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7/23/2019 Lymphatics of the Body
1/30
Lymphat
ics of
theBody
-
Liste
d
Alph
abeti
callyStructure Location Afferents from Efferents to
Regions
drained Notes
accessory
nodes
posterior
triangle of
the neck,
arrangedalong the
accessory n.
occipital nodes,
retroauricular
nodes
transverse
cervical
chain of
nodes
occipital
region
and
posteriorscalp
accessory
nodes also
collect lymph
from thenape of the
neck and the
region
overlying thesupraspinato
us fossa
anteriorauricular
nodes
subcutaneous connective
tissue
anterior tothe ear
lymphatic vesselsfrom the side of the
head
superiorparotid
nodes;
superiordeep
cervical
nodes
anteriorpart of
the
parietalregion
of the
scalp;anterior
surfaceof the
ear andexternal
acoustic
meatus
anteriorauricular
nodes are 1
or 2 innumber
anterior along the lymphatic vessels inferior deep skin and anterior
7/23/2019 Lymphatics of the Body
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jugular nodes anterior
jugular vein
from the anterior
inferior part of the
neck
cervical
nodes
mm. of
the
anteriorinfrahyo
id region
of theneck
jugular nodes
are located
between thesuperficial
layer of deep
cervicalfascia and
the
infrahyoid
mm.
anterior
mediastinal
nodes
along the
course of the
brachiocepha
lic vesselsand aorta
lymphatic vessels
from the anterior
mediastinum and
middlemediastinum
bronchomed
iastinal
trunk
thymus,
anterior
respirato
rydiaphrag
m,
pericardium, part
of the
heart
anterior
mediastinal
nodes are
from 2 to 5in number
apical axillarynodes
apex of theaxilla
lateral axillarynodes; central
axillary nodes;
subscapularaxillary nodes;
pectoral nodes;
accessorylymphatic vesselsfrom the mammary
gland; lymphatic
vesselsaccompanying the
cephalic v.
subclavianlymphatic
trunk; deep
cervicallymph
nodes
upperlimb,
most of
themammar
y gland,
some oftheanterolat
eral
chestwall,
posterior
thoracicwall and
scapular
region
apicalaxillary
nodes are !
12 innumber; this
is the highest
node groupin the axillaand all other
node groups
drain throughthese nodes;
a very
importantgroup of
nodes in
cases of
metastaticspread of
breast
cancer;connections
to deep
cervicalnodes may
7/23/2019 Lymphatics of the Body
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result in
spread of
breast cancerthrough the
deep neck
auricular
nodes, anterior
subcutaneou
s connectivetissue
anterior to
the ear
lymphatic vessels
from the side of thehead
superior
parotidnodes;
superior
deepcervical
nodes
anterior
part ofthe
parietal
regionof the
scalp;
anterior
surfaceof the
ear and
externalacoustic
meatus
anterior
auricularnodes are 1
or 2 in
number
axillary nodes axilla cubital nodes;
lymphatic vesselsfrom the upper
limb, thoracic wall
and subscapularregion
efferents
vessels formthe
subclavian
trunk, somedrainage to
inferior deep
cervicalnodes
upper
limb,most of
the
mammary gland,
some of
theanterolateral
chest
wall,posterior
thoracic
wall andscapular
region
axillary
nodesnumber from
2" to #" and
are organi$edin five
groups based
on theirpositionwithin the
axilla% 1&
pectoralnodes, along
the lateral
border of thepectoralis
major m.; 2&
lateral nodes,
located alongthe distal
axillary v.; #&
centralnodes,
centrally
located alongaxillary v.; '&
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subscapular
nodes,
located alongthe
subscapular
v. and itstributaries; 5&
apical nodes,
located at the
apex of axilla
axillary nodes,
apical
apex of the
axilla
lateral axillary
nodes; central
axillary nodes;
subscapularaxillary nodes;
pectoral nodes;
accessorylymphatic vessels
from the mammary
gland; lymphaticvessels
accompanying the
cephalic v.
subclavian
lymphatic
trunk; deep
cervicallymph
nodes
upper
limb,
most of
themammar
y gland,
some ofthe
anterolat
eralchest
wall,
posterior
thoracicwall and
scapular
region
apical
axillary
nodes are !
12 innumber; this
is the highest
node groupin the axilla
and all other
node groupsdrain through
these nodes;
a very
importantgroup of
nodes in
cases of
metastaticspread of
breastcancer;
connections
to deepcervical
nodes may
result in
spread ofbreast cancer
through thedeep neck
axillary nodes,central
in the fat ofthe axilla
lateral axillarynodes; pectoral
nodes; subscapular
nodes; lymphaticvessels from the
apicalaxillary
nodes
upperlimb,
most of
themammar
centralaxillary
nodes are '
or 5 innumber; they
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mammary gland
and upper limb
y gland,
some of
theanterolat
eral
chestwall,
posterior
thoracic
wall andscapular
region
are involved
in cancer of
themammary
gland
axillary nodes,
lateral
along the
distalaxillary v.
