254

Lymphatic system

16

Right lymphatic duct (right thoracic duct).

1

1

Systema lymphaticum.

2

Lymphatic vessels. Vasa lymphatica.

Ductus lymphaticus dexter (ductus thoracicus

dexter). It is formed by the union of the right

2

3

Lymphatic capillary. Vas lymphocapillare. Any

jugular, subclavian

and bronchomediastinal

of the vessels of the lymphatic system that

trunks. It may be absent. B

3

form closed networks and have permeable

17

Thoracic duct. Ductus thoracicus. Arises from

walls. C

the cisterna chyli a short distance below the di-

4

Lymphatic capillary network. Rete lympho-

aphragm, courses upward behind the aorta and

4

opens into the venous angle, i. e., the angle be-

capillare. Network of lymphocapillary veins. C

5

Lymphatic vessel. Vas lymphaticum. Any of the

tween the left internal jugular and subclavian

5

veins. B

valvular lymphatic vessels that communicate

18

Arch of thoracic duct. Arcus ductus thoracici.

with the lymphocapillary vessels. Their thin

Arch formed by the thoracic duct before enter-

6

walls are sparsely lined with smooth muscles. C

ing the venous angle. B

6

Lymphatic plexus. Plexus lymphaticus. Net-

19

Cervical part. Pars

cervicalis. Short cervical

7

work of lymphatic vessels lying deeper than

segment in front of C7. B

the lymphocapillary vessels. In the outer layers

20

Thoracic part. Pars thoracica. It begins at the

of the skin, it lies within and directly below the

aortic hiatus and ends at the upper margin of

8

corium. C

T1. B

7 Superficial lymphatic vessel. Vas lymphaticum

21

Abdominal part. Pars abdominalis. Very short

9

superficiale. It is situated superficially on the

segment in front of L1. B

fascia of the limbs.

22 Cisterna chyli. Variable dilatation at the origin

10

8

Deep lymphatic vessel. Vas lymphaticum pro-

of the thoracic duct. It receives the lumbar and

fundum. It lies beneath the fascia of the limbs

intestinal trunks. B

11

and often, but not always, accompanies blood

23 Lymph node. Nodus lymphaticus (Lym-

vessels.

phonodus). Lymphoreticular filtering organ, 1−

12

9

Lymphatic trunks. Trunci lymphatici. Five

25 mm in diameter, within the lymphatic ves-

main lymphatic branches of the lymph-vascu-

sels. Since lymph must usually traverse two

lar system.

lymph nodes before arriving in the blood

13

10

Right/left lumbar trunk. Truncus lumbaris

stream at the venous angle, there is double pro-

tection against the invasion of pathogens or

dexter/sinister. Main

branch

which

brings

tumor cells into the blood stream. A

14

lymph to the cisterna chyli from the legs, pelvic

24 Afferent lymphatic vessels. Vas lymphaticum

viscera, urogenital system and parts

of the

afferens. Any of the vessels that carry lymph to

abdominal wall and the abdominal viscera. B

15

a lymph node; located on the convex surface of

11

Intestinal trunks. Trunci intestinales. Main

the node. A

16

conduits which transport lymph to the cisterna

25 Efferent lymphatic vessel. Vas lymphaticum

chyli from the supply region of the superior and

efferens. Any of the vessels that carry lymph

inferior mesenteric arteries. B

away from a lymph node; located on the hilum

17

12

Right/left bronchomediastinal trunk. Truncus

of the node. A

bronchomediastinalis dexter/sinistra. It col-

26

Cortex. Part of the lymphoreticular tissue pro-

18

lects lymph from the heart, lungs and medi-

ximal to the capsule. A

astinum. On the left

side it

opens into the

27 Medulla. Lymphoreticular tissue between cor-

thoracic duct, on the right side, the right lym-

tex and hilum. A

19

phatic duct. Often, however, both may open

28

Hilum. Somewhat retracted area where blood

directly into the subclavian veins. B

20

13

Right/left subclavian trunk. Truncus sub-

vessels enter and where blood and lymphatic

vessels exit. A

clavius dexter/sinister. Arises from the arm, ac-

29

Lymphatic nodule.

Nodulus lymphaticus

companies the subclavian vein and usually

21

(lymphonodulus). Spherical condensation of

opens on the right side into the right lymphatic

duct and on the left side into the angle between

lymphoreticular tissue predominantly occupy-

ing the cortex. It exhibits a lighter central area

22

the left subclavian vein and internal jugular

(“reaction center”). A

vein. B

23

14

Right/left jugular trunk. Truncus jugularis

dexter/sinister. Accompanies the internal jugu-

lar vein and passes to the angle between the in-

24

ternal jugular and subclavian veins (venous

angle). B

25

15

Lymphatic ducts. Ductus lymphatici. The main

drainage ducts of the lymphatic system.

