系統(tǒng)解剖-淋巴系統(tǒng)-英文版Lymphatic-System匯總課件

LymphaticSystem淋巴系統(tǒng)LymphaticSystem淋巴系統(tǒng)1LymphaticSystem淋巴系統(tǒng)AccessorycirculationofthecardiovascularsystemTransportsandfiltersthetissuefluid,produceslymphocytesandparticipatesintheimmuneresponsesLymphaticcapillaryLymphLymphaticSystem淋巴系統(tǒng)Accessory2LymphaticSystem淋巴系統(tǒng)LymphaticnodeHeartArteryCapillariesVeinLymphaticvesselLymphatictrunkLymphaticduct90%Lymphaticcapillary120ml/h10%淋巴lymphCellTissuefluidLymphaticSystem淋巴系統(tǒng)Lymphatic3系統(tǒng)解剖-淋巴系統(tǒng)-英文版Lymphatic-System匯總課件4CompositionoftheLymphaticSystem★L(fēng)ymphaticvessels淋巴管Lymphaticcapillary毛細(xì)淋巴管Lymphaticvessels淋巴管Lymphatictrunks:淋巴干（九條）Lymphaticducts:淋巴導(dǎo)管

thoracicduct胸導(dǎo)管rightlymphaticduck右淋巴導(dǎo)管Lymphatictissue淋巴組織Lymphaticorgan淋巴器官Lymphaticnodes淋巴結(jié)Spleen脾thymus胸腺Tonsil扁桃體CompositionoftheLymphaticS5Lymphaticcapillary毛細(xì)淋巴管BeginblindlyThewalliscomposedofasinglelayerofoverlappingendothelialcellsTheyarenumerousandformcomplexnetworksBefundinalltissueandorgansofthebodyexcept（abscentin）thecentralnervoussystem,theeyeball,theinternalear,theepidermisoftheskin,thecartilage,andtheboneLymphaticcapillary毛細(xì)淋巴管Begin6Lymphaticvessel淋巴管HavevalvesthatgivethemabeadedappearanceTwosetsSuperficialset:lieinthesuperficialfasciaDeepset:runwithbloodvesselsandnervesPassesthroughatleastonelymphnodeandoftenseveralLymphaticvessel淋巴管Havevalve7淋巴干Lymphatictrunk右淋巴導(dǎo)管右頸干右支氣管縱隔干左鎖骨下干胸導(dǎo)管乳糜池左腰干右腰干腸干左頸干右鎖骨下干左支氣管縱隔干★淋巴干Lymphatictrunk左、右頸干jugulartrunk頭頸部左、右支氣管縱隔干bronchomediastinaltrunks

胸腔臟器、部分胸腹壁左、右鎖骨下干subclaviantrunk

上肢、部分胸壁左、右腰干lumbartrunk下肢、盆部、腹腔成對(duì)器官、部分腹壁腸干intestinaltrunk腹腔不成對(duì)臟器淋巴干Lymphatictrunk右淋巴導(dǎo)管右頸干右支氣管8右淋巴導(dǎo)管右頸干右支氣管縱隔干左鎖骨下干胸導(dǎo)管乳糜池左腰干右腰干腸干左頸干右鎖骨下干左支氣管縱隔干右淋巴導(dǎo)管右頸干右支氣管縱隔干左鎖骨下干胸導(dǎo)管乳糜池左腰干右9★Thoracicduct

胸導(dǎo)管

BeginsinfrontoflowerborderofT12asadilatedsac,the

cisternachyli

乳糜池,whichformedbyjoiningofleftandrightlumbartrunksandintestinaltrunkEnterthoraciccavitybypassingthroughtheaortichiatusofthediaphragmandascendsalongonthefrontofthevertebralcolumn,betweenthoracicaortaandazygosveinTravelsupward,veeringtotheleftatthelevelofT5左鎖骨下干胸導(dǎo)管乳糜池左腰干右腰干腸干左頸干左支氣管縱隔干★Thoracicduct胸導(dǎo)管

Beginsin10左鎖骨下干胸導(dǎo)管乳糜池左腰干腸干左頸干★Thoracicduct

胸導(dǎo)管

Attheroofoftheneck,itturnslaterallyandarchesforwardsanddescendstoendbyenteringtheleftvenousangleJustbeforetermination,itreceivestheleftjugular,subclavianandbronchomediastinaltrunksDrainslymphfromlowerlimbs,pelviccavity,abdominalcavity,leftsideofthorax,andleftsideofthehead,neckandleftupperlimb左支氣管縱隔干右腰干左鎖骨下干胸導(dǎo)管乳糜池左腰干腸干左頸干★Thoracic11★Rightlymphaticduct右淋巴導(dǎo)管Formedbyunionofrightjugular,subclavian,andbronchomediastinaltrunksEndsbyenteringtherightvenousangleReceiveslymphfromrighthalfofhead,neck,thoraxandrightupperlimb★Rightlymphaticduct右淋巴導(dǎo)管Fo12lymphnode淋巴結(jié)Smallovalorbean-shapedbodesAfferentvesselsenterthenodeonitsconvexsurface,andafferentvesselsleavethenodeatitsconcavesurface－thehilumArrangedingroups,alongthebloodvesselsTwosetsSuperficialset:lieinthesuperficialfascia

