Anatomy of lymphatic system presented professionally, useful for undergraduate medical students as well as surgeons and physicians

1. Lymphatic System
By
Dr.Faris Muhammed
PhD Anatomy
MSc. General Surgery
2022

3. Venous Capillary
End: Drains 17 L /day
of circulatory blood
to the heart
Arterial Capillary End:
Brings 20 L/day of circulatory
blood to the tissues
Lymphatic Capillaries :
Drain the remaining 3L of
Interstitial Plasma back to
venous circulation

6. Plan Of Lymphatic Drainage
Superficial Lymphatic's (accompany superficial veins)
Superficial L.N.s
Communicating Lymphatic's
Deep L.N.s
Deep Lymphatic's (accompany arteries)
Lymph Trunks
Either:
1. Rt Lymphatic Duct
2. Thoracic Duct
Venous
Circulation

8. Head & Neck Lymphatics

9. Plan of Head & Neck Lymphatic Drainage
A. The components of this system include:
1. superficial nodes around the head along the
external jugular vein
2. deep cervical nodes forming a chain along the
internal jugular vein
B. The basic pattern of drainage is that:
1. superficial lymphatic vessels to drain to the
superficial nodes
2. Some of these drain to the superficial cervical nodes
on their way to the deep cervical nodes
3. others drain directly to the deep cervical nodes.

10. Superficial lymph nodes (SLN)
• groups of superficial lymph nodes form a ring around the head and are
primarily responsible for the lymphatic drainage of the face and scalp.
• Their pattern of drainage is around the area of distribution of the arteries
• Include the followings:
1. occipital nodes,
2. mastoid nodes,
3. parotid nodes,
4. submandibular nodes
5. submental nodes
5

11. Lymphatic drainage from SLNs have
several directions:
1. From:
1. From:
superficial cervical LNs
(along the Ex.J.V)
Occipital LNs
Mastoid LNs
Pre-auricular LNs
Parotid LNs,
Submandibular LNs
Submental LNs
Deep Cervical LNs
(along I.J.V)

12. Submental

13. 1. Occipital LNs:
near the attachment of the
Trapezius muscle to the skull
and associated with the
occipital artery, lymphatic
drainage is from the
posterior scalp and neck

14. 2. Mastoid LNs (retro-auricular
/posterior auricular LNs):
posterior to the ear near the
attachment of Sternocleido-
mastoid muscle and associated
with the posterior auricular aa. ,
lymphatic drainage is from the
posterolateral half of the scalp

15. 3. Pre-auricular and parotid LNs. :
anterior to the ear and associated with
the superficial temporal and transverse
facial arteries lymphatic drainage is from
the anterior surface of:
the auricle,
the anterolateral scalp,
the upper half of the face,
the eyelids, and
the cheeks;

16. 4. Submandibular nodes:
inferior to the body of the
mandible and associated with
the facial artery— lymphatic
drainage is from structures
along the path of the facial
artery as high as the forehead,
as well as the gingivae, the
teeth, and the tongue;

17. 5. Submental nodes:
inferior and posterior to
the chin— lymphatic
drainage is from the
center part of the lower
lip, the chin, the floor of
the mouth, the tip of the
tongue, and the lower
incisor teeth.

18. Superficial cervical lymph nodes
are a collection of lymph nodes along
the E. J.V on the superficial surface of
the sternocleidomastoid muscle. They
primarily receive lymphatic drainage
from the posterior and posterolateral
regions of the scalp through the
occipital and mastoid nodes, and send
lymphatic vessels in the direction of
the deep cervical nodes.

19. Deep cervical lymph nodes (DLNs)
• are a collection of lymph nodes
that form a chain along the IJV.
• They are divided into upper &
lower groups where the
intermediate tendon of the
omohyoid muscle crosses the
common carotid artery and the
internal jugular vein.