256

Lymphatic system

REGIONAL LYMPH NODES. Nodi lymphatici re-

15

Submental lymph nodes. Nodi lymphatici sub-

1

1

gionales.

mentales. Nodes between the anterior bellies

2 Head and neck. Caput et collum.

of the digastric muscles. Afferents: middle of

2

lower lip, floor of mouth and tip of tongue.

3 Occipital lymph nodes. Nodi lymphatici occipi-

Efferents: deep cervical and submental lymph

3

tales. One to three lymph nodes lying close to

nodes. B

the margin of the trapezius. Afferents: scalp,

16

Submandibular lymph nodes. Nodi lymphatici

deep cervical muscles. Efferents: deep cervical

submandibulares.

Nodes

between

the

4

lymph nodes. A

mandible and submandibular gland that serve

4 Mastoid [retroauricular] lymph nodes. Nodi

as first and second filter stations. Direct affer-

5

lymphatici mastoidei [[retroauriculares]]. Usu-

ent area: inner canthus of eye, cheek, side of

ally two nodes on the mastoid process. Affer-

nose, upper lip, lateral lower lip, gingiva and

ents: posterior surface of pinna, posterior wall

anterior lateral margin of tongue. Indirect affer-

6

of external acoustic meatus and corresponding

ents: facial and submental lymph nodes. Effer-

parts of scalp. Efferents: deep cervical lymph

ents: deep cervical lymph nodes. B

7

nodes. A

17

Anterior cervical lymph nodes. Nodi lymphat-

5 Superficial partodi lymph nodes. Nodi lym-

ici cervicales anteriores.

8

phatici parotidei superficiales. They lie on the

18

Superficial (anterior jugular) lymph nodes.

parotid fascia in front of the tragus. Afferents:

Nodi lymphatici superficiales (jugulares anteri-

junction of temporal region and anterior sur-

ores). Nodes on the internal jugular vein. Affer-

9

face of pinna. Efferents: deep cervical lymph

ent region: skin of anterior side of neck. Effer-

nodes. A

ents: bilateral deep cervical lymph nodes. A

10

6

Deep parotid lymph nodes. Nodi lymphatici

19

Deep lymph nodes. Nodi lymphatici profundi.

parotidei profundi. Group beneath the parotid

Anterior group.

11

fascia.

Afferents:

tympanic

cavity,

external

19 a

Infrahyoid lymph nodes. Nodi lymphatici in-

acoustic meatus, frontotemporal region, eye-

lids, root of nose, and sometimes the posterior

frahyoidei. They lie in the midline below the

body of the hyoid bone. Afferent areas: larny-

12

floor of the nose and nasopharyngeal cavity.

geal vestibule, piriform recess and adjacent hy-

Efferents: deep cervical lymph nodes. A

popharynx.

Efferents: deep

cervical

lymph

Preauricular

lymph

nodes. Nodi lymphatici

7

13

nodes. B

prae-auriculares. Group located in front of the

20

Prelaryngeal

lymph

nodes.

Nodi

lymphatici

pinna. A

14

praelaryngeales3. Nodes on

the

cricothyroid

8

Infra-auricular lymph nodes. Nodi lymphat-

ligament. Afferent area: lower half of larynx.

ici infra-auriculares. Group beneath the pinna.

Efferents: deep cervical lymph nodes. B

15

A

21

Thyroid lymph nodes. Nodi lymphatici thyroidei.

9

Intraglandular lymph nodes. Nodi lymphatici

Nodes on the thyroid gland. Efferents: as in 20.

16

intraglandulares.

Group situated

directly

B

within the parotid. A

22

Pretracheal lymph nodes. Nodi lymphatici pre-

17

10

Facial lymph nodes. Nodi lymphatici faciales.

tracheales. Nodes in front of the trachea. Affer-

ent regions: trachea and larynx. Efferents: deep

Variable lymph nodes that receive lymph from

18

the eyelids, nose and the rest of the face and

cervical lymph nodes. B

buccal

mucosa.

Efferents:

submandibular

23

Paratracheal lymph nodes. Nodi lymphatici par-

lymph nodes. The vessels accompany the facial

atracheales. Nodes beside the trachea. Actions

artery.