Deepset:liewithbloodvesselsRegionallymphnodes

局部淋巴結(jié)lymphnode淋巴結(jié)Smallovalorbe13Lymphnodesofthehead

LocatedatjunctionofheadandneckConsistofOccipitallymphnodes枕淋巴結(jié)Mastoidlymphnodes乳突淋巴結(jié)Parotidlymphnodes

腮腺淋巴結(jié)★

Submandibularlymphnodes

下頜下淋巴結(jié)

liesnearthesubmandibulargland,receivelymphaticvesselsfromtheface,noseandmouthsubmentallymphnodes頦下淋巴結(jié)Draininto

deepcervicallymphnodes頸深淋巴結(jié)LymphnodesoftheheadLocate14LymphnodesoftheneckAnteriorcervicalln.頸前淋巴結(jié)Superficialanteriorcervicalln.頸前淺淋巴結(jié)Deepanteriorcervicalln.頸前深淋巴結(jié)Prelaryngeallymphnodes喉前淋巴結(jié)Thyroidlymphnodes甲狀腺淋巴結(jié)Pretracheallymphnodes氣管前淋巴結(jié)Paratracheallymphnodes氣管旁淋巴結(jié)LymphnodesoftheneckAnterio15LymphnodesoftheneckLateralcervicalln.頸外側(cè)淋巴結(jié)

Superficiallateralcervicalln.頸外側(cè)淺淋巴結(jié)LiealongtheexternaljugularveinDeeplateralcervicalln.頸外側(cè)深淋巴結(jié)ExtendalongtheinternaljugularveinLymphnodesoftheneckLateral16LymphnodesoftheneckDeeplateralcervicalln.

頸外側(cè)深淋巴結(jié)Extendalongtheinternaljugularveinfromthebaseofskulltotherootofnecksuperiordeeplateralcervicalln.頸外側(cè)上深淋巴結(jié)inferiordeeplateralcervicalln.頸外側(cè)下深淋巴結(jié)

Efferentvesselsformthejugulartrunk頸干Receivelymphaticvesselsfromhead,neck,tongue,larynx,cervicalpartsofesophagusandtrachea,thyroidgland,upperpartsofthethoracicwallandbreastLymphnodesoftheneckDeepla17LymphnodesoftheneckSuperiordeeplateralcervicalln.

頸外側(cè)上深淋巴結(jié)Jugulodigastricln.頸內(nèi)靜脈二腹肌淋巴結(jié)

LiesatthejunctionofposteriorbellyofdigastricandinternaljugularveinDrainthenasopharynx,palatinetonsilandrootoftougueJuguloomohyoidln.頸內(nèi)靜脈肩胛舌骨肌淋巴結(jié)

LiesatthejunctionoftheintermediatetendonofomohyoidandinternaljugularveinDraintheapexoftongueSpinalaccessoryln.副神經(jīng)淋巴結(jié)LymphnodesoftheneckSuperio18LymphnodesoftheneckInferiordeeplateralcervicalln.頸外側(cè)下深淋巴結(jié)Supraclavicularlymphnodes

鎖骨上淋巴結(jié)

Liealongtransversecervicala.&v.Scaleneln.

斜角肌淋巴結(jié)Efferentvesselsformthejugulartrunk

頸干LeftjugulartrunkjoinsthethoracicductRightjugulartrunkjointstherightlymphaticductLymphnodesoftheneckInferio19LymphnodesoftheneckRetrophrangealln.

