Lymphatics of Retroperitonium and Pelvic Wall; Supracolic and Infracolic Organs Flashcards

1
Q

Lymph nodes of the Retroperitoneum

A
  • Pre-Aortic Lymph Nodes
  • Right and Left Lateral Aortic Lymph Nodes (Lumbar/Para-Aortic Lymph Nodes)
  • Retro-Aortic Lymph Nodes
  • Cisterna Chyli
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2
Q

Pre-Aortic Lymph Nodes

A

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

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3
Q

Right and Left Lateral Aortic Lymph Nodes (Lumbar/Para-Aortic Lymph Nodes)

A

o Located on the left and right side of the abdominal aorta

o Efferent vessels form the left and right lumbar lymphatic trunks

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4
Q

Retro-Aortic Lymph Nodes

A

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

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5
Q

Cisterna Chyli

A

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

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6
Q

Coeliac Lymph Nodes

A

o Receive lymph from the Supracolic organs

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7
Q

Superior Mesenteric Lymph Nodes

A

o Receives lymph from the small and large intestine

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8
Q

Inferior Mesenteric Lymph Nodes

A

o Receives lymph from the large intestine

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9
Q

Intestinal Trunk Formation

A

• Efferent vessels from the pre-aortic lymph node groups form the intestinal trunk

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10
Q

What are the differing Lateral Aortic/Lumbar Lymph Nodes?

A
  • Right Lateral Aortic/Lumbar Lymph Nodes

* Left Lateral aortic/lumbar lymph nodes

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11
Q

Right Lateral Aortic/Lumbar Lymph Nodes

A

o Located anterior to the IVC (to the right of the abdominal aorta)

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12
Q

• Left Lateral aortic/lumbar lymph nodes

A

o Located to the left of the abdominal aorta

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13
Q

Lateral Aortic/Lumbar Lymph Nodes: Lymphatic Flow

A
  • 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
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14
Q

Lymph Nodes of the Pelvic Wall

A
  • Sacral Lymph Nodes
  • Internal Iliac Lymph Nodes
  • External Iliac Lymph Nodes
  • Common Iliac Lymph Nodes
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15
Q

Sacral Lymph Nodes

A

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

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16
Q

Internal Iliac Lymph Nodes

A

o Receive lymph from the pelvic viscera, perineum, and gluteal regions

o Efferent vessels drain into the common iliac lymph nodes

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17
Q

External Iliac Lymph Nodes

A

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

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18
Q

Common Iliac Lymph Nodes

A

o Receive from the external iliac, internal iliac and sacral lymph node groups

o Efferent vessels drain into the lateral aortic/lumbar lymph nodes

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19
Q

Lymphatics of the Liver

A
  • 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
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20
Q

Hepatic Lymph Nodes

A

o Located along the hepatic vessels and ducts

o Lymph will flow into the coeliac lymph nodes and to the intestinal trunk

21
Q

Phrenic Lymph Nodes

A

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

22
Q

Left Gastric Lymph Nodes

A

o Will flow into the coeliac lymph nodes

23
Q

Coeliac Lymph nodes

A

o Surrounds the coeliac trunk

24
Q

Right Gastric Lymph Nodes

A

o Flow into the pyloric lymph nodes and then the coeliac lymph nodes

25
Q

Pyloric Lymph Nodes

A

o Located along the pylorus of the stomach

26
Q

Gastroepiploic Lymph Nodes

A

o Located along the greater curvature of the stomach

27
Q

Pancreaticosplenic Lymph Nodes

A

o Located along the length of the splenic artery

28
Q

Lymphatics of the Anterior Duodenum

A

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

29
Q

Lymphatics of the Duodenum: Posterior

A

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

30
Q

Pancreaticosplenic lymph nodes

A

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

31
Q

Splenic Lymph Nodes

A

o Receive afferent splenic vessel drainage

o Drain into the Pancreaticosplenic lymph nodes to the coeliac lymph nodes

32
Q

Lymphatics of the Infracolic Organs

A

• All lymph drains to the superior or inferior mesenteric lymph nodes (pre-aortic lymph nodes)

33
Q

Jejunum and Ileum

A

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

34
Q

Mesenteric Lymph Nodes: 3 Groups

A
  • Parajejunal/paraileal lymph nodes
  • Arcade Lymph Nodes
  • Superior Mesenteric Lymph Nodes
35
Q

Parajejunal/paraileal lymph nodes

A

o Located close to the wall of the small intestine

o Efferent vessels drain to the arcade lymph nodes

36
Q

Arcade Lymph Nodes

A

o Located along the arterial branches

o Drain into the superior mesenteric trunk lymph nodes

37
Q

Superior Mesenteric Lymph Nodes

A

o Located along the superior mesenteric artery

o Drains into the coeliac lymph nodes and then to the intestinal trunk

38
Q

Lymphatics of the Large Intestine

A

• 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
39
Q

Drainage of the superior vagina

A

Internal or external iliac LNs

40
Q

Drainage of the middle vagina

A

Internal iliac LNs

41
Q

Drainage of inferior vagina

A

Sacral or common iliac LNs

42
Q

Drainage of external orifice of vagina

A

Superficial inguinal LNs

43
Q

Drainage of superior rectum

A

pararectal –> sacral –>inferior mesenteric

44
Q

Drainage of inferior rectum

A

Sacral LNs

45
Q

Drainage of rectal ampulla

A

Internal Iliac LNs

46
Q

Superior group of superficial inguinal LNs drainage

A

Receive lymph from inferior abdominal wall, gluteal region, external genitalia and perineal region

47
Q

Inferior group of superficial inguinal LNs drainage

A

Receive lymph from most of superficial regions of lower limb

48
Q

Position of deep inguinal LNs

A

medial to femoral vein

along the terminal end of femoral vein