So let's have a look at the specific
lymphatic drainage from various
organs. And here can
see, we are looking at
on this side. The organs
within the foregut
so we are looking at the spleen. We are looking at
the stomach. We are looking at part of the oesophagus
part of the duodenum. The liver is
not detailed here but we have got
the hepatic artery which
will go towards the
liver. And we can see
surrounding the coeliac trunk which we can find
here. We have a collection of lymph nodes
and these are be known
as a coeliac lymph nodes.
A coeliac lymph nodes which up here.
The lymph vessels and the lymph nodes
are dotted along the arteries.
So if you follow the
artery you see these
lymph nodes attached to the arteries
with their afferent and efferent
lymphatic vessels associated with them.
So we can see we have our splenic
lymph nodes here. Taking the
afferent, taking the
efferent lymphatic vessels
from the spleen and then these
will pass ultimately all the way
to the coeliac lymph nodes.
We have some around the greater curvature. So we
have the gastroomental lymph nodes.
We have some around the lesser curvature.
So we have the gastric lymph node.
We have some around the pylorus,
the pyloric lymph nodes.
So there is nothing too technical about
this, too difficult about this.
We just have a series of lymph nodes
around the organ. The organs in the foregut
so these will go on to pass
to the coeliac lymph nodes.
If we look here on the opposite side,
we can see we have in yellow here, we have the
hindgut and we can see
in green we have the midgut.
We can see these green lymph nodes are all going
to pass to the superior mesenteric lymph nodes
associated with the
superior mesenteric artery.
So we see we have right colic lymph
node. We have ileocolic lymph node.
We have juxta-intestinal mesenteric
lymph node. These are lying next
to the intestines, the small intestines.
We can see we have some lymph nodes
associated with the paracolic
region, paracolic lymph nodes
middle colic lymph nodes.
But essentially their
afferent lymphatic vessels
will pass towards
the superior mesenteric lymph nodes.
And these which we can see associated
with the superior mesenteric artery
will then run along side, what we
have here, is the intestinal trunk.
The intestinal trunk can be then
continuous with the thoracic duct.
by way of the the cisterna chyli.
We have the same when we're looking at the
hindgut. We can see we have the mesocolic for
the transverse mesolon we can see them here.
in this case they're draining into the superior
mesenteric lymph node. But we could have some
left colic lymph nodes here. We can have
some down towards the sigmoid colon.
And these are draining into the
inferior mesenteric lymph nodes.
These will then ascend up alongside
the aorta as intestinal trunks
and they aggregate with other
intestinal trunks; the left and right
to form the cisterna chyli.
The cisterna chyli as
we will see later on
will receive the lumbar lymphatic trunk
and then we have the thoracic duct.
Here we can look at actually the liver.
We can look at the pancreas and spleen
in a little bit more detail. But because these
are ultimately associated with the foregut
then again they will pass to the coeliac
lymph node around the coeliac trunk.
Coeliac lymph nodes around the coeliac
trunk passing from the splenic lymph nodes
along the splenic artery towards it.
Here we can see we have got hepatic
lymph nodes associated with the liver
and they will pass back
towards the coeliac trunk.
Pancreaticoduodenal lymph nodes and these
will pass towards the coeliac trunk.
Obviously we have this transition where
we have the superior and inferior
pancreaticoduodenal arteries coming from the
coeliac trunk or the superior mesenteric artery.
So will have some of these lymph nodes passing
into the superior mesenteric lymph nodes.
These as previously, will aggregate
and ascend as intestinal trunks.
Here we can now move on to the posterior
abdominal wall and the pelvic viscera.
And these don't merge
into intestinal trunk.
They merge into lumbar trunks.
And what we can see here in the female
is we have a whole series of other lymph nodes.
We can see in the female we have the uterus here.
We can see we have the vagina here.
We can see we have the rectum behind.
And we can that depending
on where we are positioned,
these are going to move into
the internal iliac lymph nodes
or they're going to move into
the external iliac lymph nodes.
We also have superficial inguinal lymph
nodes and we have deep inguinal lymph nodes.
So we can see that the vagina is passing
into this deep inguinal lymph nodes.
Whereas the skin of the labia is passing
into the superficial inguinal lymph nodes.
The superficial become continuous with the
deep as they follow their path back up
towards the common iliac lymph node.
These then ascend as our lumbar trunks.
If we look at the uterus, we can see the
uterus is going to pass into the
we can see the uterus is going to pass
into the internal iliac lymph nodes.
But these ultimately
then run into the
external and common iliac lymph
node and these will ascend.
So we have specific locations where these
lymph nodes from specific organs pass to.
But ultimately they all end up aggregating
together as they ascend up with.
We can see these lumbar lymph
nodes are then running up
sitting either side of the kidney.
That was in the female. In
the male we can see we have
a similar arrangement. We can see that the
lymph nodes are associated with the internal
iliac artery, we can see here. These look like
that receiving their lymph from the prostate
from the seminal vesicles. We can see
the testes, the testes are important
example. Because if you can
follow the pathway of the testes
you will see that its lymph is actually running
all the way up to into this lumbar lymph nodes.
And that's indicative of the movement, the
migration the testes did during the development.
Because if you look where
the skin of the scrotum is
this is passing into the superficial and into
the deep inguinal lymph nodes which we can see
which we can see here and here.
So with all the testes is within the scrotum
and they are very adjacent in their position
but actually have a very different
lymphatic drainage. The skin we can see
is draining into the
lymph nodes. We can see
the skin of the penis
is draining into the deep
inguinal lymph nodes. And we
can see the testes are actually
passing all the way up
and draining into the lumbar
lymph nodes. This is really important
if you are considering removing
a testis due to testicular cancer.
Its important that if
the testicle is cancerous
and it has the potential
of metastasizing tumour cells
then you want to
limit the removal of the
testis to a region which has
a similar lymphatic drainage.
So what you don't want to do is to
really take it out via the scrotum.
But if you did, you would be interfering
with these superficial inguinal lymph nodes
and you could be spreading
them into this system.
So its often best to try and take them
out may be via the anterior abdominal wall.
rather than take them out
through the skin of the scrotum.