咽后淋巴結(jié)LyingverticallybehindthepharynxLymphnodesoftheneck20Lymphnodesofupperlimb

Cubitallymphnode

肘淋巴結(jié)liesabovemedialepicondyleofhumerusInfraclavicularnodes

鎖骨下淋巴結(jié)

Axillarylymphnode

腋淋巴結(jié)Lymphnodesofupperlimb

Cubi21★

AxillarylymphnodesAxillarylymphnodesvaryinsizefromapin-headtoalargebean.Theyarearrangedinfivegroups胸肌淋巴結(jié)Pectoralln.外側(cè)淋巴結(jié)Lateralln.肩胛下淋巴結(jié)Subscapularlymphnode中央淋巴結(jié)Centralln.尖淋巴結(jié)Apicalln.尖淋巴結(jié)中央淋巴結(jié)外側(cè)淋巴結(jié)肩胛下淋巴結(jié)胸肌淋巴結(jié)★AxillarylymphnodesAxillary22AxillarylymphnodesPectorallymphnodes

胸肌淋巴結(jié)LyingalongthelowerborderofpectoralisminorbehindthepectoralismajorReceivelymphvesselsfromthelateralquadrantsofthebreastandsuperficialvesselsfromtheanterolateralabdominalwallabovetheleveloftheumbilicusAxillarylymphnodesPectorall23AxillarylymphnodesLaterallymphnodes

外側(cè)淋巴結(jié)AlongmedialsidedistalpartaxillaryveinReceiveslymphfromupperlimbAxillarylymphnodesLaterally24AxillarylymphnodesSubscapularlymphnode

肩胛下淋巴結(jié)Lyingalongsubscapularvessels,infrontofthesubscapularisReceivesuperficiallymphvesselsfromtheback,downasfarastheleveloftheiliaccrestsEfferentsabovethreegroupspasstocentrallymphnodeAxillarylymphnodesSubscapula25AxillarylymphnodesCentrallymphnode

中央淋巴結(jié)LyinginthecenteroftheaxillaintheaxillaryfatReceivelymphfromtheabovethreenodesEfferentspasstoapicallymphnodeAxillarylymphnodesCentrally26AxillarylymphnodesApicallymphnode

尖淋巴結(jié)LyingattheapexoftheaxillaatthelateralborderofthefistribReceivelymphtheefferentlymphvesselsfromalltheotheraxillarynodesandsuperiorregionofbreastTheefferentsoftheapicalnodesformthesubclaviantrunkLeftsubclaviantrunkjoinsthethoracicduct

RightsubclaviantrunkjointstherightlymphaticductAxillarylymphnodesApicallym27AxillarylymphnodesLateralln.Pectoralln.Subscapularln.Centralln.Apicalln.SubclaviantrunkAxillarylymphnodesLateralln28LymphaticdrainageofthoraxThelymphaticdrainageofthoracicwallToaxillarylymphnodesToparasternallymphnodes(alonginternalthoracicvessels)TointercostalslymphnodesfromdeeperstructuresLymphaticdrainageofthoraxTh29lymphnodesofthethoraxlymphnodesofthethoracicwallParasternalln.胸骨旁淋巴結(jié)Intercostalln.肋間淋巴結(jié)Superiorphrenicln.膈上淋巴結(jié)lymphnodesofthethoraxlymph30lymphnodesofthethoraxPulmonaryln.

肺淋巴結(jié)LieintheanglesofbifurcationofbranchinglobarbronchiBronchopulmonaryhilarln.

支氣管肺門(mén)淋巴結(jié)LieinthehilusofthelungTracheobronchialln.

氣管支氣管淋巴結(jié)Situatedaboveorbelowthebifurcationoftrachea★Paratrachealln.

氣管旁淋巴結(jié)AlongeachsideofthetrachealymphnodesofthethoraxPulmo31lymphnodesofthethorax★Anteriormediastinallymphnode縱隔前淋巴結(jié)

LiesanteriortothelargebloodvesselsofthoraciccavityandpericardiumTheefferentsunitewiththoseofparatracheallymphnodesandparasternallymphnodestoformtherightandleftbronchomediastinaltrunks

支氣管縱隔干Theleftbronchomediastinaltrunkterminatesinthoracicduct,andrightintherightlymphticductPosteriormediastinallymphnodes縱隔后淋巴結(jié)

Liealongtheesophagusandthoracicaortalymphnodesofthethorax★Ant32LymphnodesoflowerlimbPoplitealln.

腘淋巴結(jié)EmbeddedinthefattyconnectivetissueofpoplitealfossaReceivesuperficiallymphaticvesselsfromposterolateralpartofcalf,andfromdeeplymphaticvesselsaccompanyinganteriorandposteriortibiala.Efferentspasstothedeepinguinalln.★inguinallymphnodes

腹股溝淋巴結(jié)Superficialinguinallymphnodes

腹股溝淺淋巴結(jié)Deepinguinallymphnodes

腹股溝深淋巴結(jié)LymphnodesoflowerlimbPopli33Lymphnodesoflowerlimb★Superficialinguinallymphnodes腹股溝淺淋巴結(jié)Superiorgroup