cubital nodes;
lymphatic vesselsof the arm
central
axillarynodes,
apical
axillarynodes
upper
limb
lateral
axillarynodes
become
inflamedduring upper
limb
infections;also known
as% brachial
nodes
axillary nodes,subscapular
along thecourse of the
subscapular
vessels
lymphatic vesselsfrom the skin of the
back and back of
the neck; lymphaticvessels from themuscles of the
scapular region
centralaxillary
nodes
skin ofthe back
and back
of theneck;muscles
of the
scapularand
subscap
ularregions
subscapularaxillary
nodes are 5
or innumber; alsoknown as%
posterior
axillarynodes
bronchomedias
tinal 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%
rightlymphatic
duct
thoracic
wall and
viscera;medial
part of
themammar
y gland
right
bronchomedi
astinal trunkreceives
lymph from
the lowerlobe of the
left lung;
bronchomedi
astinal trunk
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may drain
directly into
the venoussystem on
either side
bronchopulmo
nary nodes
hilum of the
lung
pulmonary nodes tracheobron
chial nodes
lung bronchopulm
onary nodesare also
known as%
hilar nodes
celiac nodes around theceliac trunk
hepatic nodes,gastric nodes,
pancreaticosplenic
nodes
intestinallymph trunk
liver,gall
bladder,
stomach,spleen,
pancreas
celiac nodesare from # to
in number
central axillary
nodes
in the fat of
the axilla
lateral axillary
nodes; pectoralnodes; subscapular
nodes; lymphatic
vessels from the
mammary glandand upper limb
apical
axillarynodes
upper
limb,most of
the
mammar
y gland,some of
the
anterolateral
chestwall,posterior
thoracic
wall and
scapularregion
central
axillarynodes are '
or 5 in
number; they
are involvedin cancer of
the
mammarygland
cervical nodes,
deep
in and
around
carotidsheath
posterior and
lateral to theinternal
jugular v.
lymphatic vessels
and numerous node
groups from thehead and neck
jugular
trunk
head and
neck
superior and
inferior
subdivisionsof deep
cervical
nodes aredelineated by
the crossing
of theomohyoid m.
cisterna chyli between the right and ( left thoracic all of the cisterna chyli
7/23/2019 Lymphatics of the Body
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abdominal
aorta and the
inferior venacava anterior
to the body
of the )1 or)2 vertebra
lumbar trunks;
possibly the
intestinal trunk
duct body
below
therespirato
ry
diaphragm; all of
the
abdomin
al andpelvic
viscera
is an
enlargement
of the lowerend of the
thoracic duct;
it occurs inabout 25* of
individuals
colic nodes,
middle
along the
course of themiddle colic
vessels
peripheral nodes
located along theattachment of the
mesentery
superior
mesentericnodes
transvers
e colon
middle colic
nodes areapproximatel
y '" in
number
colic nodes,right
along thecourse of the
right colic
vessels
peripheral nodeslocated along the
marginal a.
superiormesenteric
nodes
ascending colon,
cecum
right colicnodes are
approximatel
y +" innumber
common iliac
nodes
along the
common
iliac vessels;over the
sacralpromontory
external iliac
nodes, internal iliac
nodes
lumbar
lateral
aortic& chainof nodes
lower
limb;
pelvicorgans,
perineum, lowerpart of
the
anterior
abdominal wall
common iliac
nodes are
approximately in
number
cubital nodes cubital fossa
of the upper
limb
lymphatic vessels
from the forearm
lateral
axillary
nodes
deep
tissues
of theforearm
and
hand
cubital nodes
small and are
5 or innumber
cystic node near the neckof the gall
bladder
lymphatic vesselsof the gall bladder
hepaticnodes
gallbladder
cystic nodedrains to the
node of the
omentalforamen,
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then to
hepatic nodes
deep cervical
nodes
in and
aroundcarotid
sheath
posterior andlateral to the
internal
jugular v.
lymphatic vessels
and numerous nodegroups from the
head and neck
jugular
trunk
head and
neck
superior and
inferiorsubdivisions
of deep
cervicalnodes are
delineated by
the crossingof the
omohyoid m.
deep cervical
nodes, inferior
around the
internaljugular v.,
inferior tothe crossing
of theomohyoid m.
superior deep
cervical nodes;numerous node
groups of the neck
jugular
trunk
head and
neck
inferior deep
cervicalnodes are in
directcontinuity
with thesuperior deep
cervical
chain ofnodes
deep cervical
nodes, superior
around the
internal
jugular v.,superior to
the crossingof theomohyoid m.
numerous node
groups of the head
and upper neck,including
retropharyngealnodes and deepparotid nodes
inferior deep
cervical
nodes
head and
the
superiorpart of
the neck
the superior
deep cervical
node grouphas many
large nodes;thejugulodigastr
ic and
juguloomohy
oid nodes aremembers of
this group
deep inguinal
nodes
along the
medial sideof the
femoral v.
deep to thefascia lata
and inguinal
ligament
superficial inguinal
nodes, poplitealnodes
external
iliac nodes
lower
limb,external
genitalia
, lowerpart of
the
anteriorabdomin
al wall
the deep
inguinal nodein the
femoral canal
is called thenode or
gland& of
-louet
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deep parotid
nodes
on the lateral
side of the
pharyngealwall, deep to
the parotid
gland
lymphatic vessels
from the ear
superior
deep
cervicalnodes
external
acoustic
meatus,auditory
tube,
middleear
deep parotid
nodes are
part of thedeep cervical
chain of
nodes
external iliac
nodes
along the
external iliac
vessels
superficial inguinal
nodes; deep
inguinal nodes;inferior epigastric
nodes
common
iliac nodes
lower
limb;
externalgenitalia
; lower
part of
theanterior
abdomin
al wall
external iliac
nodes are /
to 1" innumber
externaljugular nodes
along theexternal
jugular v.
