Upper Limb Lymphatics Flashcards
What is the function of the lymphatic system?
Drain tissue fluid, plasma proteins, and other cellular debris back into the blood stream. Also involved in immune defence.
Where do the superficial lymphatic vessels of the upper body arise from?
Lymphatic plexuses in the skin of the hand.
What are the lymphatic vessels of the upper body close to as they ascend up the arm?
They are in close proximity to the major superficial veins.
What happens to the lymphatic vessels shadowing the basilic vein?
Enter the cubital lymph nodes - medial to vein, and proximal to the medial epicondyle of the humerus. Then continue up the arm and terminate in the lateral axillary lymph nodes.
What happens to the lymphatic vessels shadowing the cephalic vein?
They mostly cross the proximal part of the arm and shoulder to enter the apical axillary lymph nodes, but some exception instead enter the more superficial deltopectoral lymph nodes.
Where do deep lymphatic vessels terminate?
They follow major deep veins to terminate in the humeral axillary lymph nodes.
What is the function of deep lymphatic vessels?
Drain lymph from joint capsules, periosteum, tendons and muscles.
What are the five anatomical groups of upper lymph nodes?
Pectoral (anterior) - 3-5 nodes, in medial wall of axilla. Receive lymph from anterior thoracic wall.
Subscapular (posterior) - 6-7 nodes, posterior axillary fold and subscapular blood vessels. Receive lymph from posterior thoracic wall and scapular region.
Humeral (lateral) - 4-6 nodes, in the lateral wall of the axilla, posterior to the axillary vein. Receive lymph from upper limb.
Central - 3-4 large nodes, near base of axilla. Receive lymph via efferent vessels from the pectoral, subscapular, and humeral axillary lymph node groups.
Apical - at apex of axilla, close to axillary vein and 1st part of axillary artery. Receive lymph from efferent vessels of the central axillary lymph nodes and from lymphatic vessels accompanying cephalic vein.
What do efferent lymphatic vessels from the apical axillary nodes converge to form?
The subclavian lymphatic trunk after travelling through the cervico-axillary canal.
What happens to the right subclavian lymphatic trunk?
Forms the right lymphatic duct, and enters the right venous angle.
What happens to the left subclavian lymphatic trunk?
It drains into the thoracic duct.
What are some possible causes of enlargement of axillary lymph nodes?
Infection of the upper limb, causes lymphangitis - inflammation of the lymphatic vessels, with tender, enlarged lymph nodes. Humeral group of lymph nodes affected first.
Infections of the pectoral region and breast.
Metastasis of breast cancers.
What is axillary lymph node dissection used for?
Removed and analysed for breast cancer staging.
What are some complications of axillary lymph node dissection?
Lymphoedema - where the accumulated lymph in the subcutaneous tissue leads to painful swelling of the upper limb.
Damage to long thoracic nerve, or thoracodorsal nerve.
