Midterm I: Lymph (Ben)

Question 1

What 3 main lymph vessels branch off of the thoracic and right lymphatic ducts near their junction with the angulus venosus?

Answer 1

Right and left…

1. Jugular Trunks
2. Subclavian Trunks
3. Bronchomediastinal Trunks

Question 2

What two main lymph vessels branch off the cisterna chyli inferiorly?

Answer 2

Lumbar Trunks

Question 3

At what level is the cisterna chyli?

Answer 3

L1

Question 4

To where does the upper lateral quadrant lymph of the breast drain?

What is the significance of this?

Answer 4

First to Sorgius Node, a “sentinal node” of the breast

Then to Axillary Nodes

• Palpating Sorgius node can be a good way to diagnose breast cancers.

Question 5

Where exactly can Sorgius’ Node be found?

Answer 5

At the bottom of pec major around the 3rd digitation of serratus anterior

Question 6

Most breast tumors are in what quadrant of the breast?

What percent?

Answer 6

95% are in the upper lateral quadrant

Question 7

To where does lower lateral quadrant of the breast lymph drain?

Answer 7

Pectoral Nodes…

then to axillary nodes

Question 8

What network of lymph vessels is found in the center of the breast?

Answer 8

Areolar Plexus

Question 9

To where does medial quadrant breast lymph drain?

Answer 9

Both medial quadrants drain to…

Parasternal Nodes…

then to Supraclavicular Nodes

Question 10

What parts of the body do the thoracic duct and right lymphatic duct drain?

Answer 10

Thoracic = Whole left side plus right leg and right lower abdomen

R Lymphatic Duct = Right side above lower abdomen

Question 11

Describe the lymph drainage of the lung…

4 sets of nodes, plus where the 4th set drains to

Answer 11

1. Intrapulmonary nodes, throughout lung, to…
2. Bronchopulmonary nodes, in the hilum of each lung, to…
3. Tracheobroncheal nodes, in angles btwn trachea + bronchi and btwn the 2 primary bronchi, to…
4. Paratracheal nodes, along the length of the trachea, to…

… finally the Bronchomediastinal Trunk

Question 12

Generally, what course does abdominal lymph take to get to the thoracic duct?

Answer 12

Nodes in the wall of or around abdominal organs drain to nodes which follow unpaired aorta branches.

(Celiac, Sup. Mes., Inf. Mes.)

Question 13

Where does intraperitoneal organs’ lymph drain to generally?

Answer 13

Celiac Node –> Cisterna Chyli

Question 14

Where do the inferior mesenteric nodes drain to?

Answer 14

Lumbar Trunk

Question 15

Where does lymph from intraperitoneal organs draining to the superior mesenteric nodes then go to?

And retroperitoneal?

Answer 15

Intra: Sup Mes. nodes –> Celiac nodes –> C. Chyli

Retro: Sup. Mes nodes –> lumbar trunk

Question 16

What are the 4 groups of nodes draining the stomach?

And their general locations.

Answer 16

1. Left Gastric Nodes - around cardia + fundus
2. Pancreatico-lienal Nodes - right side btwn stomach + spleen + running along pancreas
3. Right Gastric Nodes - greater curvature
4. Pyloric Nodes - around antrum + sphincter

Question 17

Where do all the gastric nodes drain?

One set drains to two places.

Which set and to where?

Answer 17

All drain to cisterna chyli, but…

Left Gastric Nodes can also drain to vessels which travel through the esophageal hiatus to the posterior mediastinum and eventually to the left supraclavicular node of Virchow

Question 18

What is the importance of the left supraclavicular node clinically?

And the name associated with it?

Answer 18

Swelling of …Virchow’s L. supraclavicular node…

can be indicative of stomach or medial left breast tumors.