lymphatic vesselsfrom the side of the
head
superiordeep
cervical
nodes
inferiorpart of
the ear
and theparotid
region
there are oneor two nodes
in this group
facial nodes along the
course of thefacial a. and
v.
lymphatic vessels
from the face
submandibu
lar nodes
eyelids,
nose,cheek
and lips
facial nodes
are groupedinferior to
the orbit; atthe angle ofthe mouth
and over the
mandible
gastric nodes,left
on the lessercurvature of
the stomach,
along the
course of theleft gastric
vessels
lymphatic vesselsfrom the lesser
curvature of the
stomach
celiac nodes lessercurvatur
e of the
stomach
left gastricnodes are 1"
to 2" in
number
gastric nodes,
right
on the lesser
curvature ofthe stomach,
along the
course of theright gastric
lymphatic vessels
from the lessercurvature of the
stomach
celiac nodes lesser
curvature of the
stomach
right gastric
nodes are 2to # in
number
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vessels
gastro!omental
nodes, left
on the
greater
curvature ofthe stomach,
along the left
gastro!omental
vessels
lymphatic vessels
from the greater
curvature of thestomach
splenic
nodes
left half
of the
greatercurvatur
e of the
stomach
left gastro!
omental
nodes are 1or 2 in
number
gastro!omental
nodes, right
on the
greatercurvature of
the stomach,
along theright gastro!
omentalvessels
lymphatic vessels
from the greatercurvature of the
stomach
pyloric
nodes
greater
curvature of the
stomach
right gastro!
omentalnodes are
to 12 in
number
hepatic nodes along thecourse of the
common
hepatic a.
right gastric nodes,pyloric nodes
celiac nodes liver andgall
bladder;
extrahep
aticbiliary
apparatu
s;respirato
rydiaphragm; head
of
pancreas
andduodenu
m
hepatic nodesdrain a
portion of the
respiratory
diaphragmbecause of
the common
embryonicorigin of the
diaphragmand the liverseptum
transversum&
hilar nodes at hilum of
lung
pulmonary nodes tracheobron
chial nodes
lung also known
as%bronchopulm
onary nodes
ileocolic nodes along the
origin andterminal end
of the
ileocolicvessels
peripheral nodes
located along theattachment of the
mesentery
superior
mesentericnodes
ileum,
cecum,appendi
x
ileocolic
nodes locatednear the
ileocecal
junction maybe divided
7/23/2019 Lymphatics of the Body
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into two
subsidiary
groups% cecalnodes and
appendicular
nodes
iliac nodes,common
along thecommon
iliac vessels;
over thesacral
promontory
external iliacnodes, internal iliac
nodes
lumbarlateral
aortic& chain
of nodes
lowerlimb;
pelvic
organs,perineu
m, lower
part of
theanterior
abdomin
al wall
common iliacnodes are
approximatel
y innumber
iliac nodes,external
along theexternal iliac
vessels
superficial inguinalnodes; deep
inguinal nodes;
inferior epigastricnodes
commoniliac nodes
lowerlimb;
external
genitalia; lower
part of
theanterior
abdomin
al wall
external iliacnodes are /
to 1" in
number
iliac nodes,internal
along theinternal iliac
vessels
lymphatic vesselsfrom the pelvic
viscera
commoniliac nodes,
external
iliac nodes
pelvis,perineu
m and
gluteal
region
internal iliacnodes are '
to / in
number
inferior deep
cervical nodes
around the
internal
jugular v.,
inferior tothe crossing
of the
omohyoid m.
superior deep
cervical nodes;
numerous node
groups of the neck
jugular
trunk
head and
neck
inferior deep
cervical
nodes are in
directcontinuity
with the
superior deepcervical
chain of
nodes
inferiormesenteric
around theroot of the
peripheral nodeslocated along the
lumbarchain of
distal10# of
inferiormesenteric
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nodes inferior
mesenteric a.
marginal a. nodes,
superior
mesentericnodes
the
transvers
e colon,descendi
ng
colon,sigmoid
colon,
rectum
nodes may
number as
high as ";an important
node group
in cases ofcancer of the
colon and
rectum
inferiortracheobronchi
al nodes
inferior totracheal
bifurcation
bronchopulmonarynodes, left side
inferior
tracheobronchial
nodes drain intoright inferior
tracheobronchial
nodes
rightsuperior
tracheobron
chial nodes
lowerlobes of
the
lungs;
middlemediasti
num;
posteriormediasti
num
left inferiortracheobronc
hial nodes
drain to the
right side
infraclavicular
nodes
along the
cephalic v. inthe
deltopectoral
groove
lymphatic vessels
from the superficialupper limb
apical
axillarynodes
skin and
superficial fascia
of the
upperlimb
infraclavicul
ar nodes maybecome
inflamed
duringinfections of
the
superficialtissues of theupper limb
inguinal nodes,
deep
along the
medial side
of thefemoral v.