LiesjustdistaltotheinguinalligamentReceivelymphvesselsfromanteriorabdominalwallbelowumbilicus,glutealregion,perinealregion,externalgenitalorgansInferiorgroupLiesverticalalongtheterminalgreatsaphenousv.Receivesallsuperficiallymphvesselsoflowerlimb,exceptforthosefromtheposterolateralpartofcalfEfferentvesselsdrainintothedeepinguinalln.orexternaliliacln.Lymphnodesoflowerlimb★Sup34Lymphnodesoflowerlimb★Deepinguinallymphnodes腹股溝深淋巴結(jié)Liemedialtothefemoralv.Receivedeeplymphvesselsoflowerlimb,perinealregion,andefferentvesselsfromthesuperficialinguinalln.Drainintotheexternaliliacln.Lymphnodesoflowerlimb★Dee35Lymphangiogramshowingtheinguinallymphvesselsandnodes.Lymphangiogramshowingtheing36LymphnodesofpelvisInternaliliacln.

髂內(nèi)淋巴結(jié)SurroundinternaliliacvesselsReceiveafferentsfrompelvicviscera,perineum,buttockandbackofthighExternaliliacln.

髂外淋巴結(jié)LiealongexternaliliacarteryReceiveafferentsfromlowerlimbandsomepartsofpelvicvisceraCommoniliacln.

髂總淋巴結(jié)LiealongcommoniliacarteryReceiveafferentsfromalltheabovenodesEfferentpasstolumbarlymphnodeSacrallymphnode

骶淋巴結(jié)LymphnodesofpelvisInternal37Lymphnodesofabdomen

---abdominalwallToaxillarylymphnodefromregionaboveumbilicusTosuperficialinguinallymphnodefromregionbelowumbilicusTolumbarlymphnodefrompostwallofabdomenLymphnodesofabdomen

---a38LymphnodesofabdomenLumbarlymphnodes

腰淋巴結(jié)Lieonposteriorabdominalwall,alongtheabdominalaortaandinferiorvenacavaReceivelymphfromkidneys,suprarenalglands,testes,ovaries,fundusofuterus,ovary,andcommoniliacnodesefferentvesselsformtheRightandleftlumbartrunksLymphnodesofabdomenLumbarl39Lymphnodesofabdomen

---abdominalwall★Unpairedorgans→celiaclymphnodes→

superiormesentericln.→

inferiormesentericln.Pairedorgans→lumbarlymphnodesIntestinaltrunkLymphnodesofabdomen

---a40LymphnodesofabdomenRightandleftgastricln.

胃左、右淋巴結(jié)Liealongthesamevesselsandfinallytotheceliacln.Rightandleftgastroomentalln.

胃網(wǎng)膜左、右淋巴結(jié)Liealongthesamevessels,theformerdrainintosubpyloricln.,thelatterdrainintosplenicln.Suprapyloricandsubpyloricln.幽門(mén)上、下淋巴結(jié)Receivelymphaticsfrompyloricpartandfinallytotheceliacln.LymphnodesofabdomenRightan41LymphnodesofabdomenSplenicln.脾淋巴結(jié)Receivelymphaticsfromfundusandleftthirdofstomach,andfinallytotheceliacln.Hepaticln.

肝淋巴結(jié)Pancreaticln.胰淋巴結(jié)★Celiaclymphnodes

腹腔淋巴結(jié)Situatedaroundtheceliactrunk

LymphnodesofabdomenSplenic42Lymphnodesofabdomen★Superiormesentericlymphnode

腸系膜上淋巴結(jié)Situatedaroundsuperiormesenterica.★Inferiormesentericlymphnode

腸系膜下淋巴結(jié)Situatedaroundinferiormesenterica.★Intestinaltrunk

腸干Formedbyefferentvesselofceliac,superiorandinferiormesentericlymphnodesLymphnodesofabdomen★Superi43Lymphangiogramshowingthelateralaorticandproximaliliaclymphnodes.Theradiographwastakenapproximately24hoursaftertheinjectionofcontrastmediumintothelymphaticsofthedorsumofthefoot.Intravenouscontrastopacifiestherenalcollectingsystem.Lymphangiogramshowingthelat44上肢尖淋巴結(jié)鎖骨下干頭頸頸外側(cè)深淋巴結(jié)頸干胸部氣管旁淋巴結(jié)縱隔前淋巴結(jié)胸骨旁淋巴結(jié)支氣管縱隔干

＜左右＜＜左右左右腹部不成對(duì)臟器腹腔淋巴結(jié)腸系膜上淋巴結(jié)腸系膜下淋巴結(jié)腸干腹部成對(duì)臟器腰淋巴結(jié)腰干乳糜池胸導(dǎo)管右淋巴導(dǎo)管左靜脈角右靜脈角靜脈盆髂內(nèi)淋巴結(jié)髂總淋巴結(jié)下肢髂外淋巴結(jié)左右上肢尖淋巴結(jié)鎖骨下干頭頸頸外側(cè)深淋巴結(jié)頸干胸部氣管旁淋巴結(jié)支45LymphdrainageofthebreastLateralandcentralparts--

PectoralLn.Superiorpart--ApicalLn.andSupraclavicularLn.

