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THE CIRCULATORY SYSTEM
Chapter 12 The Lymphatic System
Main Collecting Lymphatic Channels
Lymphatic Drainage of the Head and Neck
Lymphatic Drainage of the Upper Limb
Lymphatic Drainage of the Thorax
Lymphatic Drainage of the Lower Limb
Lymphatic Drainage of the Abdomen and pelvis
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general introduction
The lymphatic system
consists of lymphatic
vessels and various
lymphatic tissues and
organs
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•The lymphatic vessels and the sinuses of the lymph nodes
contain tissue fluid，which is called lymph.
lymphatic capillary
tissue
fluid
histiocyte
blood capillary
（artery）
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blood capillary
（vein）
The composition and construction features of lymphatic system
lymphatic vessel
lymphatic capillary:
the initiation is dead end, the endothelium is thin and
intercellular spaces are wide 。
histiocyte
endothelial cell
The lymphatic capillaries do not present in epithelium , cornea,
lens, cartilage, brain and spinal cord
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lymphatic vessel
• superficial lymphatic vessel
(located in superficial fascia)
The stems go in company
with cutaneous vein
• deep lymphatic vessel
(located in deep fascia)
The stems go in company
with deep vein
there are affluent
communications between
the superficial and deep
lymphatic vessels
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lymphatic trunk
right jugular trunk
left jugular trunk
right subclavian trunk
left subclavian trunk
right bronchomediastinal trunk
left bronchomediastinal trunk
right lumbar trunk
left lumbar trunk
intestinal trunks
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lymphatic duct
The lymphatic capillaries join to
form progressively larger vessels,
until finally the thoracic duct and
the right lymphatic duct
the thoracic duct return to left
venous angle, and the right
lymphatic duct return to right
venous angle,
a few lymphatic vessels return to
renal vein、superarenal vein and
inferior vena cava.
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lymphatic tissues
diffuse lymphoid tissue
They main located in the lamina propria mucosae of
digestive tract and respiratory tract.
lymphatic nodule
they include the solitary and aggregated lymphatic follicles
which present in the submucosa of the small intestine , and
lymphatic nodules which present in
the wall of vermiform appendix.
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lymphatic organ
The lymphatic organs include the lymph nodes, tonsils ,
thymus and spleen.
lymph node
•afferent lymphatic vessel
•efferent lymphatic vessel
•superficial lymph node
•deep lymph node
•hilum of lymph node
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lymphatic duct
thoracic duct
left venous angle
left jugular trunk ：
converying lymph from the
left side of the head and neck
thoracic
duct
left subclavian trunk ：
draining lymph from the left
upper limb and part of the
thorax on the left side
left bronchomediastinal trunk ：
draining lymph from Left
thoracic cavity
cisterna
chyli
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intestinal trunk, ：draining most
of the lymph from the abdominal
part of the alimentary canal, liver,
pancreas and spleen
left and right 1umbar trunks ：
conveying lymph from the
lower limbs and the pelvic
viscera
right lymphatic duct
right venous angle
right jugular trunk ： receive
lymph from the right
Side of head and neck
right
lymphatic
duct
right subclavian trunk ：
receive lymph from the right
upper limb and the right side of
the thorax
right bronchomediastinal trunk
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position of lymph node and lymphatic drainage
lymphatic vessels and lymph nodes of the head and neck
Lymph node of the head
occipital lymph node
mastoid lymph node
Parotid lymph node
submandibular lymph node
submental lymph node
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Lymph nodes of the neck
anterior cervical lymph node
superficial anterior cervical lymph node
deep anterior cervical lymph node
prelaryngeal lymph node
thyroid lymph node
pretracheal lymph node
paratracheal lymph node
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lateral cervical lymph node
superficial lateral cervical lymph node
deep lateral cervical lymph node
superior deep lateral cervical lymph node
inferior deep lateral cervical lymph node
supraclavicular lymph node
Scalene lymph node
left scalene lymph node
(Virchow lymph node)
retropharyngeal lymph node
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lymphatic vessels and lymph
nodes of the upper limb
cubital lymph node
The superficial group are also called
supratrochlear lymph nodes
deltopectoral lymph node
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axillary lymph node
pectoral lymph node
lateral lymph node
subscapular lymph node
central lymph node
apical lymph node
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lymphatic vessles and lymph nodes of thorax
lymph nodes of chest wall
parasternal lymph node
intercostal lymph node