deep to the
fascia lataand inguinal
ligament
superficial inguinal
nodes, popliteal
nodes
external
iliac nodes
lower
limb,
externalgenitalia
, lower
part ofthe
anterior
abdominal wall
the deep
inguinal node
in thefemoral canal
is called the
node orgland& of
-louet
inguinal nodes,
superficial
in the
superficial
fasciaparallel to
the inguinal
lymphatic vessels
from the superficial
lower limb,superficial
abdominal wall,
external
iliac nodes;
deepinguinal
nodes
lower
abdomin
al wall;external
genitalia
superficial
inguinal
nodes are 12!2" in
number; they
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ligament and
along the
terminal partof the greater
saphenous v.
perineum ;
superfici
al partsof the
lower
limb
become
inflamed
duringinfections of
the lower
limb; theymay become
inflamed
during
infections ofthe external
genitalia
intercostal
nodes
near the
heads of theribs
lymphatic vessels
from the intercostalspace
cisterna
chyli0thoracic duct,
jugulosubcla
vian duct
intercost
al spaceand
posterol
ateralthoracic
wall
usually two
nodes occurin each
intercostal
space
internal iliac
nodes
along the
internal iliacvessels
lymphatic vessels
from the pelvicviscera
common
iliac nodes,external
iliac nodes
pelvis,
perineum and
gluteal
region
internal iliac
nodes are 'to / in
number
intestinallymphatic
trunk
left side ofthe
abdominalaorta orbetween the
abdominal
aorta and the
inferior venacava near the
level of the
superiormesenteric
artery
union of efferentlymphatic vessels
from the celiacnodes and superiormesenteric nodes
left lumbartrunk or the
cisternachyli0thoracic duct
largeand
smallintestines
intestinallymph trunk
carries lymphthat is rich infat; drains
into the left
lumbar trunk
+"*&,cisterna chyli
25*& or
right lumbartrunk 5*&
jugular
lymphatictrunk
carotid
sheath inroot of neck
deep cervical nodes left% thoracic
duct near itstermination;
right% right
lymphaticduct or
junction of
head (
neck
jugular trunk
carries mostof the lymph
from the
head andneck
7/23/2019 Lymphatics of the Body
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right
subclavian
and rightinternal
jugular vv.
jugular nodes,
anterior
along the
anteriorjugular vein
lymphatic vessels
from the anteriorinferior part of the
neck
inferior deep
cervicalnodes
skin and
mm. ofthe
anterior
infrahyoid region
of the
neck
anterior
jugular nodesare located
between the
superficiallayer of deep
cervical
fascia and
theinfrahyoid
mm.
jugular nodes,
external
along the
externaljugular v.
lymphatic vessels
from the side of thehead
superior
deepcervical
nodes
inferior
part ofthe ear
and the
parotidregion
there are one
or two nodesin this group
jugulodigastric
node
anterolateral
to internal
jugular v.where it is
crossed byposteriorbelly of the
digastric
superior deep
cervical nodes
inferior deep
cervical
nodes
oral
cavity,
tongue,palatine
tonsil
a member of
the superior
deep cervicalnode group;
importantnode topalpate
during
physical
exam
juguloomohyoi
d node
lateral to
internal
jugular v.
where it iscrossed by
superior
belly ofomohyoid
superior deep
cervical nodes
inferior deep
cervical
nodes
subment
al region
and tip
oftongue;
head (
neckabove
this
level
an important
node to
examine in
cases of oralcancer
caused by
use oftobacco
products
juxtavisceralnodes
adjacent tothe cervical
cervical viscera superiordeep
esophagus,
four groupsof
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viscera cervical
nodes,
inferior deepcervical
nodes
larynx,
trachea
andthyroid
gland
juxtavisceral
nodes are
recogni$ed%infrahyoid,
prelaryngeal,
pretrachealand
paratracheal
lateral aortic
nodes
along the
inferior venacava and
abdominal
aorta from
the aorticbifurcation
to the aortic
hiatus of thediaphragm
common iliac
nodes; lymphaticvessels from the
posterior
abdominal wall and
viscera
efferents
form onelumbar
trunk on
each side
lower
limb;pelvic
organs;
perineu
m;anterior
and
posteriorabdomin
al wall;
kidney;supraren
al gland;
respirato
rydiaphrag
m
also known
as% lumbarnodes; the
intestinal
trunk drains
into to theleft lumbar
trunk; the
lumbartrunks unite
to form the
thoracicduct0cisterna
chyli
lateral axillarynodes along thedistalaxillary v.
cubital nodes;lymphatic vesselsof the arm
centralaxillarynodes,
apical
axillarynodes
upperlimb lateralaxillarynodes
become
inflamedduring upper
limb
infections;also known
as% brachial
nodes
left gastricnodes
on the lessercurvature of
the stomach,
along thecourse of the
left gastric
vessels
lymphatic vesselsfrom the lesser
curvature of the
stomach
celiac nodes lessercurvatur
e of the
stomach
left gastricnodes are 1"
to 2" in
number
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left gastro!
omental nodes
on the
greater
curvature ofthe stomach,
along the left
gastro!omental
vessels
lymphatic vessels
from the greater
curvature of thestomach
splenic
nodes
left half
of the
greatercurvatur
e of the
stomach
left gastro!
