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Department of Neurobiology and Developmental Sciences: Human Structure Module
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  9. Lymphatics of the Thorax

Lymphatics of the Thorax

StructureLocationAfferents fromEfferents toRegions drainedNotes
anterior mediastinal nodesalong the course of the brachiocephalic vessels and aortalymphatic vessels from the anterior mediastinum and middle mediastinumbronchomediastinal trunkthymus, anterior respiratory diaphragm, pericardium, part of the heartanterior mediastinal nodes are from 2 to 5 in number
axillary nodesaxillacubital nodes; lymphatic vessels from the upper limb, thoracic wall and
subscapular region
efferents vessels form the subclavian trunk, some drainage to inferior deep
cervical nodes
upper limb, most of the mammary gland, some of the anterolateral chest wall,
posterior thoracic wall and scapular region
axillary nodes number from 20 to 30 and are organized in five groups based on their position within the axilla: 1) pectoral nodes, along the lateral border of the pectoralis major m.; 2) lateral nodes, located along the distal axillary v.; 3) central nodes, centrally located along axillary v.; 4) subscapular nodes, located along the subscapular v. and its tributaries; 5) apical nodes, located at the apex of axilla
axillary nodes, apical apex of the axillalateral axillary nodes; central axillary nodes; subscapular axillary nodes; pectoral nodes; accessory lymphatic vessels from the mammary gland; lymphatic vessels accompanying the cephalic v. subclavian lymphatic trunk; deep cervical lymph nodesupper limb, most of the mammary gland, some of the anterolateral chest wall, posterior thoracic wall and scapular region
apical axillary nodes are 6- 12 in number; this is the highest node group in the axilla and all other node groups drain through these nodes; a very important group of nodes in cases of metastatic spread of breast cancer; connections to deep cervical nodes may result in spread of breast cancer through the deep neck
axillary nodes, centralin the fat of the axillalateral axillary nodes; pectoral nodes; subscapular nodes; lymphatic vessels from the mammary gland and upper limbapical axillary nodesupper limb, most of the mammary gland, some of the anterolateral chest wall, posterior thoracic wall and scapular regioncentral axillary nodes are 4 or 5 in number; they are involved in cancer of the mammary gland
axillary nodes, lateralalong the distal axillary v.cubital nodes; lymphatic vessels of the armcentral axillary nodes, apical axillary nodesupper limblateral axillary nodes become inflamed during upper limb infections; also known as: brachial nodes
axillary nodes, subscapularalong the course of the subscapular vesselslymphatic vessels from the skin of the back and back of the neck; lymphatic vessels from the muscles of the scapular regioncentral axillary nodesskin of the back and back of the neck; muscles of the scapular and subscapular regionssubscapular axillary nodes are 5 or 6 in number; also known as: posterior axillary nodes
bronchomediastinal trunkalong the course of the brachiocephalic v.union of efferents from the paratracheal nodes, parasternal nodes and anterior mediastinal nodesleft: thoracic duct; right: right lymphatic ductthoracic wall and viscera; medial part of the mammary glandright bronchomediastinal trunk receives lymph from the lower lobe of the left lung; bronchomediastinal trunk may drain directly into the venous system on either side
bronchopulmonary nodeshilum of the lungpulmonary nodestracheobronchial nodeslungbronchopulmonary nodes are also known as: hilar nodes
cisterna chylibetween the abdominal aorta and the inferior vena cava anterior to the body of the L1 or L2 vertebraright and & left lumbar trunks; possibly the intestinal trunkthoracic ductall of the body below the respiratory diaphragm; all of the abdominal and pelvic visceracisterna chyli is an enlargement of the lower end of the thoracic duct; it occurs in about 25% of individuals
hilar nodesat hilum of lungpulmonary nodestracheobronchial nodeslungalso known as: bronchopulmonary nodes
infraclavicular nodesalong the cephalic v. in the deltopectoral groovelymphatic vessels from the superficial upper limbapical axillary nodesskin and superficial fascia of the upper limbinfraclavicular nodes may become inflamed during infections of the superficial tissues of the upper limb
intercostal nodesnear the heads of the ribslymphatic vessels from the intercostal spacecisterna chyli/thoracic duct, jugulosubclavian ductintercostal space and posterolateral thoracic wallusually two nodes occur in each intercostal space
mediastinal nodes, anterioralong the course of the brachiocephalic vessels and aortalymphatic vessels from the anterior mediastinum and middle mediastinumbronchomediastinal trunkthymus, anterior respiratory diaphragm, pericardium, part of the heartanterior mediastinal nodes are from 2 to 5 in number
mediastinal nodes, posterioralong azygos system of veins and esophagusviscera of the posterior mediastinum and chest wallthoracic duct, inferior tracheobronchial nodes, superior tracheobronchial nodesposterior mediastinum, posterior aspect of the heart and pericardium, posterior part of the respiratory diaphragmposterior mediastinal nodes drain primarily to the thoracic duct