MedialpartDeep--parasternalLn.Superficial--totheoppositesideMedialandinferiorparts–

tolymphaticofliverviatheseofabdomenanddiaphragm

LymphdrainageofthebreastLa46Lymphedema（elephantiasis）filariidBreastcancer(afterLNclearance)Lymphedema（elephantiasis）fila47filariidfilariid48filariidfilariid49Spleen脾GeneralThelargestsinglemassoflymphoidtissueinthebodyReddishincolorProduce,storeanddestroythebloodcell,andparticipiteintheimmuneresponses★L(fēng)ocation:liesinthelefthypochondriacregion(betweenstomachanddiaphragm)deeptothe9thto11thribitslongaxiscorrespondsroughlytothe10thribItslowerpoleextendsforwardonlyasfarasthemidlineandcannotbepalpatedonclinicalexaminationSpleen脾General50Spleen脾★FeaturesTwosurfacesDiaphragmatic:smooth,convexVisceral:concave,hilumofspleenTwoextremities

Anterior－widerPosterior－rounderTwoborder

Superior－h(huán)as2-3

splenicnotch脾切跡,whichserveasalandmarkonpalpationwhenitisenlarge;normallyitisnotpalpableInferior－rounderSpleen脾★Features51PeritonealconnectionsofthespleenseenonCTscan.TheperitonealligamentscontainlowattenuationfatonCT.TheposteriorconnectionisthesplenorenalligamentPeritonealconnectionsofthe52思考題1.淋巴系由哪幾部分組成?2.全身有哪些淋巴干？各匯入什么淋巴導(dǎo)管？3.右淋巴導(dǎo)管的組成和注入部位？4.乳糜池如何形成？位于何處？5.試述胸導(dǎo)管的起始、行程和注入部位。6.腋淋巴結(jié)分為哪幾群?7.簡(jiǎn)述乳房的淋巴回流。8.試述脾的形態(tài)和位置思考題1.淋巴系由哪幾部分組成?53掌握淋巴系統(tǒng)的組成。掌握全身九條淋巴干的名稱、來(lái)源、收納范圍

及注流關(guān)系。掌握右淋巴導(dǎo)管與胸導(dǎo)管的合成、注入部位及引流范圍

。掌握下頜下淋巴結(jié)、頸外側(cè)淺淋巴結(jié)和頸外側(cè)深淋巴結(jié)的位置及引流范圍。

掌握腋淋巴結(jié)的分群、各群的位置及引流范圍

。掌握支氣管肺淋巴結(jié)、氣管旁淋巴結(jié)的位置及收納范圍。掌握腰淋巴結(jié)、腹腔淋巴結(jié)、腸系膜上淋巴結(jié)、腸系膜下淋巴結(jié)的位置及引流范圍

掌握腹股溝淺淋巴結(jié)的位置及收納范圍

。掌握脾的形態(tài)、位置

。掌握胸腺的形態(tài)、位置

。掌握淋巴系統(tǒng)的組成。54LymphaticSystem淋巴系統(tǒng)LymphaticSystem淋巴系統(tǒng)55LymphaticSystem淋巴系統(tǒng)AccessorycirculationofthecardiovascularsystemTransportsandfiltersthetissuefluid,produceslymphocytesandparticipatesintheimmuneresponsesLymphaticcapillaryLymphLymphaticSystem淋巴系統(tǒng)Accessory56LymphaticSystem淋巴系統(tǒng)LymphaticnodeHeartArteryCapillariesVeinLymphaticvesselLymphatictrunkLymphaticduct90%Lymphaticcapillary120ml/h10%淋巴lymphCellTissuefluidLymphaticSystem淋巴系統(tǒng)Lymphatic57系統(tǒng)解剖-淋巴系統(tǒng)-英文版Lymphatic-System匯總課件58CompositionoftheLymphaticSystem★L(fēng)ymphaticvessels淋巴管Lymphaticcapillary毛細(xì)淋巴管Lymphaticvessels淋巴管Lymphatictrunks:淋巴干（九條）Lymphaticducts:淋巴導(dǎo)管