omental
nodes are 1or 2 in
number
lumbar nodes along the
inferior venacava and
abdominal
aorta from
the aorticbifurcation
to the aortic
hiatus of thediaphragm
common iliac
nodes; lymphaticvessels from the
posterior
abdominal wall and
viscera
efferents
form onelumbar
trunk on
each side
lower
limb;pelvic
organs;
perineu
m;anterior
and
posteriorabdomin
al wall;
kidney;supraren
al gland;
respirato
rydiaphrag
m
also known
as% lateralaortic nodes;
the intestinal
trunk drains
into to theleft lumbar
trunk; the
lumbartrunks unite
to form the
thoracicduct0cisterna
chyli
lumbar trunk between thelumbarvertebral
bodies and
inferior venacava right&
or aorta left&
at the upperend of the
lumbar chain
of nodes
lumbar lateralaortic& nodes; theintestinal trunk
joins the left
lumbar trunk
thoracicduct0cisternachyli
leftlumbartrunk !
left side
of thebody
below
therespirato
ry
diaphrag
m, gut;right
lumbar
trunk !right
side of
bodybelow
lumbartrunks uniteto form the
lower end of
the thoracicduct; an
enlargement
of the lowerend of the
thoracic duct
called the
cisternachyli& occurs
in about 25*
ofindividuals,
and when it
is present,the lumbar
7/23/2019 Lymphatics of the Body
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the
diaphrag
m
trunks drain
into it
mediastinalnodes, anterior
along thecourse of the
brachiocepha
lic vesselsand aorta
lymphatic vesselsfrom the anterior
mediastinum and
middlemediastinum
bronchomediastinal
trunk
thymus,anterior
respirato
rydiaphrag
m,
pericardium, part
of the
heart
anteriormediastinal
nodes are
from 2 to 5in number
mediastinalnodes,
posterior
along a$ygossystem of
veins andesophagus
viscera of theposterior
mediastinum andchest wall
thoracicduct,
inferiortracheobron
chial nodes,superior
tracheobron
chial nodes
posteriormediasti
num,posterior
aspect ofthe heart
and
pericardium,
posterior
part ofthe
respirato
rydiaphragm
posteriormediastinal
nodes drainprimarily to
the thoracicduct
mesenteric
nodes
along the
vasa recta
and branchesof the
superior
mesenteric a.between the
leaves of
peritoneumforming the
mesentery
peripheral nodes
located along the
attachment of themesentery
superior
mesenteric
nodes
small
intestine
mesenteric
nodes may
number asmany as 2"";
an important
node groupin cases of
intestinal
cancer
mesenteric
nodes, inferior
around the
root of theinferior
mesenteric a.
peripheral nodes
located along themarginal a.
lumbar
chain ofnodes,
superior
distal
10# ofthe
transvers
inferior
mesentericnodes may
number as
7/23/2019 Lymphatics of the Body
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mesenteric
nodes
e colon,
descendi
ngcolon,
sigmoid
colon,rectum
high as ";
an important
node groupin cases of
cancer of the
colon andrectum
mesenteric
nodes, superior
along the
course of the
superiormesenteric a.
mesenteric nodes,
ileocolic nodes,
right colic nodes,middle colic nodes
celiac
nodes,
intestinallymph trunk
gut and
viscera
suppliedby the
superior
mesenter
ic a.
superior
mesenteric
nodes areimportant in
the spread of
cancer from
the small andlarge
intestine
middle colic
nodes
along the
course of themiddle colic
vessels
peripheral nodes
located along theattachment of the
mesentery
superior
mesentericnodes
transvers
e colon
middle colic
nodes areapproximatel
y '" in
number
occipital nodes superiornuchal line,
along the
course of theoccipital a.
and v.
lymphatic vesselsfrom the posterior
head and neck
accessorynodes
occipitalpart of
the scalp
and thesuperior
neck
occipitalnodes are 2
or # nodes
locatedbetween the
attachmentsof thesternocleido
mastoid m.
and the
trape$ius m.
pancreaticoduo
denal nodes
along the
pancreaticod
uodenal
arcade ofvessels
lymphatic vessels
from the duodenum
and pancreas
pyloric
nodes
duodenu
m and
head of
thepancreas
lymph from
the pancreas
is drained in
threedifferent
directions%
pancreaticoduodenal
nodes,
pancreaticosplenic nodes,
superior
7/23/2019 Lymphatics of the Body
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mesenteric
nodes
pancreaticospl
enic nodes
along the
splenicvessels
lymphatic vessels
from the pancreasand greater
curvature of the
stomach
celiac nodes neck,
bodyand tail
of the
pancreas; left
half of
thegreater
curvatur
e of the
stomach
lymph from
the pancreasis drained in
three
differentdirections%
pandreaticod
uodenalnodes,
pancreaticos
plenic nodes,
superiormesenteric
nodes
paracardial
nodes
around the
esophagogastric junction
lymphatic vessels
of the fundus andcardia of the
stomach
left gastric
nodes
fundus
andcardia of
the
stomach
paracardial
nodes are 5or in
number
pararectalnodes
along thecourse of the
superior
rectal vessels
lymphatic vesselsfrom the rectum
and anal canal
inferiormesenteric
nodes
rectumand anal
canal
pararectalnodes are
small lymph
nodes thatare not well
locali$ed
parasternal
nodes
lateral border
of sternum,along the
course of the
internalthoracic
vessels
anterior phrenic
nodes, lymphaticvessels from the
anterior thoracic
wall
larger
lymphaticvessels in
the root of
the neck
medial
side ofthe
mammar
y gland;medial
part of
the
anteriorchest
wall and
muscles
parasternal
nodesconstitute an
important
drainagepattern in
cases of
cancer of the
mammarygland; one or
two
parasternalnodes may
be found in
the anteriorend of
intercostal
7/23/2019 Lymphatics of the Body
20/30
spaces 1!;
also known
as% sternalnodes
paratracheal
nodes
coursing
along the
lateralsurface of
the trachea
andesophagus
superior
tracheobronchial
nodes
bronchomed
iastinal
trunk
lungs,
trachea,
upperesophag
us, the
part ofthe
larynx
below
thevocal
folds
paratracheal
nodes are an
importantgroup of
nodes in
cases ofpulmonary
infection or
lung cancer;
also knownas% tracheal
nodes
parotid nodes,
deep
on the lateral
side of thepharyngeal
wall, deep to
the parotidgland
lymphatic vessels
from the ear
superior
deepcervical
nodes
external
acousticmeatus,
auditory
tube,middle
ear
deep parotid
nodes arepart of the
deep cervical
chain ofnodes
parotid nodes,
superficial
superficial to
the parotidgland and
also deep tothe parotidfascia
anterior auricular
nodes
superior
deepcervical
nodes
anterior
surfaceof the
ear andexternalacoustic
meatus;
temporal
andfrontal
regions;
eyelids,lacrimal
gland
cheekand nose
superficial
parotid nodesare up to 1"
in numberand may belocated
superficial or
deep to the
parotid fascia
pectoral nodes along the
lateral border
of thepectoralis
major m.
