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1、Lymphatic System 淋巴系统Lymphatic System 淋巴系统Accessory circulation of the cardiovascular systemTransports and filters the tissue fluid, produces lymphocytes and participates in the immune responsesLymphatic capillaryLymphLymphatic System 淋巴系统Lymphatic nodeHeart Artery Capillaries Vein Lymphatic vesselL

2、ymphatic trunkLymphatic duct90%Lymphatic capillary120ml/h10%淋巴 lymphCell Tissue fluidComposition of the Lymphatic System Lymphatic vessels 淋巴管Lymphatic capillary 毛细淋巴管Lymphatic vessels 淋巴管Lymphatic trunks: 淋巴干(九条)Lymphatic ducts: 淋巴导管 thoracic duct 胸导管right lymphatic duck 右淋巴导管Lymphatic tissue 淋巴组织L

3、ymphatic organ 淋巴器官Lymphatic nodes 淋巴结Spleen 脾thymus 胸腺Tonsil 扁桃体Lymphatic capillary 毛细淋巴管Begin blindlyThe wall is composed of a single layer of overlapping endothelial cellsThey are numerous and form complex networks Be fund in all tissue and organs of the body except(abscent in) the central nervou

4、s system, the eyeball, the internal ear, the epidermis of the skin, the cartilage, and the boneLymphatic vessel 淋巴管Have valves that give them a beaded appearanceTwo setsSuperficial set: lie in the superficial fascia Deep set: run with blood vessels and nervesPasses through at least one lymph node an

5、d often several淋巴干Lymphatic trunk右淋巴导管右颈干右支气管纵隔干左锁骨下干胸导管乳糜池左腰干右腰干肠干左颈干右锁骨下干左支气管纵隔干淋巴干Lymphatic trunk左、右颈干jugular trunk头颈部左、右支气管纵隔干bronchomediastinal trunks 胸腔脏器、部分胸腹壁左、右锁骨下干subclavian trunk 上肢、部分胸壁左、右腰干lumbar trunk下肢、盆部、腹腔成对器官、部分腹壁肠干intestinal trunk腹腔不成对脏器右淋巴导管右颈干右支气管纵隔干左锁骨下干胸导管乳糜池左腰干右腰干肠干左颈干右锁骨下干左支

6、气管纵隔干 Thoracic duct 胸导管Begins in front of lower border of T12 as a dilated sac, the cisterna chyli 乳糜池, which formed by joining of left and right lumbar trunks and intestinal trunkEnter thoracic cavity by passing through the aortic hiatus of the diaphragm and ascends along on the front of the verteb

7、ral column, between thoracic aorta and azygos veinTravels upward, veering to the left at the level of T5左锁骨下干胸导管乳糜池左腰干右腰干肠干左颈干左支气管纵隔干左锁骨下干胸导管乳糜池左腰干肠干左颈干 Thoracic duct 胸导管At the roof of the neck, it turns laterally and arches forwards and descends to end by entering the left venous angleJust before t

8、ermination, it receives the left jugular, subclavian and bronchomediastinal trunksDrains lymph from lower limbs, pelvic cavity, abdominal cavity, left side of thorax, and left side of the head, neck and left upper limb左支气管纵隔干右腰干 Right lymphatic duct 右淋巴导管Formed by union of right jugular, subclavian,

9、 and bronchomediastinal trunksEnds by entering the right venous angleReceives lymph from right half of head, neck, thorax and right upper limblymph node 淋巴结Small oval or bean-shaped bodesAfferent vessels enter the node on its convex surface, and afferent vessels leave the node at its concave surface

10、the hilumArranged in groups, along the blood vesselsTwo setsSuperficial set: lie in the superficial fascia Deep set: lie with blood vesselsRegional lymph nodes 局部淋巴结Lymph nodes of the head Located at junction of head and neckConsist of Occipital lymph nodes 枕淋巴结Mastoid lymph nodes 乳突淋巴结Parotid lymph

11、 nodes 腮腺淋巴结 Submandibular lymph nodes 下颌下淋巴结 lies near the submandibular gland, receive lymphatic vessels from the face, nose and mouthsubmental lymph nodes 颏下淋巴结Drain into deep cervical lymph nodes 颈深淋巴结Lymph nodes of the neckAnterior cervical ln. 颈前淋巴结Superficial anterior cervical ln. 颈前浅淋巴结Deep

12、anterior cervical ln. 颈前深淋巴结Prelaryngeal lymph nodes 喉前淋巴结Thyroid lymph nodes 甲状腺淋巴结Pretracheal lymph nodes 气管前淋巴结Paratracheal lymph nodes 气管旁淋巴结Lymph nodes of the neckLateral cervical ln. 颈外侧淋巴结 Superficial lateral cervical ln. 颈外侧浅淋巴结Lie along the external jugular veinDeep lateral cervical ln. 颈外侧