thoracicduct胸導(dǎo)管rightlymphaticduck右淋巴導(dǎo)管Lymphatictissue淋巴組織Lymphaticorgan淋巴器官Lymphaticnodes淋巴結(jié)Spleen脾thymus胸腺Tonsil扁桃體CompositionoftheLymphaticS59Lymphaticcapillary毛細(xì)淋巴管BeginblindlyThewalliscomposedofasinglelayerofoverlappingendothelialcellsTheyarenumerousandformcomplexnetworksBefundinalltissueandorgansofthebodyexcept（abscentin）thecentralnervoussystem,theeyeball,theinternalear,theepidermisoftheskin,thecartilage,andtheboneLymphaticcapillary毛細(xì)淋巴管Begin60Lymphaticvessel淋巴管HavevalvesthatgivethemabeadedappearanceTwosetsSuperficialset:lieinthesuperficialfasciaDeepset:runwithbloodvesselsandnervesPassesthroughatleastonelymphnodeandoftenseveralLymphaticvessel淋巴管Havevalve61淋巴干Lymphatictrunk右淋巴導(dǎo)管右頸干右支氣管縱隔干左鎖骨下干胸導(dǎo)管乳糜池左腰干右腰干腸干左頸干右鎖骨下干左支氣管縱隔干★淋巴干Lymphatictrunk左、右頸干jugulartrunk頭頸部左、右支氣管縱隔干bronchomediastinaltrunks

胸腔臟器、部分胸腹壁左、右鎖骨下干subclaviantrunk

上肢、部分胸壁左、右腰干lumbartrunk下肢、盆部、腹腔成對(duì)器官、部分腹壁腸干intestinaltrunk腹腔不成對(duì)臟器淋巴干Lymphatictrunk右淋巴導(dǎo)管右頸干右支氣管62右淋巴導(dǎo)管右頸干右支氣管縱隔干左鎖骨下干胸導(dǎo)管乳糜池左腰干右腰干腸干左頸干右鎖骨下干左支氣管縱隔干右淋巴導(dǎo)管右頸干右支氣管縱隔干左鎖骨下干胸導(dǎo)管乳糜池左腰干右63★Thoracicduct

胸導(dǎo)管

BeginsinfrontoflowerborderofT12asadilatedsac,the

cisternachyli

乳糜池,whichformedbyjoiningofleftandrightlumbartrunksandintestinaltrunkEnterthoraciccavitybypassingthroughtheaortichiatusofthediaphragmandascendsalongonthefrontofthevertebralcolumn,betweenthoracicaortaandazygosveinTravelsupward,veeringtotheleftatthelevelofT5左鎖骨下干胸導(dǎo)管乳糜池左腰干右腰干腸干左頸干左支氣管縱隔干★Thoracicduct胸導(dǎo)管

Beginsin64左鎖骨下干胸導(dǎo)管乳糜池左腰干腸干左頸干★Thoracicduct

胸導(dǎo)管

Attheroofoftheneck,itturnslaterallyandarchesforwardsanddescendstoendbyenteringtheleftvenousangleJustbeforetermination,itreceivestheleftjugular,subclavianandbronchomediastinaltrunksDrainslymphfromlowerlimbs,pelviccavity,abdominalcavity,leftsideofthorax,andleftsideofthehead,neckandleftupperlimb左支氣管縱隔干右腰干左鎖骨下干胸導(dǎo)管乳糜池左腰干腸干左頸干★Thoracic65★Rightlymphaticduct右淋巴導(dǎo)管Formedbyunionofrightjugular,subclavian,andbronchomediastinaltrunksEndsbyenteringtherightvenousangleReceiveslymphfromrighthalfofhead,neck,thoraxandrightupperlimb★Rightlymphaticduct右淋巴導(dǎo)管Fo66lymphnode淋巴結(jié)Smallovalorbean-shapedbodesAfferentvesselsenterthenodeonitsconvexsurface,andafferentvesselsleavethenodeatitsconcavesurface－thehilumArrangedingroups,alongthebloodvesselsTwosetsSuperficialset:lieinthesuperficialfascia

Deepset:liewithbloodvesselsRegionallymphnodes

局部淋巴結(jié)lymphnode淋巴結(jié)Smallovalorbe67Lymphnodesofthehead

LocatedatjunctionofheadandneckConsistofOccipitallymphnodes枕淋巴結(jié)Mastoidlymphnodes乳突淋巴結(jié)Parotidlymphnodes

腮腺淋巴結(jié)★

Submandibularlymphnodes

下頜下淋巴結(jié)

liesnearthesubmandibulargland,receivelymphaticvesselsfromtheface,noseandmouthsubmentallymphnodes頦下淋巴結(jié)Draininto

deepcervicallymphnodes頸深淋巴結(jié)LymphnodesoftheheadLocate68LymphnodesoftheneckAnteriorcervicalln.頸前淋巴結(jié)Superficialanteriorcervicalln.頸前淺淋巴結(jié)Deepanteriorcervicalln.頸前深淋巴結(jié)Prelaryngeallymphnodes喉前淋巴結(jié)Thyroidlymphnodes甲狀腺淋巴結(jié)Pretracheallymphnodes氣管前淋巴結(jié)Paratracheallymphnodes氣管旁淋巴結(jié)LymphnodesoftheneckAnterio69LymphnodesoftheneckLateralcervicalln.頸外側(cè)淋巴結(jié)