lymphatic vessels
from the mammary
gland andanterolateral
thoracic wall
central
axillary
nodes
anterolat
eral
thoracicwall and
muscles;
an important
group of
nodes toexamine
during a
7/23/2019 Lymphatics of the Body
21/30
along the
course of the
lateralthoracic
vessels
most of
the
mammary gland
breast
physical
exam; alsoknown as%
anterior
axillarynodes
phrenic nodes on the
thoracic
surface ofthe
respiratory
diaphragm
lymphatic vessels
from the
diaphragm, liverand thoracic wall
lumbar
nodes,
posteriormediastinal
nodes
superior
surface
of theliver,
respirato
ry
diaphragm
phrenic
nodes drain
twostructures
that are very
closely
related indevelopment
al origin ! the
liver anddiaphragm
septum
transversum&; three
subgroups of
phrenic
nodes arerecogni$ed%
anterior,
middle and
posterior
popliteal nodes in the
popliteal
fossa alongthe popliteal
vessels
lymphatic vessels
that accompany the
anterior tibial ,posterior tibial and
fibular vessels
deep and
superficial
inguinalnodes
leg and
foot
5 or nodes
located in the
fat of thepopliteal
fossa
posterior
mediastinalnodes
along a$ygos
system ofveins and
esophagus
viscera of the
posteriormediastinum and
chest wall
thoracic
duct,inferior
tracheobron
chial nodes,superior
tracheobron
chial nodes
posterior
mediastinum,
posterior
aspect ofthe heart
and
pericardium,
posterior
part of
the
posterior
mediastinalnodes drain
primarily to
the thoracicduct
7/23/2019 Lymphatics of the Body
22/30
respirato
ry
diaphragm
pulmonary
nodes
within the
lung
parenchyma
lymphatic vessels
from the
parenchyma of thelung
bronchopul
monary
hilar& nodes
lung
parench
yma,bronchia
l tree
withinthe
lungs
pulmonary
nodes are
located alongthe larger
bronchi of
the lung
pyloric nodes near the
terminationof the
gastroduodenal a.
pancreaticoduodena
l nodes
hepatic
nodes
head of
pancreasand
duodenum; right
half ofgreater
curvatur
e ofstomach
pyloric nodes
are to / innumber
retroauricular
nodes
posterior to
the ear
lymphatic vessels
from the ear and
side of the head
superior
deep
cervicalnodes
scalp
overlyin
g theposterior
parietalregion;skin of
the
posterior
surfaceof the
ear
retroauricular
nodes are 1
or 2 nodeslocated at the
insertion ofthesternocleido
mastoid m.
retropharyngea
l nodes
posterior to
pharynx inthe
retropharyng
eal space
lymphatic vessels
from the nasal andpharyngeal regions
superior
deepcervical
nodes
nasal
fossae,paranasa
l
sinuses,hard
palate,
softpalate,
middle
retropharyng
eal nodes areone or two in
number; they
are part ofthe deep
cervical
chain ofnodes
7/23/2019 Lymphatics of the Body
23/30
ear,
orophary
nx
right colicnodes
along thecourse of the
right colic
vessels
peripheral nodeslocated along the
marginal a.
superiormesenteric
nodes
ascending colon,
cecum
right colicnodes are
approximatel
y +" innumber
right gastric
nodes
on the lesser
curvature of
the stomach,along the
course of the
right gastricvessels
lymphatic vessels
from the lesser
curvature of thestomach
celiac nodes lesser
curvatur
e of thestomach
right gastric
nodes are 2
to # innumber
right gastro!omental nodes
on thegreater
curvature ofthe stomach,
along the
right gastro!
omentalvessels
lymphatic vesselsfrom the greater
curvature of thestomach
pyloricnodes
greatercurvatur
e of thestomach
right gastro!omental
nodes are to 12 in
number
right
lymphatic duct
root of neck
on the right
side
formed by the
union of the right
jugular trunk,theright subclavian
trunk, and the right
bronchomediastinaltrunk
junction of
the right
subclavianv. and right
internal
jugular v.
