Medical Gross Anatomy
Anatomy Tables - Lymphatics
|
|
|
|
Medical Gross Anatomy |
|
|
Lymphatics of the Thorax - Listed Alphabetically |
|||||
|---|---|---|---|---|---|
| Structure | Location | Afferents from | Efferents to | Regions drained | Notes |
| anterior mediastinal nodes | along the course of the brachiocephalic vessels and aorta | lymphatic vessels from the anterior mediastinum and middle mediastinum | bronchomediastinal trunk | thymus, anterior respiratory diaphragm, pericardium, part of the heart | anterior mediastinal nodes are from 2 to 5 in number |
| axillary nodes | axilla | cubital nodes; lymphatic vessels from the upper limb, thoracic wall and subscapular region | efferents vessels form the subclavian trunk, some drainage to inferior deep cervical nodes | upper limb, most of the mammary gland, some of the anterolateral chest wall, posterior thoracic wall and scapular region | axillary nodes number from 20 to 30 and are organized in five groups based on their position within the axilla: 1) pectoral nodes, along the lateral border of the pectoralis major m.; 2) lateral nodes, located along the distal axillary v.; 3) central nodes, centrally located along axillary v.; 4) subscapular nodes, located along the subscapular v. and its tributaries; 5) apical nodes, located at the apex of axilla |
| axillary nodes, apical | apex of the axilla | lateral axillary nodes; central axillary nodes; subscapular axillary nodes; pectoral nodes; accessory lymphatic vessels from the mammary gland; lymphatic vessels accompanying the cephalic v. | subclavian lymphatic trunk; deep cervical lymph nodes | upper limb, most of the mammary gland, some of the anterolateral chest wall, posterior thoracic wall and scapular region | apical axillary nodes are 6- 12 in number; this is the highest node group in the axilla and all other node groups drain through these nodes; a very important group of nodes in cases of metastatic spread of breast cancer; connections to deep cervical nodes may result in spread of breast cancer through the deep neck |
| axillary nodes, central | in the fat of the axilla | lateral axillary nodes; pectoral nodes; subscapular nodes; lymphatic vessels from the mammary gland and upper limb | apical axillary nodes | upper limb, most of the mammary gland, some of the anterolateral chest wall, posterior thoracic wall and scapular region | central axillary nodes are 4 or 5 in number; they are involved in cancer of the mammary gland |
| axillary nodes, lateral | along the distal axillary v. | cubital nodes; lymphatic vessels of the arm | central axillary nodes, apical axillary nodes | upper limb | lateral axillary nodes become inflamed during upper limb infections; also known as: brachial nodes |
| axillary nodes, subscapular | along the course of the subscapular vessels | lymphatic vessels from the skin of the back and back of the neck; lymphatic vessels from the muscles of the scapular region | central axillary nodes | skin of the back and back of the neck; muscles of the scapular and subscapular regions | subscapular axillary nodes are 5 or 6 in number; also known as: posterior axillary nodes |
| bronchomediastinal trunk | along the course of the brachiocephalic v. | union of efferents from the paratracheal nodes, parasternal nodes and anterior mediastinal nodes | left: thoracic duct; right: right lymphatic duct | thoracic wall and viscera; medial part of the mammary gland | right bronchomediastinal trunk receives lymph from the lower lobe of the left lung; bronchomediastinal trunk may drain directly into the venous system on either side |
| bronchopulmonary nodes | hilum of the lung | pulmonary nodes | tracheobronchial nodes | lung | bronchopulmonary nodes are also known as: hilar nodes |
| cisterna chyli | between the abdominal aorta and the inferior vena cava anterior to the body of the L1 or L2 vertebra | right and & left lumbar trunks; possibly the intestinal trunk | thoracic duct | all of the body below the respiratory diaphragm; all of the abdominal and pelvic viscera | cisterna chyli is an enlargement of the lower end of the thoracic duct; it occurs in about 25% of individuals |
| hilar nodes | at hilum of lung | pulmonary nodes | tracheobronchial nodes | lung | also known as: bronchopulmonary nodes |
| infraclavicular nodes | along the cephalic v. in the deltopectoral groove | lymphatic vessels from the superficial upper limb | apical axillary nodes | skin and superficial fascia of the upper limb | infraclavicular nodes may become inflamed during infections of the superficial tissues of the upper limb |
| intercostal nodes | near the heads of the ribs | lymphatic vessels from the intercostal space | cisterna chyli/thoracic duct, jugulosubclavian duct | intercostal space and posterolateral thoracic wall | usually two nodes occur in each intercostal space |
| mediastinal nodes, anterior | along the course of the brachiocephalic vessels and aorta | lymphatic vessels from the anterior mediastinum and middle mediastinum | bronchomediastinal trunk | thymus, anterior respiratory diaphragm, pericardium, part of the heart | anterior mediastinal nodes are from 2 to 5 in number |
| mediastinal nodes, posterior | along azygos system of veins and esophagus | viscera of the posterior mediastinum and chest wall | thoracic duct, inferior tracheobronchial nodes, superior tracheobronchial nodes | posterior mediastinum, posterior aspect of the heart and pericardium, posterior part of the respiratory diaphragm | posterior mediastinal nodes drain primarily to the thoracic duct |