parasternal nodeslateral border of sternum, along the course of the internal thoracic vesselsanterior phrenic nodes, lymphatic vessels from the anterior thoracic walllarger lymphatic vessels in the root of the neckmedial side of the mammary gland; medial part of the anterior chest wall and musclesparasternal nodes constitute an important drainage pattern in cases of cancer of the mammary gland; one or two parasternal nodes may be found in the anterior end of intercostal spaces 1-6; also known as: sternal nodes
paratracheal nodescoursing along the lateral surface of the trachea and esophagussuperior tracheobronchial nodesbronchomediastinal trunklungs, trachea, upper esophagus, the part of the larynx below the vocal foldsparatracheal nodes are an important group of nodes in cases of pulmonary infection or lung cancer; also known as: tracheal nodes
pectoral nodesalong the lateral border of the pectoralis major m. along the course of the lateral thoracic vesselslymphatic vessels from the mammary gland and anterolateral thoracic wall
central axillary nodesanterolateral thoracic wall and muscles; most of the mammary gland
an important group of nodes to examine during a breast physical exam; also known as: anterior axillary nodes
phrenic nodeson the thoracic surface of the respiratory diaphragmlymphatic vessels from the diaphragm, liver and thoracic walllumbar nodes, posterior mediastinal nodessuperior surface of the liver, respiratory diaphragmphrenic nodes drain two structures that are very closely related in developmental origin - the liver and diaphragm (septum transversum); three subgroups of phrenic nodes are recognized: anterior, middle and posterior
posterior mediastinal nodesalong azygos system of veins and esophagusviscera of the posterior mediastinum and chest wallthoracic duct, inferior tracheobronchial nodes, superior tracheobronchial nodesposterior mediastinum, posterior aspect of the heart and pericardium, posterior part of the respiratory diaphragmposterior mediastinal nodes drain primarily to the thoracic duct
pulmonary nodeswithin the lung parenchymalymphatic vessels from the parenchyma of the lungbronchopulmonary (hilar) nodeslung parenchyma, bronchial tree within the lungspulmonary nodes are located along the larger bronchi of the lung
sternal nodeslateral border of sternum, along the course of the internal thoracic vesselsanterior phrenic nodes, lymphatic vessels from the anterior thoracic walllarger lymphatic vessels in the root of the neckmedial side of the mammary gland; medial part of the anterior chest wall and musclessternal nodes constitute an important drainage pattern in cases of cancer of the mammary gland; one or two sternal nodes may be found in the anterior end of intercostal spaces 1-6; also known as: parasternal nodes
subclavian trunkalong the course of the subclavian v.apical axillary nodes; infraclavicular nodesdrains into the junction of the internal jugular v. and the subclavian v.upper limb, most of breast, anterolateral chest wallsubclavian lymphatic trunk occasionally drains into the thoracic duct on the left side; on the right it occasionally drains into the right lymphatic duct
supraclavicular nodesin and around carotid sheath below level of omohyoidsuperior deep cervical nodes, transverse cervical nodes, spinal accessory nodesefferents form the jugular lymphatic trunkhead and neckalso known as: inferior deep cervical nodes
thoracic ductbetween the esophagus anteriorly and the thoracic vertebral bodies posteriorlyformed by the union of the lumbar lymph trunks, sometimes dilated to form a cisterna chylijunction of the left subclavian v. and the left internal jugular v.all of the body and limbs below the respiratory diaphragm; the left side of the chest, left upper limb and the left side of the head and neck above the diaphragmthoracic duct is the largest lymphatic vessel; it passes through the aortic hiatus on the right side of aorta; it swings to the left side of the esophagus at the T4-T5 intervertebral disc (at the level of the sternal angle)
thymusroot of the neck and superior mediastinum posterior to sternumnoneparasternal nodesessential for normal development of the immune system maturationthymus involutes at puberty and is mostly replaced by a mass of fat
tracheobronchial nodesalong the trachea, around the tracheal bifurcation and primary bronchi lymphatic vessels from the lungbronchomediastinal lymph trunklungs, visceral pleura, bronchi, thoracic part of trachea, left side of heart, esophagus, posterior mediastinumtracheobronchial nodes may be divided into five groups: paratracheal (tracheal), superior tracheobronchial, inferior tracheobronchial, bronchopulmonary (hilar), pulmonary
tracheobronchial nodes, inferiorinferior to tracheal bifurcationbronchopulmonary nodes, left side inferior tracheobronchial nodes drain into right inferior tracheobronchial nodesright superior tracheobronchial nodeslower lobes of the lungs; middle mediastinum; posterior mediastinumleft inferior tracheobronchial nodes drain to the right side
tracheobronchial nodes, superiorsuperolateral to the tracheal bifurcationbronchopulmonary (hilar) nodes paratracheal (tracheal) nodeslungs, middle mediastinum, posterior mediastinuminferior tracheobronchial nodes drain lymph from the lower lobe of the left lung to the right superior tracheobronchial nodes
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