right
half of
the headand
neck;
rightupper
limb;
rightside of
the chest
right
lymphatic
duct has avalve near its
termination;
the threetrunks that
form right
lymphaticduct may
drain
separately
into thevenous
system
sacral nodes along the
course of thelateral sacral
aa.
lymphatic vessels
from the pelvicviscera
common
iliac nodes
prostate
gland,uterus,
vagina,
rectum,posterior
sacral nodes
are 2 or # innumber
7/23/2019 Lymphatics of the Body
24/30
pelvic
wall
spleen in the
abdominalcavity below
the left dome
of thediaphragm,
anterior to
the leftkidney
splenic brs. of the
splenic a.
splenic v. filters
blood byphagocy
tosis;
produces ( 3!
lymphoc
ytes
spleen
containsnodules of
lymphatic
tissue
sternal nodes lateral border
of sternum,
along thecourse of the
internalthoracic
vessels
anterior phrenic
nodes, lymphatic
vessels from theanterior thoracic
wall
larger
lymphatic
vessels inthe root of
the neck
medial
side of
themammar
y gland;medial
part ofthe
anterior
chestwall and
muscles
sternal nodes
constitute an
importantdrainage
pattern incases of
cancer of themammary
gland; one or
two sternalnodes may
be found in
the anteriorend of
intercostal
spaces 1!;also knownas%
parasternal
nodes
subclaviantrunk
along thecourse of the
subclavian v.
apical axillarynodes;
infraclavicular
nodes
drains intothe junction
of the
internaljugular v.
and the
subclavianv.
upperlimb,
most of
breast,anterolat
eral
chestwall
subclavianlymphatic
trunk
occasionallydrains into
the thoracic
duct on theleft side; on
the right it
occasionallydrains into
the right
lymphatic
duct
7/23/2019 Lymphatics of the Body
25/30
submandibular
nodes
along the
inferior
border of thesubmandibul
ar gland
submental nodes;
facial nodes;
lymphatic vesselsfrom the
submandibular and
sublingual regions
superior
deep
cervicalnodes;
juguloomoh
yoid node
anterior
part of
tongue,lower
lip, floor
of themouth,
nose,
cheeks,
chin,gums
and
lowerincisor
teeth,
lower
surfaceof palate
submandibul
ar nodes may
be within thesheath of the
submandibul
ar gland; thisgroup
consists of
from # to
nodes
submental
nodes
under the
mandible onthe
mylohyoid
m.
lymphatic vessels
from the lower faceand chin
submandibu
lar nodes,juguloomoh
yoid node
tip of the
tongue,lower
lip, floor
of the
mouth,chin,
gums
and
lowerincisor
teeth
submental
nodes areimportant
nodes to
examine in
cases of oralcancer
caused by the
use of
tobaccoproducts
subscapularaxillary nodes
along thecourse of the
subscapular
vessels
lymphatic vesselsfrom the skin of the
back and back of
the neck; lymphaticvessels from the
muscles of the
scapular region
centralaxillary
nodes
skin ofthe back
and back
of theneck;
muscles
of the
scapularand
subscap
ularregions
subscapularaxillary
nodes are 5
or innumber; also
known as%
posterior
axillarynodes
superficial
cervical nodes
in superficial
fascia and
along
lymphatic vessels
from superficial
structures in head
varies by
group;
ultimate
head (
neck
several
groups are
designated
7/23/2019 Lymphatics of the Body
26/30
superficial
vessels of
the head (neck
( neck destination
is the
jugulartrunk
by location%
occipital,
retroauricular, anterior
auricular,
superficialparotid,
facial,
submental,
submandibular, external
jugular,
anteriorjugular
superficial
inguinal nodes
in the
superficial
fasciaparallel to
the inguinal
ligament andalong the
terminal part
of the greater
saphenous v.
lymphatic vessels
from the superficial
lower limb,superficial
abdominal wall,
perineum
external
iliac nodes;
deepinguinal
nodes
lower
abdomin
al wall;external
genitalia
;superfici
al parts
of the
lowerlimb
superficial
inguinal
nodes are 12!2" in
number; they
becomeinflamed
during
infections of
the lowerlimb; they
may become
inflamed
duringinfections of
the externalgenitalia
superficial
parotid nodes
superficial to
the parotid
gland andalso deep to
the parotid
fascia
anterior auricular
nodes
superior
deep
cervicalnodes
anterior
surface
of theear and
external
acoustic
meatus;temporal
and
frontalregions;
eyelids,
lacrimalgland
superficial
parotid nodes
are up to 1"in number
and may be
located
superficial ordeep to the
parotid fascia
7/23/2019 Lymphatics of the Body
27/30
cheek
and nose
superior deep
cervical nodes
around the
internaljugular v.,
superior to
the crossingof the
omohyoid m.
numerous node
groups of the headand upper neck,
including
retropharyngealnodes and deep
parotid nodes
inferior deep
cervicalnodes
head and
thesuperior
part of
the neck
the superior
deep cervicalnode group
has many
large nodes;the
jugulodigastr
ic andjuguloomohy
oid nodes are
members of
this group
superior
mesentericnodes
along the
course of thesuperior
mesenteric a.
