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Lymphatic Drainage – Lymphatic Drainage of Abdominopelvic Organs

by James Pickering, PhD
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    00:01 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 that surrounding 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.

    00:40 A coeliac lymph nodes which up here.

    00:42 The lymph vessels and the lymph nodes are dotted along the arteries.

    00:46 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.

    01:11 We have some around the greater curvature. So we have the gastroomental lymph nodes.

    01:17 We have some around the lesser curvature. So we have the gastric lymph node.

    01:22 We have some around the pylorus, the pyloric lymph nodes.

    01:26 So there is nothing too technical about this, too difficult about this.

    01:29 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.

    01:41 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.

    01:51 We can see these green lymph nodes are all going to pass to the superior mesenteric lymph nodes associated with the superior mesenteric artery.

    02:01 So we see we have right colic lymph node. We have ileocolic lymph node.

    02:06 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.

    02:31 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.

    02:41 The intestinal trunk can be then continuous with the thoracic duct.

    02:46 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.

    02:56 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.

    03:08 And these are draining into the inferior mesenteric lymph nodes.

    03:13 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.

    03:24 The cisterna chyli as we will see later on will receive the lumbar lymphatic trunk and then we have the thoracic duct.

    03:35 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.

    03:51 Coeliac lymph nodes around the coeliac trunk passing from the splenic lymph nodes along the splenic artery towards it.

    04:00 Here we can see we have got hepatic lymph nodes associated with the liver and they will pass back towards the coeliac trunk.

    04:08 Pancreaticoduodenal lymph nodes and these will pass towards the coeliac trunk.

    04:15 Obviously we have this transition where we have the superior and inferior pancreaticoduodenal arteries coming from the coeliac trunk or the superior mesenteric artery.

    04:25 So will have some of these lymph nodes passing into the superior mesenteric lymph nodes.

    04:32 These as previously, will aggregate and ascend as intestinal trunks.

    04:38 Here we can now move on to the posterior abdominal wall and the pelvic viscera.

    04:44 And these don't merge into intestinal trunk.

    04:48 They merge into lumbar trunks.

    04:50 And what we can see here in the female is we have a whole series of other lymph nodes.

    04:56 We can see in the female we have the uterus here.

    05:01 We can see we have the vagina here. We can see we have the rectum behind.

    05:06 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.

    05:18 We also have superficial inguinal lymph nodes and we have deep inguinal lymph nodes.

    05:26 So we can see that the vagina is passing into this deep inguinal lymph nodes.

    05:33 Whereas the skin of the labia is passing into the superficial inguinal lymph nodes.

    05:40 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.

    05:51 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.

    06:02 But these ultimately then run into the external and common iliac lymph node and these will ascend.

    06:10 So we have specific locations where these lymph nodes from specific organs pass to.

    06:15 But ultimately they all end up aggregating together as they ascend up with.

    06:20 We can see these lumbar lymph nodes are then running up sitting either side of the kidney.

    06:28 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.

    07:00 And that's indicative of the movement, the migration the testes did during the development.

    07:07 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.

    07:21 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 superficial inguinal 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.

    07:54 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.

    08:15 So what you don't want to do is to really take it out via the scrotum.

    08:18 But if you did, you would be interfering with these superficial inguinal lymph nodes and you could be spreading them into this system.

    08:27 So its often best to try and take them out may be via the anterior abdominal wall.

    08:32 rather than take them out through the skin of the scrotum.


    About the Lecture

    The lecture Lymphatic Drainage – Lymphatic Drainage of Abdominopelvic Organs by James Pickering, PhD is from the course Pelvis.


    Included Quiz Questions

    1. Coeliac lymph nodes
    2. Gastro-omental nodes
    3. Superior mesenteric lymph nodes
    4. Inferior mesenteric lymph nodes
    5. Middle colic lymph nodes
    1. Superficial inguinal lymph nodes
    2. Deep inguinal lymph nodes
    3. Inferior mesenteric lymph nodes
    4. Internal iliac lymph nodes
    5. External iliac lymph nodes
    1. Gastro-omental lymph nodes
    2. Gastric lymph nodes
    3. Pyloric lymph nodes
    4. Superior mesenteric lymph nodes
    5. Aortic lymph nodes
    1. Deep inguinal lymph nodes
    2. Superficial inguinal lymph nodes
    3. Internal iliac lymph nodes
    4. External iliac lymph nodes
    5. Lumbar lymph nodes

    Author of lecture Lymphatic Drainage – Lymphatic Drainage of Abdominopelvic Organs

     James Pickering, PhD

    James Pickering, PhD


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