Lymph Nodes (Lumbar/Para-Aortic Lymph Nodes)
- Retro-Aortic Lymph Nodes
- Cisterna Chyli
Pre-Aortic Lymph Nodes
o Consists of the coeliac, superior mesenteric and inferior mesenteric lymph nodes
o Located anterior to the abdominal aorta, scattered around the origin of the respective arteries
Right and Left Lateral Aortic Lymph Nodes (Lumbar/Para-Aortic Lymph Nodes)
o Located on the left and right side of the abdominal aorta
o Efferent vessels form the left and right lumbar lymphatic trunks
Retro-Aortic Lymph Nodes
o Located anterior to the bodies of L3 and L4
o Receive lymph from the pre-aortic and lateral aortic lymph nodes
o Efferent vessels drain to the cisterna chyli
Cisterna Chyli
o Drains into the thoracic duct
o Located anterior to L1 and L2
o Receives lymph from the intestinal trunk, right and left lumbar trunks, right and left inferior intercostal trunks
Coeliac Lymph Nodes
o Receive lymph from the Supracolic organs
Superior Mesenteric Lymph Nodes
o Receives lymph from the small and large intestine
Inferior Mesenteric Lymph Nodes
o Receives lymph from the large intestine
Intestinal Trunk Formation
• Efferent vessels from the pre-aortic lymph node groups form the intestinal trunk
What are the differing Lateral Aortic/Lumbar Lymph Nodes?
- Right Lateral Aortic/Lumbar Lymph Nodes
* Left Lateral aortic/lumbar lymph nodes
Right Lateral Aortic/Lumbar Lymph Nodes
o Located anterior to the IVC (to the right of the abdominal aorta)
• Left Lateral aortic/lumbar lymph nodes
o Located to the left of the abdominal aorta
Lateral Aortic/Lumbar Lymph Nodes: Lymphatic Flow
- Both groups receive lymph from the common iliac lymph nodes, ovaries/testes, uterus, kidneys, suprarenal glands and abdominal muscles
- Efferent vessels from the lateral/aortic lumbar lymph node groups from the right and left lumbar trunks
Lymph Nodes of the Pelvic Wall
- Sacral Lymph Nodes
- Internal Iliac Lymph Nodes
- External Iliac Lymph Nodes
- Common Iliac Lymph Nodes
Sacral Lymph Nodes
o Located anteriorly in the concavity of the sacrum
o Receive lymph from the posteroinferior pelvic viscera
o Efferent vessels drain to either the internal iliac lymph nodes or the common iliac lymph nodes
Internal Iliac Lymph Nodes
o Receive lymph from the pelvic viscera, perineum, and gluteal regions
o Efferent vessels drain into the common iliac lymph nodes
External Iliac Lymph Nodes
o Receive lymph from the deep inguinal lymph nodes, the inferior deep abdominal wall and some of the pelvic viscera
o Efferent vessels drain to the common iliac lymph nodes
Common Iliac Lymph Nodes
o Receive from the external iliac, internal iliac and sacral lymph node groups
o Efferent vessels drain into the lateral aortic/lumbar lymph nodes
Lymphatics of the Liver
- Liver produces a significant amount of lymph (approximately 1/3 to ½ of all lymph draining into the thoracic duct originating from the liver
- Drains into the hepatic lymph nodes or phrenic lymph nodes
Hepatic Lymph Nodes
o Located along the hepatic vessels and ducts
o Lymph will flow into the coeliac lymph nodes and to the intestinal trunk
Phrenic Lymph Nodes
o Located on the superior surface of the thoracic diaphragm
o Lymph will flow into the posterior mediastinal lymph nodes and to the bronchomediastinal trunk
Left Gastric Lymph Nodes
o Will flow into the coeliac lymph nodes
Coeliac Lymph nodes
o Surrounds the coeliac trunk
Right Gastric Lymph Nodes
o Flow into the pyloric lymph nodes and then the coeliac lymph nodes
Pyloric Lymph Nodes
o Located along the pylorus of the stomach
Gastroepiploic Lymph Nodes
o Located along the greater curvature of the stomach
Pancreaticosplenic Lymph Nodes
o Located along the length of the splenic artery
Lymphatics of the Anterior Duodenum
Pancreaticoduodenal Lymph Nodes (Anterior)
o Located along the duodenum at the head of the pancreas
o Efferent vessels drain into the pyloric lymph nodes, to then flow into the coeliac lymph nodes and the intestinal trunk
Lymphatics of the Duodenum: Posterior
o Afferent vessels from the duodenum drain directly into the superior mesenteric lymph nodes (located at the superior mesenteric artery)
o Lymph then flows superiorly to the coeliac lymph nodes
Pancreaticosplenic lymph nodes
o Receives afferent pancreatic vessel drainage
o Located along the splenic artery or the pyloric lymph nodes
o Efferent vessels from these lymph nodes will drain to the coeliac lymph nodes or the superior mesenteric lymph nodes
Splenic Lymph Nodes
o Receive afferent splenic vessel drainage
o Drain into the Pancreaticosplenic lymph nodes to the coeliac lymph nodes
Lymphatics of the Infracolic Organs
• All lymph drains to the superior or inferior mesenteric lymph nodes (pre-aortic lymph nodes)
Jejunum and Ileum
o Specialised lymphatic vessels
o Located within the villi of the small intestine
o Absorbs fat
o Release milky-fluid which drains into the mesenteric lymph nodes
Mesenteric Lymph Nodes: 3 Groups
- Parajejunal/paraileal lymph nodes
- Arcade Lymph Nodes
- Superior Mesenteric Lymph Nodes
Parajejunal/paraileal lymph nodes
o Located close to the wall of the small intestine
o Efferent vessels drain to the arcade lymph nodes
Arcade Lymph Nodes
o Located along the arterial branches
o Drain into the superior mesenteric trunk lymph nodes
Superior Mesenteric Lymph Nodes
o Located along the superior mesenteric artery
o Drains into the coeliac lymph nodes and then to the intestinal trunk
Lymphatics of the Large Intestine
• Afferent vessels flow into the epicolic lymph nodes
o Located on the wall of the large intestine
• Efferent vessels flow into the paracolic lymph nodes
o Located along the inner border of the large intestine
- Lymph then flows into the intermediate lymph nodes (located along the branches of the superior and inferior lymph node)
- Lymph then flows into the lymph nodes of the superior or inferior mesenteric trunk
- Lymph will then drain into the lymph nodes of the superior or inferior mesenteric lymph nodes
Drainage of the superior vagina
Internal or external iliac LNs
Drainage of the middle vagina
Internal iliac LNs
Drainage of inferior vagina
Sacral or common iliac LNs
Drainage of external orifice of vagina
Superficial inguinal LNs
Drainage of superior rectum
pararectal –> sacral –>inferior mesenteric
Drainage of inferior rectum
Sacral LNs
Drainage of rectal ampulla
Internal Iliac LNs
Superior group of superficial inguinal LNs drainage
Receive lymph from inferior abdominal wall, gluteal region, external genitalia and perineal region
Inferior group of superficial inguinal LNs drainage
Receive lymph from most of superficial regions of lower limb
Position of deep inguinal LNs
medial to femoral vein
along the terminal end of femoral vein