mesenteric nodes,
ileocolic nodes,right colic nodes,
middle colic nodes
celiac
nodes,intestinal
lymph trunk
gut and
viscerasupplied
by thesuperior
mesenter
ic a.
superior
mesentericnodes are
important inthe spread of
cancer from
the small andlarge
intestine
superior
tracheobronchial nodes
superolateral
to thetracheal
bifurcation
bronchopulmonary
hilar& nodes
paratracheal
tracheal&nodes
lungs,
middlemediasti
num,posteriormediasti
num
inferior
tracheobronchial nodes
drain lymphfrom thelower lobe of
the left lung
to the right
superiortracheobronc
hial nodes
supraclavicular
nodes
in and
aroundcarotid
sheath below
level ofomohyoid
superior deep
cervical nodes,transverse cervical
nodes, spinal
accessory nodes
efferents
form thejugular
lymphatic
trunk
head and
neck
also known
as% inferiordeep cervical
nodes
thoracic duct between the
esophagus
anteriorlyand the
formed by the
union of the lumbar
lymph trunks,sometimes dilated
junction of
the left
subclavianv. and the
all of the
body
andlimbs
thoracic duct
is the largest
lymphaticvessel; it
7/23/2019 Lymphatics of the Body
28/30
thoracic
vertebral
bodiesposteriorly
to form a cisterna
chyli
left internal
jugular v.
below
the
respiratory
diaphrag
m; theleft side
of the
chest,
leftupper
limb and
the leftside of
the head
and neck
abovethe
diaphrag
m
passes
through the
aortic hiatuson the right
side of aorta;
it swings tothe left side
of the
esophagus at
the '!5intervertebral
disc at the
level of thesternal angle&
thymus root of the
neck and
superior
mediastinumposterior to
sternum
none parasternal
nodes
essential
for
normal
development of
the
immune
systemmaturati
on
thymus
involutes at
puberty and
is mostlyreplaced by a
mass of fat
tonsil, lingual superiorsurface of
the root of
the tongue
lymphatic vesselsof the tongue
superiordeep
cervical
nodes
4guards4the
entrance
of theorophary
nx
lingual tonsilis part of the
tonsillar ring
ofaldeyer&
tonsil, palatine lateral wall
of theoropharynx
between the
palatoglossaland
palatopharyn
geal arches
lymphatic vessels
of the posteriortongue and
palatoglossal0palato
pharyngeal archregion
superior
deepcervical
nodes,
especiallythe
jugulodigast
ric node
4guards4
theentrance
of the
oropharynx
palatine
tonsil is partof the
tonsillar ring
ofaldeyer&
7/23/2019 Lymphatics of the Body
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tonsil,
pharyngeal
roof and
posterior
wall of thenasopharynx
lymphatic vessels
of the wall of the
pharynx
superior
deep
cervicalnodes
4guards4
the
entranceto the
nasophar
ynx
pharyngeal
tonsil is part
of thetonsillar ring
of
aldeyer&;also known
as% adenoids
tonsil, tubal pharyngeal
recess
lymphatic vessels
of the torustubarius and
auditory tube
superior
deepcervical
nodes
4guards4
theentrance
to the
nasophar
ynx
tubal tonsil is
located at thepharyngeal
orifice of the
auditory tube
tracheal nodes coursing
along thelateral
surface ofthe trachea
and
esophagus
superior
tracheobronchialnodes
bronchomed
iastinaltrunk
lungs,
trachea,upper
esophagus, the
part of
thelarynx
below
thevocal
folds
tracheal
nodes are animportant
group ofnodes in
cases of
pulmonaryinfection or
lung cancer;
also knownas%
paratracheal
nodestracheobronchial nodes
along thetrachea,
around the
tracheal
bifurcationand primary
bronchi
lymphatic vesselsfrom the lung
bronchomediastinal
lymph trunk
lungs,visceral
pleura,
bronchi,
thoracicpart of
trachea,
left sideof heart,
esophag
us,posterior
mediasti
num
tracheobronchial nodes
may be
divided into
five groups%paratracheal
tracheal&,
superiortracheobronc
hial, inferior
tracheobronchial,
bronchopulm
onary hilar&,pulmonary
tracheobronchi
al nodes,
inferior to
tracheal
bronchopulmonary
nodes, left side
right
superior
lower
lobes of
left inferior
tracheobronc
7/23/2019 Lymphatics of the Body
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inferior bifurcation inferior
tracheobronchial
nodes drain intoright inferior
tracheobronchial
nodes
tracheobron
chial nodes
the
lungs;
middlemediasti
num;
posteriormediasti
num
hial nodes
drain to the
right side
tracheobronchi
al nodes,superior
superolateral
to thetracheal
bifurcation
bronchopulmonary
hilar& nodes
paratracheal
tracheal&nodes
lungs,
middlemediasti
num,
posterior
mediastinum
inferior
tracheobronchial nodes
drain lymph
from the
lower lobe ofthe left lung
to the right
superiortracheobronc
hial nodes
transverse
cervical nodes
along the
course of thetransverse
cervical
blood vessels
accessory chain of
nodes, sometimesthe apical axillary
nodes
variable%
jugularlymphatic
trunk, right
lymphatictrunk or
thoracic
duct
lateral
part ofthe neck,
anterior
thoracicwall,
mammar
y gland
transverse
cervicalnodes are
approximatel
y 1" innumber and
may drain
directly intothe internaljugular v. or
subclavian v.
Recommended