19

similar to those of 22. B

11

Buccinator

node.

[Nodus

buccinatorius].

23 a Retropharyngeal lymph nodes. Nodi lymphatici

20

Lymph node situated deep within the buccina-

retropharyngeales. Deep cervical lymph nodes

tor muscle. A

in front of the arch of the atlas. See p. 258.13

21

12

Nasolabial node. [Nodus nasolabialis]. Lymph

node located below the nasolabial fold. A

22

13

Malar node. [Nodus malaris]. Superficial

lymph node of the cheek.

23

14 Mandibular

node.

[Nodus

mandibularis].

Lymph node located on the mandible. A

24

14 a

Lingual lymph nodes. Nodi lymphatici lingu-

ales. Nodes located on the hyoglossus muscle.

They drain lymph from the lower surface and

25

lateral margin to tongue as well as the medial

anterior two-thirds of its dorsal surface.

258

Lymphatic system

Lateral cervical lymph nodes. Nodi lymphatici

17

Apical lymph nodes. Nodi lymphatici apicales.

1

1

cervicales laterales. Groups of lymph nodes

Nodes medial to the axillary vein that extend

lateral to the neck which are classified as fol-

from the upper margin of the prectoralis minor

2

lows.

to the apex of the axilla. Afferent areas: upper

2

Superficial lymph nodes. Nodi lymphatici su-

lateral part of the breast and all remaining axil-

lary lymph nodes. Efferents: (left) subclavian

3

perficiales. Nodes on the external jugular vein.

trunk to the thoracic duct or subclavian vein;

Afferent regions: lower pinna and area below

(right) into the vein directly or after joining the

the parotid. Efferents: deep cervical lymph

4

jugular trunk. C

nodes. See p. 257 A

18

Brachial lymph

nodes. Nodi

lymphatici

3

Superior deep lymph nodes. Nodi lymphatici

5

brachiales. Nodes along the axillary artery that

profundi superiores. Nodes that form the sec-

drain lymph from the arm. C

ond filter station for almost all of the head

19

Subscapular lymph nodes. Nodi lymphatici

6

lymph nodes but also receive direct peripheral

tributaries from their surroundings. Efferents:

subscapulares. Nodes alongside the subscapu-

7

jugular trunk. A

lar artery that drain lymph from the posterior

4

Lateral lymph nodes. Nodi lymphatici laterales.

thorax and shoulder as well as from the lower

nuchal region. C

8

They lie lateral to the internal jugular vein. A

20

Pectoral lymph nodes. Nodi lymphatici pec-

5

Anterior lymph nodes. Nodi lymphatici anteri-

torales. Nodes along the lateral margin of the

9

ores. Group of lymph nodes in front of the in-

pectoralis minor that drain lymph from the

ternal jugular vein. A

anterior and lateral wall of the trunk as far as

6 Jugulodigastric node. Nodus jugulodigastricus. It

the navel, as well as the central and lateral part

10

of the breast. C

is the most cranial of the deep cervical nodes

Central lymph nodes. Nodi lymphatici cen-

and is palpable when the tonsil, tongue or

21

11

pharynx is inflamed. A

trales. Nodes in the fat of the axillar that filter

lymph from the brachial, subscapular and pec-

7

Inferior deep cervical lymph nodes. Nodi

toral lymph nodes. C

12

lymphatici profundi inferiores. They form the

22

Interpectoral lymph nodes. Nodi lymphatici

second filter station for the lymph nodes of the

cervical viscera and the last filter station for the

interpectorales. Small group of nodes situated

13

lymph nodes of the head. They also receive

between the pectoralis major and minor. Affer-

direct tributaries. Efferents: jugular trunk.

ent area: mammary gland. Efferents: apical

14

8

Jugulo-omohyoid node. Nodus juguloomohy-

lymph nodes. C

23

Deltopectoral

(infraclavicular)

lymph

oideus. Node between the omohyoid muscle

15

and internal jugular vein. Afferent area: tongue.

nodes. Nodi lymphatici deltopectorales (infra-

A

claviculares). Nodes on the cephalic vein in the

9 Lateral lymphatic nodes. Nodi lymphatici later-

deltopectoral groove that receive lymph from

16

the arm. C

ales. They lie lateral to the internal jugular vein.

24

Brachial lymph nodes. Nodi lymphatici

A

17

10

Anterior lymph nodes. Nodi lymphatici anteri-

brachiales. Single lymph nodes along the

brachial vessels.

ores. Group in front of the internal jugular vein.