| parasternal nodes | lateral border of sternum, along the course of the internal thoracic vessels | anterior phrenic nodes, lymphatic vessels from the anterior thoracic wall | larger lymphatic vessels in the root of the neck | medial side of the mammary gland; medial part of the anterior chest wall and muscles | parasternal nodes constitute an important drainage pattern in cases of cancer of the mammary gland; one or two parasternal nodes may be found in the anterior end of intercostal spaces 1-6; also known as: sternal nodes |
| paratracheal nodes | coursing along the lateral surface of the trachea and esophagus | superior tracheobronchial nodes | bronchomediastinal trunk | lungs, trachea, upper esophagus, the part of the larynx below the vocal folds | paratracheal nodes are an important group of nodes in cases of pulmonary infection or lung cancer; also known as: tracheal nodes |
| pectoral nodes | along the lateral border of the pectoralis major m. along the course of the lateral thoracic vessels | lymphatic vessels from the mammary gland and anterolateral thoracic wall | central axillary nodes | anterolateral thoracic wall and muscles; most of the mammary gland | an important group of nodes to examine during a breast physical exam; also known as: anterior axillary nodes |
| phrenic nodes | on the thoracic surface of the respiratory diaphragm | lymphatic vessels from the diaphragm, liver and thoracic wall | lumbar nodes, posterior mediastinal nodes | superior surface of the liver, respiratory diaphragm | phrenic nodes drain two structures that are very closely related in developmental origin - the liver and diaphragm (septum transversum); three subgroups of phrenic nodes are recognized: anterior, middle and posterior |
| posterior mediastinal nodes | along azygos system of veins and esophagus | viscera of the posterior mediastinum and chest wall | thoracic duct, inferior tracheobronchial nodes, superior tracheobronchial nodes | posterior mediastinum, posterior aspect of the heart and pericardium, posterior part of the respiratory diaphragm | posterior mediastinal nodes drain primarily to the thoracic duct |
| pulmonary nodes | within the lung parenchyma | lymphatic vessels from the parenchyma of the lung | bronchopulmonary (hilar) nodes | lung parenchyma, bronchial tree within the lungs | pulmonary nodes are located along the larger bronchi of the lung |
| sternal nodes | lateral border of sternum, along the course of the internal thoracic vessels | anterior phrenic nodes, lymphatic vessels from the anterior thoracic wall | larger lymphatic vessels in the root of the neck | medial side of the mammary gland; medial part of the anterior chest wall and muscles | sternal nodes constitute an important drainage pattern in cases of cancer of the mammary gland; one or two sternal nodes may be found in the anterior end of intercostal spaces 1-6; also known as: parasternal nodes |
| subclavian trunk | along the course of the subclavian v. | apical axillary nodes; infraclavicular nodes | drains into the junction of the internal jugular v. and the subclavian v. | upper limb, most of breast, anterolateral chest wall | subclavian lymphatic trunk occasionally drains into the thoracic duct on the left side; on the right it occasionally drains into the right lymphatic duct |
| supraclavicular nodes | in and around carotid sheath below level of omohyoid | superior deep cervical nodes, transverse cervical nodes, spinal accessory nodes | efferents form the jugular lymphatic trunk | head and neck | also known as: inferior deep cervical nodes |
| thoracic duct | between the esophagus anteriorly and the thoracic vertebral bodies posteriorly | formed by the union of the lumbar lymph trunks, sometimes dilated to form a cisterna chyli | junction of the left subclavian v. and the left internal jugular v. | all of the body and limbs below the respiratory diaphragm; the left side of the chest, left upper limb and the left side of the head and neck above the diaphragm | thoracic duct is the largest lymphatic vessel; it passes through the aortic hiatus on the right side of aorta; it swings to the left side of the esophagus at the T4-T5 intervertebral disc (at the level of the sternal angle) |
| thymus | root of the neck and superior mediastinum posterior to sternum | none | parasternal nodes | essential for normal development of the immune system maturation | thymus involutes at puberty and is mostly replaced by a mass of fat |
| tracheobronchial nodes | along the trachea, around the tracheal bifurcation and primary bronchi | lymphatic vessels from the lung | bronchomediastinal lymph trunk | lungs, visceral pleura, bronchi, thoracic part of trachea, left side of heart, esophagus, posterior mediastinum | tracheobronchial nodes may be divided into five groups: paratracheal (tracheal), superior tracheobronchial, inferior tracheobronchial, bronchopulmonary (hilar), pulmonary |
| tracheobronchial nodes, inferior | inferior to tracheal bifurcation | bronchopulmonary nodes, left side inferior tracheobronchial nodes drain into right inferior tracheobronchial nodes | right superior tracheobronchial nodes | lower lobes of the lungs; middle mediastinum; posterior mediastinum | left inferior tracheobronchial nodes drain to the right side |
| tracheobronchial nodes, superior | superolateral to the tracheal bifurcation | bronchopulmonary (hilar) nodes | paratracheal (tracheal) nodes | lungs, middle mediastinum, posterior mediastinum | inferior tracheobronchial nodes drain lymph from the lower lobe of the left lung to the right superior tracheobronchial nodes |
| The material presented in these tables is
contained in the book: MedCharts Anatomy by Thomas R. Gest & Jaye Schlesinger Published by ILOC, Inc., New York Copyright © 1995, unauthorized use prohibited. |
The excellent editorial assistance of Dr. Pat Tank, UAMS is gratefully acknowledged. |
|
||
| Copyright© 2000 The University of Michigan. Unauthorized use prohibited. |
|
|