1. Introduction of lymphology
苏州大学医学院人体解剖教研室

2. The Lymphatic System 淋巴系统
Lymphatic ducts
Lymphatic trunks V A
Lymph nodes
Cap
Lymphatic
Lymphatic-Capillary

3. A assistant system to the vein

4. Composition Lymphatic vessels 淋巴管道 Lymphatic organs 淋巴器官
Lymphatic capillary毛细淋巴管
Lymph vessels淋巴管
Lymphatic trunks (9)淋巴干
Lymphatic ducts(2)淋巴导管
thoracic duct 胸导管
right lymphatic duck右淋巴导管
Lymphatic organs 淋巴器官
Lymph nodes 淋巴结
spleen 脾
thymus胸腺
tonsil扁桃体,
Lymphatic tissues 淋巴组织

5. Lymphatic capillary 毛细淋巴管
Lymphatic vessels 淋巴管道
Lymphatic capillary 毛细淋巴管
Features of structure:
Blind end
Single layer of overlapping endothelial cells
More permeable than that of blood capillary
Absent from avascular structures, brain, spinal cord splenic pulp and bone marrow

6. Lymphatic vessels 淋巴管道
Features of structure
Three layered wall similar to, but thinner than vein,
More numerous valves than in vein
Interposed by lymph node at interval along the course
Arranged in superficial and deep sets

7. Lymphatic vessels 淋巴管道
Lymphatic trunks 淋巴干
right and left jugular trunks
(颈干)
right and left subclavian trunks
（锁骨下干）
right and left bronchomediastinal trunks
（支气管纵隔干）
right and left lumbar trunks
（腰干）
intestinal trunk（肠干）

8. Lymphatic vessels 淋巴管道
Lymphatic ducts 淋巴导管
Right lymphatic duct 右淋巴导管
Formed by union of right jugular, subclavian, and bronchomediastinal trunks
Ends by entering the right venous angle右静脉角
Receives lymph from right half of head, neck, thorax and right upper limb

9. Lymphatic vessels 淋巴管道
Thoracic duct 胸导管
Begins in front of L1 as a dilated sac, the cisterna chyli 乳糜池, which formed by joining of left and right lumbar trunks and intestinal trunk
Enter thoracic cavity by passing through the aortic hiatus of the diaphragm and ascends along on the front of the vertebral column, between thoracic aorta and azygos vein

10. Lymphatic vessels 淋巴管道
Thoracic duct 胸导管
Travels upward, veering to the left at the level of T5
At the roof of the neck, it turns laterally and arches forwards and descends to enter the left venous angle
Just before termination, it
receives the left jugular,
subclavian and bronchomediastinal
trunks

11. Lymphatic vessels 淋巴管道
Thoracic duct 胸导管
Just before termination, it receives the left jugular, subclavian and bronchomediastinal trunks
Drains lymph from lower limbs, pelvic cavity, abdominal cavity, left side of thorax, and left side of the head, neck and left upper limb

12. Lymph node 淋巴结 Features Bean-shaped bodies
With afferent lymph vessels输入淋巴管 (entering at the periphery) and efferent lymph vessels输出淋巴管(emerging at the hilus)
Arranged in groups, along the blood vessels or the flexural side of the joint
Divided into superficial and deep groups

13. Lymph node 淋巴结
Regional Lymph Node局部淋巴结 is the lymph node where the lymph of the organ or part of the body drainge to firstly
Sentinel Lymph Node前哨淋巴结(in clinic)

14. Lymph drainage of the body

15. Ⅰ.Lymph drainage of the head 头部的淋巴引流
Lymph nodes of head
Located at junction of head and neck
Consist of occipital, mastoid, parotid, submandibular, submental lymph nodes
Drain into deep cervical lymph nodes
Submandibular lymph node 下颌下淋巴结 lies near the submandibular gland, receive lymphatic vessels from the face, nose and mouth

16. Lymph drainage of neck 颈部的淋巴引流
Anterior cervical lymph nodes颈前淋巴结
Superficial anterior cervical lymph nodes
Deep anterior cervical lymph nodes
Lateral cervical lymph node 颈外侧淋巴结
Superficial lateral cervical lymph nodes－lie along the external jugular vein
Deep lateral cervical lymph nodes

17. Lymph drainage of neck 颈部的淋巴引流
Deep lateral cervical lymph nodes颈外侧深淋巴结
extend along the internal jugular vein from the base of skull to the root of neck
divide into
Superior deep lateral cervical lymph nodes颈外侧上深淋巴结
Inferior deep lateral cervical lymph nodes颈外侧下深淋巴结

18. Lymph drainage of neck 颈部的淋巴引流
Deep lateral cervical lymph nodes颈外侧深淋巴结
receive lymphatic vessels from head, neck, tongue, larynx, cervical parts of esophagus and trachea, thyroid gland, upper parts of the thoracic wall and breast
efferent vessels form the jugular trunk →thoracic duct(left)
→ right lymphatic duct
(right)

19. Lymph drainage of neck 颈部的淋巴引流
Superior deep lateral cervical lymph nodes 颈外侧上深淋巴结
Jugulodigastric lymph node 颈内静脉二腹肌淋巴结: lies at the junction of posterior belly of digastric and internal jugular vein
Inferior deep lateral cervical lymph nodes 颈外侧下深淋巴结
Juguloomohyoid lymph node 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 vein
Supraclavicular lymph nodes 锁骨上淋巴结: lie along the subclavian artery

20. The lymphatic drainage of upper limb 上肢的淋巴引流
Lymphatic vessels
Superficial lymphatic vessels 浅淋巴管
伴随浅静脉
注入滑车上淋巴结和腋淋巴结
Deep lymphatic vessels 深淋巴管
伴随深静脉
注入腋淋巴结
lymph nodes
Cubital lymph node滑车上淋巴结
Axillary lymph node腋淋巴结

