Thorax 5 - Lymphatic drainage of the thorax

Question 1

Where does the upper right quadrant drain into? Where does the head, nec, upper limb, thorax drain?

Answer 1

Drains via seperate duct than rest of body.

Right subclavian vein

Question 2

Where does the rest of th ebody drain?

Answer 2

Thoracic duct - left subclavian vein

Question 3

Into which part do these lymph nodes drain into: (with the way)

• parasternal
• intercostal (upper and lower)
• Diaphragmatic
• Superficial

Answer 3

Parasternal – drain upwards (can remember by knowing that all drainage ends up in the neck), towards bronchomediastinal trunks
Intercostal (upper) drains into
-	Bronchomediastinal trunks
Intercostal (lower) drains into
-	Thoracic duct
Diaphragmattic
-	Brachiocephalic
-	Aortic/lumbar
Superficial
- axillary or parasternal

Question 4

Where does the thoracic duct begin? Where is it situated?

Answer 4

At the cisterna chyli (drains abdomen, pelvis, perineum and lower limbs)
Begins at L2 level
Between aorta and azygous veins

Question 5

When does the azygous vein cross over?

Answer 5

L5

Question 6

Describe the lymphatics of the heart

Answer 6

Follow the coronary arteries and drain into:
- Brachiocephalic lymph nodes (situated on brachiocephalic vein)
- Tracheobronchial
Same lymph nodes that drain the lungs because all going back to same place

Question 7

Describe the lymphatics of the lungs

Answer 7

Tracheobronchial lymph nodes
-	Around bronchi and trachea
-	From within lung through hilum
-	Unite with vessels from parasternal and brachiocephalic nodes anterior to brachiocephalic veins to form:
Bronchomediastinal (left and right)

Question 8

Describe the ymphatics of the posterior mediastinum

Answer 8

Nodes on aorta receive lymph from oesophagus, diaphragm, liver and pericardium and drain into to:
– thoracic duct
– Posterior mediastinal
esophageal cancer / hepatic cancer -> spread easily