Lymphatic system and lymphatic drainage of upper limbs

Statistics & Basic Terminologies:-
Fluid Nature Quantity w.r.t. Each other.
Total Body Water ( TBW ) 60 % of Total Body weight
Intracellular Fluid ( ICF ) 2/3 (66.67%) of TBW
Extracellular Fluid ( ECF ) 1/3 (33.33 %) of TBW
Interstitial Fluid ( ISF ) Thursday, May 16,
2019Thursday, May 16,
20191:47:12 PM1
May 16, 2019 Thursday O1:48:07 AM
PMAS-UAAR,,,,,(IFNS)
1

Term Definition
Lymph Fluid that flows through the lymphatic system.
Lymph Node Small bean shaped structure that filters substances traveling
through the Lymphatic fluid .
Lymphatic Drainage Removal of Lymph.
Interstitial Fluid Lymph
1. Interstitial fluid is the
fluid between cells, not
contained in any vessels.
2. Interstitial fluid and
lymph are similar at first.
1. Lymph is contained within
lymphatic vessels.
2. But the lymph changes
composition later along its course,
especially as it passes through
lymph.
i.e. some things are removed from the
lymph and a lot of lymphocytes are
added to it.
May 16, 2019 Thrusday
O1:48:07 AM
PMAS-UAAR,,,,,(IFNS) 2

Lymphatic System:-
The lymphatic system is part of the Immune System.
The lymphatic or lymph system involves an extensive
network of vessels that passes through almost all
our tissues to allow for the movement of a fluid
called lymph. Lymph circulates through the body in a
similar way to blood.May 16, 2019 Thrusday
O1:48:07 AM

Lymphatic Drainage of Upper Limb:-
 The lymphatic drainage of the upper limb
follows the unnamed lymph vessels, which
starts in the hand and run upwards in the
direction of the axilla.
When they reach cubital fossa, the lymph goes
through cubital nodes.
From here, lymph vessels run superiorly to
drain into the axillary lymph nodes.
O1:48:07 AM

Lymph Vessel:-
• The lymph vessels draining the lymph
from the upper limb in the body, are split
into 2 groups:
1.Superficial
2.Deep
O1:48:07 AM

SUPERFICIAL LYMPH VESSELS:-
 The superficial lymph vessels are in the subcutaneous tissue,
accompany the superficial veins.
 They course upwards in the direction of the axilla. Most of
them end in the axillary lymph nodes.
 Those from lateral side of the limb and lateral 2 digits follow
the cephalic vein and drain into the infraclavicular lymph
nodes.
 Those from medial side of the limb and medial 3 digits follow
the basilic vein and drain into the lateral group of axillary
nodes.
 A number of the medial lymph vessels terminate in the supratrochlear
or epitrochlear nodes, that are situated just above the medial
epicondyle along the basilic vein.
 A couple of lymph vessels drain the thumb end in the deltopectoral
lymph nodes.
 The efferents from these nodes pierce the clavipectoral fascia
to drain in the apical group of axillary nodes.May 16, 2019 Thrusday
O1:48:07 AM

• Key Points to note:
• Just about all the superficial lymph
vessels of the upper limb drain into
lateral group of axillary nodes.
• Lymph from palm is drained into the
lymph plexus on the dorsum of the hand.
O1:48:07 AM

DEEP LYMPH VESSELS:-
• The deep lymph vessels are much less
numerous in relation to the superficial lymph
vessels.
• They drain structures being located deep to
deep fascia, i.e. muscles.
• The deep lymph vessels course along the
arteries and drain into the lateral group of the
axillary lymph nodes.
O1:48:07 AM

LYMPH NODES:-
• The lymph nodes draining the upper limb are split into
2 groups:
– (a) Superficial
– (b) Deep.
1. SUPERFICIAL LYMPH VESSELS:-
 The superficial lymph vessels are in the
subcutaneous tissue, accompany the superficial
veins.
 They course upwards in the direction of the axilla.
Most of them end in the axillary lymph nodes.
O1:48:07 AM