Superficiallateralcervicalln.頸外側(cè)淺淋巴結(jié)LiealongtheexternaljugularveinDeeplateralcervicalln.頸外側(cè)深淋巴結(jié)ExtendalongtheinternaljugularveinLymphnodesoftheneckLateral70LymphnodesoftheneckDeeplateralcervicalln.

頸外側(cè)深淋巴結(jié)Extendalongtheinternaljugularveinfromthebaseofskulltotherootofnecksuperiordeeplateralcervicalln.頸外側(cè)上深淋巴結(jié)inferiordeeplateralcervicalln.頸外側(cè)下深淋巴結(jié)

Efferentvesselsformthejugulartrunk頸干Receivelymphaticvesselsfromhead,neck,tongue,larynx,cervicalpartsofesophagusandtrachea,thyroidgland,upperpartsofthethoracicwallandbreastLymphnodesoftheneckDeepla71LymphnodesoftheneckSuperiordeeplateralcervicalln.

頸外側(cè)上深淋巴結(jié)Jugulodigastricln.頸內(nèi)靜脈二腹肌淋巴結(jié)

LiesatthejunctionofposteriorbellyofdigastricandinternaljugularveinDrainthenasopharynx,palatinetonsilandrootoftougueJuguloomohyoidln.頸內(nèi)靜脈肩胛舌骨肌淋巴結(jié)

LiesatthejunctionoftheintermediatetendonofomohyoidandinternaljugularveinDraintheapexoftongueSpinalaccessoryln.副神經(jīng)淋巴結(jié)LymphnodesoftheneckSuperio72LymphnodesoftheneckInferiordeeplateralcervicalln.頸外側(cè)下深淋巴結(jié)Supraclavicularlymphnodes

鎖骨上淋巴結(jié)

Liealongtransversecervicala.&v.Scaleneln.

斜角肌淋巴結(jié)Efferentvesselsformthejugulartrunk

頸干LeftjugulartrunkjoinsthethoracicductRightjugulartrunkjointstherightlymphaticductLymphnodesoftheneckInferio73LymphnodesoftheneckRetrophrangealln.

咽后淋巴結(jié)LyingverticallybehindthepharynxLymphnodesoftheneck74Lymphnodesofupperlimb

Cubitallymphnode

肘淋巴結(jié)liesabovemedialepicondyleofhumerusInfraclavicularnodes

鎖骨下淋巴結(jié)

Axillarylymphnode

腋淋巴結(jié)Lymphnodesofupperlimb

Cubi75★

AxillarylymphnodesAxillarylymphnodesvaryinsizefromapin-headtoalargebean.Theyarearrangedinfivegroups胸肌淋巴結(jié)Pectoralln.外側(cè)淋巴結(jié)Lateralln.肩胛下淋巴結(jié)Subscapularlymphnode中央淋巴結(jié)Centralln.尖淋巴結(jié)Apicalln.尖淋巴結(jié)中央淋巴結(jié)外側(cè)淋巴結(jié)肩胛下淋巴結(jié)胸肌淋巴結(jié)★AxillarylymphnodesAxillary76AxillarylymphnodesPectorallymphnodes

胸肌淋巴結(jié)LyingalongthelowerborderofpectoralisminorbehindthepectoralismajorReceivelymphvesselsfromthelateralquadrantsofthebreastandsuperficialvesselsfromtheanterolateralabdominalwallabovetheleveloftheumbilicusAxillarylymphnodesPectorall77AxillarylymphnodesLaterallymphnodes

外側(cè)淋巴結(jié)AlongmedialsidedistalpartaxillaryveinReceiveslymphfromupperlimbAxillarylymphnodesLaterally78AxillarylymphnodesSubscapularlymphnode

肩胛下淋巴結(jié)Lyingalongsubscapularvessels,infrontofthesubscapularisReceivesuperficiallymphvesselsfromtheback,downasfarastheleveloftheiliaccrestsEfferentsabovethreegroupspasstocentrallymphnodeAxillarylymphnodesSubscapula79AxillarylymphnodesCentrallymphnode

中央淋巴結(jié)LyinginthecenteroftheaxillaintheaxillaryfatReceivelymphfromtheabovethreenodesEfferentspasstoapicallymphnodeAxillarylymphnodesCentrally80AxillarylymphnodesApicallymphnode