21. Axillary lymph nodes 腋淋巴结
The axillary lymph nodes mey be divided into
lateral ln.外侧淋巴结
pectoral ln.胸肌淋巴结
subscapular ln.肩胛下淋巴结
central ln.中央淋巴结
apical ln.尖淋巴结
lateral ln.
pectoral ln.
subscapular ln.
central ln.
apical ln.
subclavian trunk

22. The lymphatic drainage of thorax 胸部的淋巴引流
The lymphatic drainage of thoracic wall
To axillary lymph nodes
To parasternal lymph nodes胸骨旁淋巴结 (along internal thoracic vessels)
To intercostals lymph nodes肋间淋巴结 from deeper structures

23. The lymphatic drainage of thorax 胸部的淋巴引流
Paratracheal lymph nodes
lymph nodes of the thoracic contents
lymph nodes of trachea, bronchi and lungs
Pulmonary lymph nodes肺淋巴结lie in the angles of bifurcation of branching lobar bronchi
Bronchopulmonary hilar lymph nodes支气管肺门淋巴结－lie in the hilus of the lung
Tracheobronchial lymph nodes气管支气管淋巴结－situated above or below the bifurcation of trachea
Paratracheal lymph nodes 气管旁淋巴结－along each side of the trachea

24. The lymphatic drainage of thorax 胸部的淋巴引流
Anterior mediastinal lymph node纵隔前淋巴结 lies anterior to the large blood vessels of thoracic cavity and pericardium; the efferents unite with those of paratracheal 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 right in the right lymphtic duct
Posterior mediastinal lymph nodes纵隔后淋巴结 lie along the esophagus and thoracic aorta

25. The lymphatic drainage of abdomen 腹部的淋巴引流
Lymphatic drainage of abdominal wall
To axillary lymph node from region above umbilicus
To superficial inguinal lymph node from region below umbilicus
To lumbar lymph node from post wall of abdomen
axillary lymph node
superficial inguinal lymph node

26. The lymphatic drainage of abdomen 腹部的淋巴引流
Lymphatic drainage of abdominal viscera
Lumbar lymph nodes 腰淋巴结
Lie on posterior abdominal wall, along the abdominal aorta and inferior vena cava
Receive lymph from kidneys, suprarenal glands, testes, ovarirs, fundus of uterus, ovary, and common iliac nodes
Their efferent vessel form the right and left lumbar trunks

27. The lymphatic drainage of abdomen 腹部的淋巴引流
Celiac lymph nodes 腹腔淋巴结 －situated around the celiac trunk
Superior mesenteric lymph node 肠系膜上淋巴结 －situated around superior mesenteric a.
Inferior mesenteric lymph node 肠系膜下淋巴结 －situated around inferior mesenteric a.
Intestinal trunk 腹腔干 －formed by efferent vessel of celiac, superior and inferior mesenteric lymph nodes

28. The lymphatic drainage of pelvis 盆部的淋巴引流
Internal iliac lymph node 髂内淋巴结
Surround internal iliac vessels
Receive lymph from pelvic viscera, perineum, buttock and back of thigh
External iliac lymph nodes 髂外淋巴结
Lie along external iliac artery
Receive lymph from lower limb and some parts of pelvic viscera

29. The lymphatic drainage of pelvis 盆部的淋巴引流
Sacral lymph node 骶淋巴结
locate along middle sacral a. and lateral sacral a.
Receive lymph from posterior pelvic wall ,rectum,prostate or uterus
Common iliac lymph node髂总淋巴结
Lie along common iliac artery
Receive afferents from all the above nodes
Efferents pass to lumbar lymph node

30. lymph drainage of lower limb下肢的淋巴
lymphatic vessels
Superficial lymphatic
Deep lymphatic
Lymph nodes
Superficial lymph node
腹股沟浅淋巴结
Deep lymph node
腹股沟深淋巴结

31. lymph drainage of lower limb下肢的淋巴
Superficial lymph node腹股沟浅淋巴结　may be divided into two groups
Upper group: below the inguinal lig.腹股沟韧带
Lower group: around the terminal part of great saphenous v.大隐静脉
Receive lymph from lower part of abdominal wall,perineum 会阴and lower limb with the exception of region drained by popliteal ln.腘淋巴结

32. lymph drainage of lower limb下肢的淋巴
deep lymph node 腹股沟深淋巴结　
Locate around the proximal end of femoral v.
Receive lymph from deep lymphatic vessels of lower limb and the efferentlymphatic vessels of superficial inguinal ln.腹股沟浅淋巴结
Their efferent lymphatic vessels empty into external iliac ln.髂外淋巴结

33. lymph drainage of lower limb下肢的淋巴
Popliteal ln.腘淋巴结
Embedded in the fatty connective tissue of popliteal fossa
Receive superficial lymphatic vessels from posterolateral part of calf小腿, and from deep lymphatic vessels accompanying anterior and posterior tibial a.
Efferents pass to the deep inguinal ln.腹股沟深淋巴结

35. Celiac lymph nodes Superior mesenteric lymph node 肠系膜上淋巴结
Inferior mesenteric lymph node 肠系膜下淋巴结

37. Spleen 脾 Location Features Function Left epigastric region
between 9th-11th rib
in line of 10th rib
Features
Diaphragmatic surface
Visceral surface - Splenic Hilum
Anterior extremity
Posterior extremity
Superior border- Splenic Notch
Inferior border
Function

39. Thymus 胸腺 Featrues Consists of two elongated lobes
Is large organ in the fetus
Occupies the thoracic cavity behind the sternum
Secrete lymphopoietin

40. Clinic information