• Those from lateral side of the limb and lateral 2
digits follow the cephalic vein and drain into the
infraclavicular lymph nodes.
• Those from medial side of the limb and medial 3
digits follow the basilic vein and drain into the
lateral group of axillary nodes.
– A number of the medial lymph vessels terminate in the
supratrochlear or epitrochlear nodes, that are situated
just above the medial epicondyle along the basilic vein.
– A couple of lymph vessels drain the thumb end in the
deltopectoral lymph nodes.
• The efferents from these nodes pierce the
clavipectoral fascia to drain in the apical group of
axillary nodes.
O1:48:07 AM

2-DEEP LYMPH VESSELS:-
• The deep lymph vessels are much less
numerous in relation to the superficial lymph
vessels.
• They drain structures being located deep to
deep fascia, i.e. muscles.
• The deep lymph vessels course along the
arteries and drain into the lateral group of
the axillary lymph nodes.
O1:48:07 AM

LYMPH NODES:-
• The majority of the upper lymph nodes are
located in the axilla. They can be divided
anatomically into 5 groups:
1. Pectoral (anterior)
2. Subscapular (posterior)
3. Humeral (lateral)
4. Central
5. Apical
O1:48:07 AM

O1:48:07 AM

Axillary lymph nodes:-
1. Pectoral (anterior) – 3-5 nodes, located in the medial
wall of the axilla. They receive lymph primarily from
the anterior thoracic wall, including most of the
breast.
2. Subscapular (posterior) – 6-7 nodes, located along
the posterior axillary fold and subscapular blood
vessels. They receive lymph from the posterior
thoracic wall and scapular region.
3. Humeral (lateral) – 4-6 nodes, located in the lateral
wall of the axilla, posterior to the axillary vein. They
receive the majority of lymph drained from the upper
limb.
O1:48:07 AM

5. Central – 3-4 large nodes, located near the base
of the axilla (deep to pectoralis minor, close to the
2nd part of the axillary artery). They receive lymph
via efferent vessels from the pectoral, subscapular
and humeral axillary lymph node groups.
6. Apical – Located in the apex of the axilla, close to
the axillary vein and 1st part of the axillary artery.
They receive lymph from efferent vessels of the
central axillary lymph nodes, therefore from all
axillary lymph node groups. The apical axillary nodes
also receive lymph from those lymphatic vessels
accompanying the cephalic vein.
O1:48:07 AM

Axillary lymph nodes:-
• Efferent vessels from the apical axillary nodes
travel through the cervico-axillary canal, before
converging to form the subclavian lymphatic
trunk.
• The right subclavian trunk continues to form the
right lymphatic duct, and enters the right venous
angle (junction of internal jugular and subclavian
veins) directly.
• The left subclavian trunk drains directly into the
thoracic duct.
O1:48:07 AM

O1:48:07 AM

-Relevance:Clinical
• Enlargement of Axillary Lymph Nodes.
• Enlargement of these lymph nodes can have a
number of either infectious or malignant causes:
• Infection of the upper limb, resulting in
lymphangitis (inflammation of lymphatic vessels,
with tender, enlarged lymph nodes). The humeral
group of lymph nodes is usually affected first, and
red, warm and tender streaks are visible in the
skin of the upper limb.
• Infections of the pectoral region and breast.
• Metastasis of breast cancers.
O1:48:07 AM

Axillary Lymph Node Dissection:-
• Removal and analysis of the axillary lymph nodes
is often a vital tool for the staging of breast
cancers. Interruption of lymphatic drainage from
the upper limb can however result in
lymphoedema, a condition whereby
accumulated lymph in the subcutaneous tissue
leads to painful swelling of the upper limb.
• During this procedure there is also a risk of
damage to either of the long thoracic nerve
(potentially causing a winged scapula deformity),
or the thoracodorsal nerve.
O1:48:07 AM

Thank you for endure.
Group No. 10
S. No. Group Members Registration No.
1. Saqib Rasheed (Group Coordinator) 18-Arid-6152.
2. Hafiz Naveed Sattar 18-Arid-6116.
3. Muhammad Mahrban 18-Arid-6131.
4. Muhammad Naeem 18-Arid-6133.
5. Usama Abdul Khaliq 18-Arid-6166.
O1:48:07 AM

Lymphatic system and lymphatic drainage of upper limbs

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to Lymphatic system and lymphatic drainage of upper limbs

Similar to Lymphatic system and lymphatic drainage of upper limbs (20)

Recently uploaded

Recently uploaded (20)

Lymphatic system and lymphatic drainage of upper limbs