lymphatic drainage lymphatic capillaries in the interstitial space, organized into lymphatic vessels and lymph nodes [located along the course of the blood vessels and are named accordingly. e.g. left gastric nodes, splenic nodes, paraaortic nodes, coeliac nodes etc.] All lymph of GIT drains into the cisterna chyli, thoracic duct, finally drains into the left subclavian vein.
lymphatic drainage of the oesophagus cervical oesophagus drains into deep cervical nodes thoracicoesophagus drains into posterior mediastinal nodes abdominal oesophagus drains into preaortic and coeliac nodes
lymphatic drainage of the stomach Area I superior 2/3 rd drains along Lt. and Rt. gastric vessels to aortic nodes Area II drains along Rt. gastroepiploic vessel to subpyloric nodes then into aortic nodes Area III drains along short gastric, splenic vessels, superior pancreatic nodes then into aortic nodes
Lt. gastric nodes cisterna chyli Rt. Gastric nodes III aortic nodes I splenic nodessuperior pancreatic nodes Subpyloric nodes II
lymphatic drainage of the small intestine drains into superior mesenteric nodes
lymphatic drainage of the large intestine drains into the central nodes located at the origin of the superior and inferior mesenteric arteries through epicolic, paracolic, intermediate nodes
epicolic nodesparacolic nodesintermediate nodescentral group of nodes
lymphatic drainage of the rectumdrain into pararectal nodes nodes along vessels supplying the rectum and then into para-aortic nodes at the origin of the IMAdrainage is mainly upwards upper half along superior rectal vessels to inferior mesenteric nodes lower half along middle rectal vessels to internal iliac nodes
lymphatic drainage of the anal canal upper canal drains into internal iliac nodes lower part drains into superficial inguinal nodes
clinical relevance Drainage area of particular group of lymph nodes Primary site of pathology Spread of infection Spread of malignant tumours (lymphatic spread) Stagingof disease ( TNM classification ) Treatment Prognosis
Lymphatic Drainage 50 tracheobronchial lymph nodes : Some of the largest lymph nodes in the body. Include: Paratracheal Superior tracheobronchial Inferior tracheobroncial Bronchopulmonary Pulmonary
Lymph Drainage of Thoracic Cavity Parasternal nodes: - Lie behind sternum along course of internal thoracic artery. - Receive lymph from thoracic wall, upper anterior abdominal wall, and diaphragm. - Also receive significant amount of lymph from mammary gland. -Drain into parasternal lymph channel.
Posterior intercostal nodes: -Lie in posterior intercostal space between heads of ribs. -Receive lymph from thoracic wall and paravertebral regions. -Drain into thoracic duct: From left and lower right. -Drain into right lymphatic duct: From upper right.
Diaphragmatic nodes: -Lie on upper surface of diaphragm. -Receive lymph from diaphragm, pericardium, upper surface of liver. -Drain to parasternal and posterior mediastinal nodes.
Posterior mediastinal nodes: Lie along esophagus and descending thoracic aorta. Brachiocephalic nodes: Lie along brachiocephalic veins.
Thoracic Duct -Begins in abdomen on right side of midline. -Receives most of lymph from body below diaphragm. -Drains left side of thoracic cavity and part of right. -Receives lymph from left internal jugular lymph CONTD trunk. …
-Receives lymph from left subclavian lymphtrunk.-Empties into venous system at junction of: Left internal jugular vein. Left subclavian vein.
Right Lymphatic Duct: -Drains upper right thoracic cavity, right upper extremity, and right side of head and neck. -Empties into venous system at junction of: Right internal jugular vein. Right subclavian vein.
Lymphatic Drainage ofLiver, Spleen & Gall Bladder
Liver Superficial and most deep lymph vessels converge at the porta and end in the hepatic lymph nodes (eg. Cystic LN near GB neck or LN of omental foramen) Hepatic LN’s drain into coeliac LN’s around the coeliac trunk, then thoracic duct Some deep lymph vessels follow hepatic veins to IVC foramen in diaphragm and end in middle phrenic LN’s