13、深淋巴结Extend along the internal jugular veinLymph nodes of the neckDeep lateral cervical ln. 颈外侧深淋巴结Extend along the internal jugular vein from the base of skull to the root of necksuperior deep lateral cervical ln.颈外侧上深淋巴结inferior deep lateral cervical ln.颈外侧下深淋巴结 Efferent vessels form the jugular tr

14、unk 颈干Receive lymphatic vessels from head, neck, tongue, larynx, cervical parts of esophagus and trachea, thyroid gland, upper parts of the thoracic wall and breastLymph nodes of the neckSuperior deep lateral cervical ln. 颈外侧上深淋巴结Jugulodigastric ln. 颈内静脉二腹肌淋巴结 Lies at the junction of posterior belly

15、 of digastric and internal jugular veinDrain the nasopharynx, palatine tonsil and root of tougueJuguloomohyoid ln. 颈内静脉肩胛舌骨肌淋巴结 Lies at the junction of the intermediate tendon of omohyoid and internal jugular veinDrain the apex of tongueSpinal accessory ln. 副神经淋巴结Lymph nodes of the neckInferior deep

16、 lateral cervical ln. 颈外侧下深淋巴结Supraclavicular lymph nodes 锁骨上淋巴结 Lie along transverse cervical a. & v.Scalene ln. 斜角肌淋巴结Efferent vessels form the jugular trunk 颈干Left jugular trunk joins the thoracic duct Right jugular trunk joints the right lymphatic ductLymph nodes of the neckRetrophrangeal ln. 咽后

17、淋巴结Lying vertically behind the pharynxLymph nodes of upper limbCubital lymph node 肘淋巴结 lies above medial epicondyle of humerusInfraclavicular nodes 锁骨下淋巴结 Axillary lymph node 腋淋巴结 Axillary lymph nodesAxillary lymph nodes vary in size from a pin-head to a large bean. They are arranged in five groups

18、胸肌淋巴结Pectoral ln.外侧淋巴结Lateral ln.肩胛下淋巴结Subscapular lymph node 中央淋巴结Central ln.尖淋巴结Apical ln.尖淋巴结中央淋巴结外侧淋巴结肩胛下淋巴结胸肌淋巴结Axillary lymph nodesPectoral lymph nodes 胸肌淋巴结Lying along the lower border of pectoralis minor behind the pectoralis majorReceive lymph vessels from the lateral quadrants of the breas

19、t and superficial vessels from the anterolateral abdominal wall above the level of the umbilicusAxillary lymph nodesLateral lymph nodes 外侧淋巴结Along medial side distal part axillary veinReceives lymph from upper limbAxillary lymph nodesSubscapular lymph node 肩胛下淋巴结Lying along subscapular vessels, in f

20、ront of the subscapularis Receive superficial lymph vessels from the back, down as far as the level of the iliac crestsEfferents above three groups pass to central lymph node Axillary lymph nodesCentral lymph node 中央淋巴结Lying in the center of the axilla in the axillary fat Receive lymph from the abov

21、e three nodesEfferents pass to apical lymph node Axillary lymph nodesApical lymph node 尖淋巴结Lying at the apex of the axilla at the lateral border of the fist rib Receive lymph the efferent lymph vessels from all the other axillary nodes and superior region of breastThe efferents of the apical nodes f

22、orm the subclavian trunkLeft subclavian trunk joins the thoracic duct Right subclavian trunk joints the right lymphatic ductAxillary lymph nodesLateral ln.Pectoral ln.Subscapular ln.Central ln.Apical ln.Subclavian trunkLymphatic drainage of thoraxThe lymphatic drainage of thoracic wallTo axillary ly

23、mph nodesTo parasternal lymph nodes (along internal thoracic vessels)To intercostals lymph nodes from deeper structureslymph nodes of the thoraxlymph nodes of the thoracic wallParasternal ln. 胸骨旁淋巴结Intercostal ln. 肋间淋巴结Superior phrenic ln. 膈上淋巴结lymph nodes of the thoraxPulmonary ln. 肺淋巴结 Lie in the

24、angles of bifurcation of branching lobar bronchiBronchopulmonary hilar ln. 支气管肺门淋巴结Lie in the hilus of the lungTracheobronchial ln. 气管支气管淋巴结Situated above or below the bifurcation of trachea Paratracheal ln. 气管旁淋巴结 Along each side of the trachealymph nodes of the thorax Anterior mediastinal lymph no

25、de纵隔前淋巴结 Lies anterior to the large blood vessels of thoracic cavity and pericardiumThe efferents unite with those of paratracheal lymph nodes and parasternal lymph nodes to form the right and left bronchomediastinal trunks 支气管纵隔干The left bronchomediastinal trunk terminates in thoracic duct, and rig