尖淋巴結(jié)LyingattheapexoftheaxillaatthelateralborderofthefistribReceivelymphtheefferentlymphvesselsfromalltheotheraxillarynodesandsuperiorregionofbreastTheefferentsoftheapicalnodesformthesubclaviantrunkLeftsubclaviantrunkjoinsthethoracicduct

RightsubclaviantrunkjointstherightlymphaticductAxillarylymphnodesApicallym81AxillarylymphnodesLateralln.Pectoralln.Subscapularln.Centralln.Apicalln.SubclaviantrunkAxillarylymphnodesLateralln82LymphaticdrainageofthoraxThelymphaticdrainageofthoracicwallToaxillarylymphnodesToparasternallymphnodes(alonginternalthoracicvessels)TointercostalslymphnodesfromdeeperstructuresLymphaticdrainageofthoraxTh83lymphnodesofthethoraxlymphnodesofthethoracicwallParasternalln.胸骨旁淋巴結(jié)Intercostalln.肋間淋巴結(jié)Superiorphrenicln.膈上淋巴結(jié)lymphnodesofthethoraxlymph84lymphnodesofthethoraxPulmonaryln.

肺淋巴結(jié)LieintheanglesofbifurcationofbranchinglobarbronchiBronchopulmonaryhilarln.

支氣管肺門(mén)淋巴結(jié)LieinthehilusofthelungTracheobronchialln.

氣管支氣管淋巴結(jié)Situatedaboveorbelowthebifurcationoftrachea★Paratrachealln.

氣管旁淋巴結(jié)AlongeachsideofthetrachealymphnodesofthethoraxPulmo85lymphnodesofthethorax★Anteriormediastinallymphnode縱隔前淋巴結(jié)

LiesanteriortothelargebloodvesselsofthoraciccavityandpericardiumTheefferentsunitewiththoseofparatracheallymphnodesandparasternallymphnodestoformtherightandleftbronchomediastinaltrunks

支氣管縱隔干Theleftbronchomediastinaltrunkterminatesinthoracicduct,andrightintherightlymphticductPosteriormediastinallymphnodes縱隔后淋巴結(jié)

Liealongtheesophagusandthoracicaortalymphnodesofthethorax★Ant86LymphnodesoflowerlimbPoplitealln.

腘淋巴結(jié)EmbeddedinthefattyconnectivetissueofpoplitealfossaReceivesuperficiallymphaticvesselsfromposterolateralpartofcalf,andfromdeeplymphaticvesselsaccompanyinganteriorandposteriortibiala.Efferentspasstothedeepinguinalln.★inguinallymphnodes

腹股溝淋巴結(jié)Superficialinguinallymphnodes

腹股溝淺淋巴結(jié)Deepinguinallymphnodes

腹股溝深淋巴結(jié)LymphnodesoflowerlimbPopli87Lymphnodesoflowerlimb★Superficialinguinallymphnodes腹股溝淺淋巴結(jié)Superiorgroup

LiesjustdistaltotheinguinalligamentReceivelymphvesselsfromanteriorabdominalwallbelowumbilicus,glutealregion,perinealregion,externalgenitalorgansInferiorgroupLiesverticalalongtheterminalgreatsaphenousv.Receivesallsuperficiallymphvesselsoflowerlimb,exceptforthosefromtheposterolateralpartofcalfEfferentvesselsdrainintothedeepinguinalln.orexternaliliacln.Lymphnodesoflowerlimb★Sup88Lymphnodesoflowerlimb★Deepinguinallymphnodes腹股溝深淋巴結(jié)Liemedialtothefemoralv.Receivedeeplymphvesselsoflowerlimb,perinealregion,andefferentvesselsfromthesuperficialinguinalln.Drainintotheexternaliliacln.Lymphnodesoflowerlimb★Dee89Lymphangiogramshowingtheinguinallymphvesselsandnodes.Lymphangiogramshowingtheing90LymphnodesofpelvisInternaliliacln.

髂內(nèi)淋巴結(jié)SurroundinternaliliacvesselsReceiveafferentsfrompelvicviscera,perineum,buttockandbackofthighExternaliliacln.

髂外淋巴結(jié)LiealongexternaliliacarteryReceiveafferentsfromlowerlimbandsomepartsofpelvicvisceraCommoniliacln.

髂總淋巴結(jié)LiealongcommoniliacarteryReceiveafferentsfromalltheabovenodesEfferentpasstolumbarlymphnodeSacrallymphnode

骶淋巴結(jié)LymphnodesofpelvisInternal91Lymphnodesofabdomen

---abdominalwallToaxillarylymphnodefromregionaboveumbilicusTosuperficialinguinallymphnodef