superior phrenic lymph node
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lymph nodes of the organs located in thoracic cavity
anterior mediastinal lymph nodes,
posterior mediastinal lymph nodes
lymph nodes of trchea ,bronchi and lung
pulmonary lymph nodes
bronchopulmonary lymph node
（pulmonary hilar lymph node）
tracheobronchial lymph node
paratracheal lymph node
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lymphatic vessles and lymph nodes of lower limb
popliteal lymph node
inguinal lymph node
superficial inguinal lymph node
deep inguinal lymph node
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lymphatic vessels and lymph
nodes of the pelvis
sacral lymph node
internal iliac lymph node
external iliac lymph node
common iliac lymph node
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lymphatic vessels and lymph nodes of abdomen
lymph node of the abdominal wall
lumbar lymph node
Left side diaphragm truck
Right side liver truck
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lymph nodes of organs located in abdominal cavity
Lymph nodes accompany celiac truck and its branches
left and right gastric lymph nodes
left and right gastroomental lymph nodes
pyloric lymph nodes
hepatic lymph nodes
pancreatic lymph nodes
splenic lymph nodes
→celiac lymph node
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Lymph nodes accompany superior mesenteric arteries and their
branches
mesenteric lymph node
ileocolic lymph node
right colic lymph node
middle colic lymph node
→superior mesenteric lymph node
Lymph nodes accompany inferior
mesenteric artery
left colic lymph node
sigmoid lymph node
superior rectal lymph node
→inferior mesenteric lymph node
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Lymphatic Drainage of some organs
lymphatic drainage of the lung
Superficial lymphatic vessels of the lung are located in the deep face of the
visceral pleura
Deep lymphatic vessels of the lung flow to the pulmonary lymph nodes and the
bronchopulmonary lymph nodes
Communication present between the superficial and deep lymphatic vessels。
pulmonary lymph node
→bronchopulmonary
lymph nodes →
tracheobronchial lymph
node and paratracheal
lymph node
lymphatic vessels from
the lower lobe flow to the
lymph nodes which
located in pulmonary
ligament
Lymphatic vessels
from the lower part of the
superior lobe of the left
lung and some lymphatic
vessels from the lower
lobe →upper group of
the right tracheobronchial
lymph node and right
paratracheal lymph node
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Lymphatic Drainage of the esophagus
Lymph of cervical part esophagus→paratracheal lymph node and inferior
deep lateral cervical lymph node。
Lymph of thoracic part esophagus→posterior mediastinal lymph node，
lymph of the superior segment of thoracic part→paratracheal lymph nodes
and tracheobronchial lymph node
lymph of the inferior segment of thoracic part →left gastric lymph node
lymphatic vessels of epicardia→left gastric lymph node
A few of lymphatic vessels of esophagus→thoracic duct
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Lymphatic Drainage of the rectum
The lymphatic vessels of the anal canal above the dentate line ：
accompany the superior rectal artery ,then ascending to enter the superior rectal
lymph nodes ；
accompany the inferior rectal aryery,then enter the internal iliac lymph nodes
accompany the anal artery and then follow the pudental artery to enter the internal
iliac lymph nodes,
part of lymphatic vessles follow the
Vessles of sacro-lateral ， then enter the sacral lymph nodes.
The lymphatic vessels of the anal canal under the
dentate line enter the superficial inguinal lymph nodes.
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Lymphatic drainage of the uterus
lymphatic vessels located in the superior aspect of fundus of uterus and body of
uterus: follow the ovarian blood vessels and ascend to terminate mainly in the
lumbar lymph nodes.
accompany the round ligament , pass the inguinal canal，and reach the superficial
inguinal lymph nodes.
lymphatic vessels located in inferior part of the uterus and cervical of the uterus：
follow blood vessels of the uterus and reach the external and internal iliac lymph
nodes ;
Pass cardinal ligament of uterus and reach the obturator lymph nodes ；follow
the sacrouterine ligament , go backward and reach the sacral lymph nodes.
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Lymphatic drainage of the breast
The lymph of the breast mainly reach the axillary lymph nodes
lymphatic vessels located in lateral and central part of the breast reach
the pectoral lymph nodes；
superior lymphatic vessels reach apical lymph nodes and supraclavicular
lymph nodes;
medial part lymphatic vessels reach parasternal lymph nodes.
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the spleen
The spleen is the largest
lymphatic organ. It functions
in storing blood,
haematogenesis, disposing
effete red cells and
immunologic response.
the spleen lies deep to the left
ninth, tenth and eleventh ribs
hilum of spleen
splenic artery
splenic vein
splenic notches
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