26、ht in the right lymphtic ductPosterior mediastinal lymph nodes纵隔后淋巴结 Lie along the esophagus and thoracic aortaLymph nodes of lower limbPopliteal ln. 腘淋巴结Embedded in the fatty connective tissue of popliteal fossaReceive superficial lymphatic vessels from posterolateral part of calf, and from deep ly

27、mphatic vessels accompanying anterior and posterior tibial a.Efferents pass to the deep inguinal ln. inguinal lymph nodes 腹股沟淋巴结Superficial inguinal lymph nodes 腹股沟浅淋巴结Deep inguinal lymph nodes 腹股沟深淋巴结Lymph nodes of lower limb Superficial inguinal lymph nodes 腹股沟浅淋巴结Superior group Lies just distal t

28、o the inguinal ligamentReceive lymph vessels from anterior abdominal wall below umbilicus, gluteal region, perineal region, external genital organsInferior groupLies vertical along the terminal great saphenous v.Receives all superficial lymph vessels of lower limb, except for those from the posterol

29、ateral part of calf Efferent vessels drain into the deep inguinal ln. or external iliac ln.Lymph nodes of lower limb Deep inguinal lymph nodes 腹股沟深淋巴结Lie medial to the femoral v.Receive deep lymph vessels of lower limb, perineal region, and efferent vessels from the superficial inguinal ln.Drain int

30、o the external iliac ln.Lymphangiogram showing the inguinal lymph vessels and nodes. Lymph nodes of pelvisInternal iliac ln. 髂内淋巴结Surround internal iliac vesselsReceive afferents from pelvic viscera, perineum, buttock and back of thighExternal iliac ln. 髂外淋巴结Lie along external iliac arteryReceive af

31、ferents from lower limb and some parts of pelvic visceraCommon iliac ln. 髂总淋巴结Lie along common iliac arteryReceive afferents from all the above nodesEfferent pass to lumbar lymph node Sacral lymph node 骶淋巴结Lymph nodes of abdomen - abdominal wallTo axillary lymph node from region above umbilicusTo su

32、perficial inguinal lymph node from region below umbilicusTo lumbar lymph node from post wall of abdomenLymph nodes of abdomenLumbar lymph nodes 腰淋巴结Lie on posterior abdominal wall, along the abdominal aorta and inferior vena cavaReceive lymph from kidneys, suprarenal glands, testes, ovaries, fundus

33、of uterus, ovary, and common iliac nodesefferent vessels form the Right and left lumbar trunksLymph nodes of abdomen - abdominal wall Unpaired organs celiac lymph nodes superior mesenteric ln. inferior mesenteric ln.Paired organslumbar lymph nodesIntestinal trunkLymph nodes of abdomenRight and left

34、gastric ln. 胃左、右淋巴结Lie along the same vessels and finally to the celiac ln.Right and left gastroomental ln. 胃网膜左、右淋巴结Lie along the same vessels, the former drain into subpyloric ln., the latter drain into splenic ln.Suprapyloric and subpyloric ln.幽门上、下淋巴结Receive lymphatics from pyloric part and fina

35、lly to the celiac ln.Lymph nodes of abdomenSplenic ln. 脾淋巴结Receive lymphatics from fundus and left third of stomach, and finally to the celiac ln. Hepatic ln. 肝淋巴结Pancreatic ln. 胰淋巴结 Celiac lymph nodes 腹腔淋巴结 Situated around the celiac trunk Lymph nodes of abdomen Superior mesenteric lymph node 肠系膜上淋

36、巴结 Situated around superior mesenteric a. Inferior mesenteric lymph node 肠系膜下淋巴结 Situated around inferior mesenteric a. Intestinal trunk 肠干 Formed by efferent vessel of celiac, superior and inferior mesenteric lymph nodesLymphangiogram showing the lateral aortic and proximal iliac lymph nodes. The r

37、adiograph was taken approximately 24 hours after the injection of contrast medium into the lymphatics of the dorsum of the foot. Intravenous contrast opacifies the renal collecting system. 上肢尖淋巴结锁骨下干头颈颈外侧深淋巴结颈干胸部气管旁淋巴结纵隔前淋巴结胸骨旁淋巴结支气管纵隔干 左右左右左右腹部不成对脏器腹腔淋巴结肠系膜上淋巴结肠系膜下淋巴结肠干腹部成对脏器腰淋巴结腰干乳糜池胸导管右淋巴导管左静脉角右静

38、脉角静脉盆髂内淋巴结髂总淋巴结下肢髂外淋巴结左右Lymph drainage of the breastLateral and central parts- Pectoral Ln.Superior part-Apical Ln. and Supraclavicular Ln. Medial partDeep-parasternal Ln.Superficial-to the opposite sideMedial and inferior parts to lymphatic of liver via these of abdomen and diaphragm Lymph edema(elephantiasis)filariid Brea

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