Systematic Anatomy Department of Anatomy,Histology & Embryology Shanghai Medical College,Fudan University Dr.Hongqi Zhang ( 张红旗 ) Email: Zhanghq58@126.com Office: Building 9,Room308, 54237151-9308 Mobile:13761809799 1
Circulatory system-part two Lymphatic system
General Introduction of the lymphatic system Organization lymphatic vessels,organs & tissues Lymph colorless or yellowish fluid, chyle-milky -from the small intestine Lymph formation: drainage excess interstitial fluid. entering the lymphatic vessel Drainage: one-way flow to the vein - heart. Lymphatic vessel: assistant vessels of the vein Function: response to immune,help to absorb fat & macromolecule; filter the lymph fluid & defence
The drainage of lymph
Lymphatic vessel is assistant one of vein in the circulatory system About 90% vein About 10% lymph
lymphatic vessels Four grades: Lymphatic capillary similar with capillary,but With more permeability (no base membrane & pericyte, thin endothelium, wide intercellular spaces) Lymphatic vessel similar with vein,with valve, sup. and deep group.beaded lymph node Lymphatic trunk nine,four-paried one-unparied one Lymphatic duct thoracic duct and right lymph duct.
Lymphatic trunks and lymphatic ducts Lymphatic trunk nine, Four-paried Left & right lumbar trunks Left & right bronchomediastinal trunks Left & right subclavian trunks Left & right cervical trunks one-unpaired one Intestinal trunk Lymphatic duct -two Thoracic duct right lymph duct
Lymphatic trunk and duct
Lymphatic trunk and lymphatic duct
The formation & drainage of the lymphatic fluid vessel
Factors related to lymph drainage Quantity:120ml/h,1/10 of interstitial fluid Smooth muscle contraction of vessel wall Valve of lymphatic vessel Arterial pulsation Contraction of neighbouring skeleton muscle Negative pressure of thoracic cavity If the lymph drainage is not good,result in swelling
Lymphatic tissue Diffuse lymphoid tissue situated in mucosa of digestive & respiratory tract Lymphatic nodule in proper layer of small intestine musoca.there are solitary & aggregated follicles Solitary lymphatic follicles Aggregated follicles
Lymphatic organs Lymph node Thymus Spleen Tonsil
Lymph node Number & size hundreds;1~20mm in diameter Distribution: by groups,around the blood vessel,run in shelter & flexed side,close to hilum, juncture between the trunk and limbs Location beaded lymph node in the lymphatic vessel Name location,sup & deep,neighbouring organ Regional (sentinel lymph node) The lymph nodes draining the given region or organ are called the regional lymph node Clinic importance Enlargement of nodes is significant in diagnosis of disease of the region or organ or metastasis
Lymph node Artery Nerve Vein Afferent vessels Efferent vessels
Lymph node
Lymphatic organ -Thymus Location the back of manubrium of sternum anterior part of superior mediastinum Lobes dissymmetric two lobes Age changes developed in newborn & child, degeneration and atrophy with age Function Endocrine Thymulin Thymocrescin
Lymphatic organ - Spleen Feature reddish or purple,weight 150g Position: deep to the left 9-11 th rib Appearance two extremeties, two surfaces, two borders Function: storage blood,haemagenesis,disposing effete red cell & platelet &immunologic response Clinical importance hypersplenism, lienectomy 9 th rib Splenic notch A & v hilum
The position of the important lymph nodes & lymph drainage all over the body
Lymphatic vessel & lymph nodes of head & neck Location: juncture of head & neck,around the vein & around digestive & respiratory tract Head: Submental lymph nodes Submandibular lymph nodes Parotid lymph nodes Mastoid lymph nodes Occipital lymph nodes
Neck: Sup.lateral cervical Ln. Deep lateral cervical Ln. (supraclavicular Ln.) cancer metastasis Clinic significance: while infection,enlargement of related lymph node, TB of cervical Ln. Superficial lymph nodes drainage to deep lymph node. At last drainage to subclavian trunk
Main lymphatic vessel & LN of upper limb Position:LCT of axillary fossa & around axillary vessels supratrochlear Ln. LN of Axillary fossa (five) Pectoral lymph nodes-lateral pectoral blood vessels Lateral lymph nodes- distal segment of axillary v. Subscapular lymph nodes-subscapular blood vessel Central lymph nodes-central of axillary fossa Apical lymph nodes-proximal segment of axillary v. Supratrachlear Ln. 1-3 Clinic infection of upper limb, breast carcinoma
Lymph node of the upper limb Axillary lymph node Supratrochlear lymph node
Lymph nodes of the axillary fossa and parasternal
Lymphatic vessel & lymph node of the thorax Position:in chest wall & around viscera of thoracic cavity chest wall lymph nodes: parasternal lymph node around the internal sternal blood vessel Visceral lymph nodes Pulmonary lymph nodes Bronchopulmonary lymph nodes-hilum Tracheobronchial lymph nodes-around the bifurcation Paratrecheal lymph node-both side of trachea Clinic: metastasis of lung cancer
Bronchopulmonary hilar lymph nodes 1 2 3 Green indicate mesenteric lymph node 1. pulmonary Ln. 2. bronchopulmonary Ln. tracheobronchial Ln. Copy Right- Hongqi 3. Paratrecheal ZHANG-Department Ln. of Anatomy-Fudan University
Parasternal lymph nodes celiac lymph nodes
Lymph node of abdominal vesera-correspond with related blood vessel Green indicate mesenteric lymph node Mesenteric lymph node
Lymphatic vessel & lymph node of the lower limb Position:superficial lymph node-sup.blood vessel.deep lymph node-deep.blood vessel Popliteal fossa: popliteal lymph node-lesser saphenous vein & around popliteal blood vessel superficial inguinal lymph nodes -two groups Superior group:in the below of inguinal lig. Receive the lymph from abdominal anterior wall (below the umblicus),buttocks perineum & uterine,
Lymphatic vessel & lymph node of the lower limb Inferior group Lie on the terminal of greater saphenous vein.receive the lymph from that exception of lateral border of foot & the posterior part of leg. Deep inguinal lymph nodes Situated in around the femoral vein. The clinic significance Enlargement after the infection of the lower limb, pelvis and perineum.
Inguinal superficial lymph nodes
Superficial lymph vessel of the lower limb Elephantiasis Filariasislymphedema
Lymphangiography of the abdomen & the lower limb External iliac lymphatic vessel Inguinal sup. lymphatic vessel Popliteal lymph node & lymphatic vessel
The end! Good Bye!