25

Cubital lymph nodes. Nodi lymphatici cubi-

18

A

11

Supraclavicular lymph nodes. Nodi lymphatici

tales. One or two lymph nodes on the brachial

artery in the cubital fossa. C

19

supraclaviculares. Nodes of the same group lo-

26 Supratrochlear lymph nodes. Nodi lymphatici

cated above the clavicle. A

supratrochlearis. Nodes that lie medial to the

20

12

Accessory nodes. Nodi accessorii.

basilic vein and above the elbow joint. C

13

Retropharyngeal lymph nodes. Nodi lym-

27

Superficial lymph nodes. Nodi lymphatici su-

21

phatici retropharyngeales. Deep cervical lymph

perficiales.

nodes at the level of the lateral mass of the atlas

28 Deep lymph nodes. Nodi lymphatici profundi.

22

and at the lateral margin of the longus capitis

Individual lymph nodes that follow the course

muscle. A B

of the deep lymphatic vessels.

260

Lymphatic system

Thorax.

13

Tracheobronchial lymph nodes. Nodi lym-

1

1

2

PARAMAMMARY LYMPH NODES. Nodi lym-

phatici tracheobronchiales. Group located

along the bronchi at the site where they enter

phatici paramammarii. Lymph nodes on the

2

into the lungs. C

lateral margin of the mammary gland. A

3

3

Parasternal lymph nodes. Nodi lymphatici

14

Superior tracheobronchial lymph nodes. Nodi

parasternales. Nodes located along the course

lymphatici tracheobronchiales superiores.

of the internal thoracic vessels. Afferent re-

Group situated cranially on the stem bronchi

and the trachea. C

4

gions: mammary gland, intercostal spaces, part

of the liver and diaphragm. Efferents: either

15 Inferior tracheobronchial lymph nodes. Nodi lym-

5

directly into the respective subclavian vein or

phatici tracheobronchiales inferiores. Group lo-

internal jugular vein or into the thoracic duct or

cated caudal to the tracheal bifurcation. C

subclavian trunk. A

16 Paratracheal lymph nodes. Nodi lymphatici

6

4

Intercostal lymph nodes. Nodi lymphatici in-

paratracheales. Group situated along the tra-

tercostales. Nodes located in the paravertebral

chea. C

7

portion of the intercostal spaces. Afferent area:

17 Node of arch of azygos vein. [Nodus arcus

pleura and intercostal spaces. D

5

Paravertebral lymph nodes. Nodi lymphatici

venae azygos]. Lymph node occasionally pre-

8

sent at the arch which the azygos vein forms

praevertebrales.3 Nodes located between the

around the hilum of the right lung before join-

esophagus and vertebral column. Afferent re-

ing the superior vena cava. B

9

gions: surroundings, if not drained by other

vessels. C D

10

6 Superior phrenic lymph nodes. Nodi lymphat-

ici phrenici superiores. Nodes situated behind

11

the cartilage-bone boundary of the 7th rib at the

site where the aorta opens into the diaphragm

and along the inferior vena cava. Afferent areas:

12

liver and diaphragm. D

7 Prepericardial lymph nodes. Nodi lymphatici

prepericardiales. Nodes located between the

13

sternum and pericardium. Afferent regions:

sternum and anterior pericardium. Efferents:

14

parasternal lymph nodes. B

262

Lymphatic system

1

Abdomen − parietal lymph nodes. Nodi lym-

16

[Anulus lymphaticus cardiae]. Lymphatic ring

1

phatici parietales. Lymph nodes in the abdom-

occasionally present around the cardia of the

inal wall.

stomach. C

2

17

2

Left lumbar lymph nodes. Nodi lymphatici

Gastro-omental lymph nodes [right and left].

lumbales (lumbares) sinistri. Nodes situated

Nodi lymphatici gastro-omentales [dextri/sin-

3

along the abdominal aorta. They mainly serve

istri]. Nodes located along the course of the

as secondary filter stations for lymph nodes lo-

right and left gastro-omental arteries at the

cated further below, but also as primary filter

greater curvature of the stomach. Their affer-

4

stations for the suprarenal gland, kidney, ure-

ents receive lymph from the stomach and the

ter, testis, ovary, uterine tubes, fundus of uterus

greater omentum and their efferents convey

and abdominal wall. Efferents: primarily into

lymph along the right side to the lymph nodes

5

the lumbar trunk. They can be divided into the

of the liver and along the left side to the lymph

following three groups.

nodes of the spleen and pancreas. C

6

3

Lateral aortic lymph nodes. Nodi lymphatici

18

Pyloric lymph nodes. Nodi lymphatici pylorici.

aortici laterales. Group on the left side of the

Situated around the pylorus. Their efferents

aorta. A

drain into the hepatic or celiac lymph nodes.

preaortici. Group situated in front of the aorta. A

Node situated above the pylorus. C

8

20

Subpyloric nodes. [Nodi subpylorici]. Nodes

5

Postaortic lymph

nodes. Nodi lymphatici

situated caudal to the pylorus. C

postaortici. This group lies between the aorta

9

and vertebral column. A

21

Retropyloric

nodes.

