Lymphatic drainage of major organs

1. Lymphatic Drainage of Major Organs

2. Lymphatic Drainage of GIT

3. lymphatic drainage lymphatic capillaries in the interstitial space, organized into lymphatic vessels and lymph nodes [located along the course of the blood vessels and are named accordingly. e.g. left gastric nodes, splenic nodes, paraaortic nodes, coeliac nodes etc .] All lymph of GIT drains into the cisterna chyli , thoracic duct, finally drains into the left subclavian vein .

4. lymphatic drainage of the oesophagus cervical oesophagus drains into deep cervical nodes thoracic oesophagus drains into posterior mediastinal nodes abdominal oesophagus drains into preaortic and coeliac nodes

5. lymphatic drainage of the stomach Area I superior 2/3 rd drains along Lt. and Rt. gastric vessels to aortic nodes Area II drains along Rt. gastroepiploic vessel to subpyloric nodes then into aortic nodes Area III drains along short gastric, splenic vessels, superior pancreatic nodes then into aortic nodes

6. Subpyloric nodes Rt. Gastric nodes Lt. and Rt. gastroepiploic nodes splenic nodes superior pancreatic nodes Lt. gastric nodes aortic nodes I II III cisterna chyli

7. lymphatic drainage of the small intestine drains into superior mesenteric nodes

8. lymphatic drainage of the large intestine drains into the central nodes located at the origin of the superior and inferior mesenteric arteries through epicolic , paracolic , intermediate nodes

9. epicolic nodes paracolic nodes intermediate nodes central group of nodes

10. lymphatic drainage of the rectum drain into pararectal nodes nodes along vessels supplying the rectum and then into para -aortic nodes at the origin of the IMA drainage is mainly upwards upper half along superior rectal vessels to inferior mesenteric nodes lower half along middle rectal vessels to internal iliac nodes

11. lymphatic drainage of the anal canal upper canal drains into internal iliac nodes lower part drains into superficial inguinal nodes

12. clinical relevance Drainage area of particular group of lymph nodes Primary site of pathology Spread of infection Spread of malignant tumours (lymphatic spread) Staging of disease ( TNM classification ) Treatment Prognosis

13. Lymphatic Drainage of Mediastinum

14. Lymphatic Drainage 50 tracheobronchial lymph nodes : Some of the largest lymph nodes in the body . Include: Paratracheal Superior tracheobronchial Inferior tracheobroncial Bronchopulmonary Pulmonary

15. Lymph Drainage of Thoracic Cavity Parasternal nodes: - Lie behind sternum along course of internal thoracic artery . - Receive lymph from thoracic wall, upper anterior abdominal wall, and diaphragm. - Also receive significant amount of lymph from mammary gland . -Drain into parasternal lymph channel.

16. Posterior intercostal nodes : -Lie in posterior intercostal space between heads of ribs. -Receive lymph from thoracic wall and paravertebral regions. -Drain into thoracic duct: From left and lower right. -Drain into right lymphatic duct: From upper right.

17. Diaphragmatic nodes: -Lie on upper surface of diaphragm . -Receive lymph from diaphragm, pericardium, upper surface of liver . -Drain to parasternal and posterior mediastinal nodes.

18. Posterior mediastinal nodes: Lie along esophagus and descending thoracic aorta . Brachiocephalic nodes: Lie along brachiocephalic veins.

19. Lymph Trunks Bronchiomediastinal lymph trunks receive lymph from : - Posterior mediastinal nodes - Brachiocephalic nodes - Tracheobronchial nodes - Parasternal nodes

20. Thoracic Duct -Begins in abdomen on right side of midline . -Receives most of lymph from body below diaphragm. -Drains left side of thoracic cavity and part of right. -Receives lymph from left internal jugular lymph trunk. CONTD…

21. -Receives lymph from left subclavian lymph trunk. -Empties into venous system at junction of: Left internal jugular vein. Left subclavian vein.

22. Right Lymphatic Duct : -Drains upper right thoracic cavity, right upper extremity , and right side of head and neck . -Empties into venous system at junction of: Right internal jugular vein. Right subclavian vein.

23. Lymphatic Drainage of Liver, Spleen & Gall Bladder

24. Liver Superficial and most deep lymph vessels converge at the porta and end in the hepatic lymph nodes ( eg . Cystic LN near GB neck or LN of omental foramen ) Hepatic LN’s drain into coeliac LN’s around the coeliac trunk, then thoracic duct Some deep lymph vessels follow hepatic veins to IVC foramen in diaphragm and end in middle phrenic LN’s

25. Biliary Duct Cystic LN, node of omental foramen, hepatic LN’s

26. Spleen Pancreaticosplenic LN’s

27. Lymphatic Drainage of Male Genital Tract

28. Lymph Drainage of the Scrotum Lymph from the skin and fascia , including the tunica vaginalis , drains into the superficial inguinal lymph nodes .

29. Lymphatic Drainage of The Testes para -aortic lymph nodes.

30. Lymphatics of The Prostate Lymph vessels terminate in internal iliac and sacral lymph nodes Some vessels from posterior surface pass with lymph vessels from bladder to external iliac LN’s

31. Lymphatics of The Penis The skin of the penis is drained into the medial group of superficial inguinal nodes . The deep structures of the penis are drained into the internal iliac nodes .

32. Lymphatic Drainage of Female Genital Tract

33. Nodes Primary Afferent Connections Aortic/ Paraaortic Ovary, fallopian tubes, upper uterine corpus; drainage from common iliac nodes Common Iliac Drainage from external and internal iliac nodes External Iliac Upper vagina, cervix, upper uterine corpus; drainage from inguinal nodes Internal Iliac Lateral Sacral Superior Gluteal Inferior Gluteal Obturator Vescical Rectal Parauterine Upper vagina, cervix, lower uterine corpus Inguinal Superficial Deep Vulva, lower vagina; (rare: uterus, fallopian tubes, ovaries)

34. Lymphatics of the Female Pelvis Lumbar lymphatic trunks Paraaortic nodes Common iliac nodes Sacral nodes Internal iliac nodes External iliac nodes Obturator nodes Inguinal nodes Parametrial nodes