20. • The most superior node in the
upper deep cervical group
is the jugulodigastric node.
This large node is where the
posterior belly of the digastric
muscle crosses the I.J.V and
receives lymphatic drainage from
the tonsils and tonsillar region.
1. Jugulodigastric LN

21. associated with the lower deep
cervical group because it is at or
just inferior to the intermediate
tendon of the omohyoid muscle,
is the jugulo-omohyoid node .
This node receives lymphatic
drainage from the tongue.
2. Jugulo-omohyoid LN

22. • The DLNs eventually all lymph-atic
drainage from the head and neck either directly
or through regional groups of nodes.
• From the deep cervical nodes, lymphatic vessels
form the right and left jugular trunks, which
empty into the right lymphatic duct on the right
side or the thoracic duct on the left side.
Receive

23. Superior deep cervical
Inferior deep cervical
Prelaryngeal
Paratracheal
pretracheal
C
Lymph nodes, lymphatic
trunks and thoracic ducts

25. Planes of
Cervical LNs

26. Face & scalp
lymphatics
Occipital
Mastoid
Parotid
Buccal
Submandibular
Submental
Superficial cervical
Deep cervical
* Retropharyngeal
Lymph node groups

27. To Submental lymph nodes

29. Lymphatic Drainage of Palate

30. Lymphatic Drainage of Gingiva

32. Jugulodigastric LNs
Jugulo-Omohyoid LNs
Retropharyngeal LNs

33. lymphatics of thyroid,
larynx and trachea

34. Pathway of
Lymphatics :
pharynx & tonsils
( waldeyer ring )

35. To Submental lymph nodes

36. Pathway of
Lymphatics :
pharynx & tonsils
( waldeyer ring )

37. Robbins Classification:
Neck regions (levels)
that are used clinically
to evaluate LNs

38. a
b

39. lymphatics of thyoid,
larynx and trachea

40. Axillary LNs
• All lymphatics from the upper limb, shoulder 75% of
the mammary gland drain into LNs in the axilla
• In addition, axillary LNs receive drainage from an
extensive area on the adjacent trunk, which includes
regions of the upper back, the lower neck, the chest,
and the upper anterolateral abdominal wall.

41. Axillary nodes also receive drainage from
approximately The 20–30 axillary nodes are generally
divided into five groups on the basis of location:
1. Humeral (lateral) nodes
2. Pectoral (anterior) nodes
3. Subscapular (posterior) nodes
4. Central nodes
5. Apical nodes

42. posteromedial to the
axillary vein receive most
of the lymphatic drainage
from upper limb
Humeral (lateral) nodes

43. Pectoral (anterior) nodes
• occur along the inferior margin
of the pectoralis minor muscle
along the course of the lateral
thoracic vessels and receive
drainage from the abdominal
wall, the chest, and the
mammary gland.

44. Subscapular (posterior) nodes
on the posterior axillary wall in
association with the subscapular
vessels drain the posterior
axillary wall and receive
lymphatics from the back, the
shoulder, and the neck.

45. Central nodes
are embedded in axillary fat and
receive tributaries from
humeral, subscapular, and
pectoral groups of nodes.

46. Apical nodes
are the most superior group of nodes
in the axilla, at the lateral border
of 1st rib and drain all other groups
of nodes in the region. In addition,
they receive lymphatic vessels that
accompany the cephalic vein as well
as vessels that drain the superior
region of the mammary gland.

47. • Efferent vessels from the apical group
converge to form the subclavian trunk
(Rt. Lymphatic duct), which usually joins the
venous system at the junction between the
right subclavian vein and the right internal
jugular vein in the neck. On the left, the
subclavian trunk usually joins the thoracic
duct in the base of the neck.

49. Lymphatic drainage of the breast

54. Infraclavicular
group LNs
Supratroclear LNs
Lateral axillary
group LNs

55. Cisterna Chyli

56. Thoracic Lymphatics

58. Chest Wall Lymphatics

61. Mediastinal Lymphatics

62. Esophageal Lymphatic Drainage
1. Cervical esophagus
deep cervcal LNs
2. Thoracic esophagus
posterior mediastinal LNs
3. Abdominal esophagus
preaortic & coeliac LNs
1
2
3

65. Tracheobronchial LNs
A single lymphatic vessel ascend
Between PA and LA
Lymphatic vessels
in coronary grooves
Subendocardial lymphatic plexus
Lymphatics Of The Heart

70. Lower Limb Lymphatics

73. Lymphatic Drainage Of
Abdominopelvis

86. Spleen/Pancreatic Lymphatic Drainage

89. Kidney/Ureter Lymphatic Drainage

93. Lymphatic
Drainage
Of The
Uterus

94. Lumbar(caval/Aortic)
Inferior Mesenteric
Common Illiac
Internal Iliac
External Iliac
Superficial Inguinal
Deep Inguinal
Sacral
Pararectal

95. Lumbar(caval/Aortic)
Inferior Mesenteric
Common Illiac
Internal Iliac
External Iliac
Superficial Inguinal
Deep Inguinal
Sacral
Pararectal