[Nodi

retropylorici].

6 Intermediate lumbar lymph nodes. Nodi lym-

Group of nodes located dorsal to the pylorus. C

22

Pancreatic lymph nodes. Nodi lymphatici pan-

10

phatici lumbales (lumbares) intermedii. Group

situated between the aorta and inferior vena

creatici. Situated along the upper and lower

cava. They function as described in 2−A

margins of the pancreas. Their efferent vessels

11

7

Right lumbar lymph nodes. Nodi lymphatici

convey lymph to the

splenic

lymph

nodes,

mesenteric

lymph nodes and pancreati-

lumbales (lumbares) dextri. Group situated

coduodenal lymph nodes.

12

along the inferior vena cava. They function as de-

23

Superior pancreatic lymph nodes. Nodi lym-

scribed in (2) and are subdivided into the follow-

ing three groups.

phatici pancreatici superiores. Group of nodes

13

located along the upper margin of the pancreas.

8

Lateral caval lymph nodes. Nodi lymphatici

A C

cavales laterales. Nodes on the right side of the

14

24

Inferior pancreatic lymph nodes. Nodi lym-

inferior vena cava. A

phatici pancreatici inferiores. Group of nodes lo-

9

Precaval lymph nodes. Nodi lymphatici pre-

cated along the lower margin of the pancreas. A C

15

cavales.Nodessituatedinfrontofthevenacava.A

25

Splenic (lienal) lymph nodes. Nodi lymphatici

10

Postcaval lymph nodes. Nodi lymphatici

splenici (lienales). Nodes near the hilum of the

16

postcavales. Nodes

located behind the vena

spleen that convey their lymph to the celiac

cava. A

lymph nodes. A C

17

11

Inferior phrenic lymph nodes. Nodi lymphatici

26

Pancreaticoduodenal lymph nodes. Nodi lym-

phrenici inferiores. Nodes situated along the

phatici pancreaticoduodenales. Small nodes be-

inferior surface of the diaphragm near the aor-

tween the pancreas and duodenum. Afferent re-

18

tic opening. A C

gions: duodenum and pancreas.

12

Inferior epigastric lymph nodes. Nodi lym-

27

Superior

pancreaticoduodenal

lymph

19

phatici epigastrici inferiores. Three or four

nodes. Nodi lymphatici pancreaticoduodenales

nodes along the inferior epigastric artery that

superiores. Cranially situated group of nodes.

20

receive lymph from its supply area. B

Efferents: hepatic nodes. C

13

Visceral nodes. Abdomen − nodi lymphatici

28

Inferior pancreaticoduodenal lymph nodes.

viscerales. Lymph nodes of the abdominal

Nodi lymphatici pancreaticoduodenales inferi-

21

viscera.

ores. Caudal group of lymph nodes. Efferents:

14 Celiac lymph nodes. Nodi lymphatici coeliaci.

mesenteric lymph nodes. C

29

Hepatic lymph nodes. Nodi lymphatici hepat-

22

Nodes situated the celiac trunk. They form the

secondary filter station for the stomach,

ici. Nodes situated near the hilum of the liver and

duodenum, liver, gallbladder, pancreas and

in the hepatoduodenal ligament. Their lymph is

23

spleen.Efferents:someformtheintestinaltrunk,

taken partly from the liver, partly from adjacent

some pass directly into the cisterna chyli. A C

lymph nodes and transported to the celiac

24

15 Gastric lymph nodes [right and left].Nodilym-

lymph nodes.

30

Cystic node. Nodus cysticus. Larger lymph node

phatici gastrici [dextri/sinistri]. From the lesser

curvature of the stomach, they follow the course

near the neck of the gallbladder. C

25

of the right and left gastric arteries. Afferent re-

31

Foraminal node. Nodus foraminalis. Larger

gion: stomach. Efferents: celiac lymph nodes. C

lymph node near the epiploic foramen. C

Lymphatic system

263

11

1

14

23

25

2

9

3

6

4

4

24