Lymphatic Drainage of the Abdominopelvic Organs

by James Pickering, PhD

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    00:01 So, let's have a look at some specifics.

    00:03 So, let's have a look at the stomach and liver.

    00:05 So, here the stomach is supplied by branches coming from the celiac artery.

    00:09 So, ultimately, they're going to be draining into the celiac lymph nodes.

    00:13 They do this via a number of lymph nodes which are scattered around the stomach.

    00:18 You may not need to know all of these specific names.

    00:22 For example, around the stomach.

    00:23 We have the cardiac lymphatic ring.

    00:26 Some left and right gastric lymph nodes, gastro-omental lymph nodes, and supra pyloric lymph nodes.

    00:33 And these are all going to drain from the stomach into the celiac lymph nodes.

    00:37 Associated with the liver, we have the hepatic lymph nodes. We can see here.

    00:42 So, lymph draining from these regions will pass towards that celiac lymph node.

    00:47 If we then have a look also at the celiac lymph nodes, but those structures that also receive blood supply from the celiac trunk.

    00:55 We can now talk about the spleen for example.

    00:58 So, we have the superior pancreatic lymph nodes, inferior pancreatic lymph nodes, and splenic lymph nodes draining these areas of the organs respectively.

    01:08 We can also have the pancreaticoduodenal lymph nodes.

    01:11 We can see here.

    01:12 But these are also going to be supplying the superior mesenteric lymph nodes.

    01:17 Remembering that there is that anastomosis of course between the celiac trunk and the superior mesenteric artery in supplying this region.

    01:24 So, therefore, makes sense that the lymph will pass parallel to those blood vessels.

    01:30 So, we're going to see a combination of these lymph nodes pairing up here.

    01:35 If we look at the small and large intestine, then we have the superior mesenteric lymph nodes here.

    01:40 We can see some intermediate mesenteric lymph nodes, some juxta-intestinal lymph nodes associated with the blood supply going towards the small intestines.

    01:49 We have the ileocecal lymph nodes similar to the ileocecal artery we had.

    01:53 Here we've got some right colic, some middle colic lymph nodes, and all of these are associated with the superior mesenteric lymph nodes.

    02:01 Just as these blood vessels were associated with a superior mesenteric artery.

    02:06 So, again, we've got some pairing up of these lymphatic vessels to the corresponding arterial supply.

    02:13 Let's continue and have a look at the descending colon, we can see here.

    02:17 associated this time as you'd expect with the inferior mesenteric lymph nodes as they come in from the inferior mesenteric artery.

    02:24 So we have the left colic lymph nodes, mesocolic lymph nodes within the sigmoid mesocolon.

    02:29 and here we have superior rectal lymph nodes as well.

    02:33 Again, following pretty much the pattern of the arterial supply coming from the inferior mesenteric artery, we have the respective lymph nodes passing back towards the inferior mesenteric lymph nodes.

    02:46 Now, let's enter into the pelvis.

    02:48 And again, please make sure you need to know the level of detail here that we're going to talk about in terms of drainage of pelvic lymph.

    02:56 So here we have the common iliac lymph nodes. We can see here.

    03:00 We have some sacral lymph nodes we can see and some internal iliac lymph nodes alongside there pairing with some external iliac lymph nodes.

    03:09 So, this makes sense.

    03:10 The common iliac artery gives rise to internal and external iliac artery.

    03:14 And here we have some internal and iliac lymph nodes.

    03:18 Draining lymph from the destination that those arteries go to.

    03:22 We can also see how some superficial inguinal lymph nodes here.

    03:26 And if we have superficial inguinal lymph nodes, typically we're going to have a deep version as well.

    03:31 So here we have some deep inguinal lymph nodes.

    03:33 And all of these structures form a very complex pattern of lymphatic drainage.

    03:38 Let's have a look at the male reproductive organs, for example.

    03:42 So, here we have the testis.

    03:44 These are going to be supplied by the testicular artery, and they're going to pass towards the lateral aortic lymph nodes, which we can see here.

    03:51 That's important, because that's going to be associated with the inguinal canal.

    03:56 And the inguinal canal is going to be supplied via those superficial inguinal nodes.

    04:03 That means that if you were to remove the testi, from the scrotal sac, because of testicular cancer, then it's important to actually try and remove the testi from the wall off the abdomen.

    04:15 Don't take the testi away from the scrotal sac, because developmentally, they have very different lymphatic drainage.

    04:22 So the lymphatic drainage of the testi, because of its own biological origin, is that of the anterior abdominal wall.

    04:28 So superficial inguinal lymph nodes.

    04:30 So you want to take the testi away up from the inguinal canal.

    04:34 If you were to remove the testi from the scrotal sac, because they're drained by the deep inguinal lymph nodes, you could introduce those cancer cells into that aspect of the lymphatic system, and that could enhance the spread of the cancer, which you'd want to avoid.

    04:49 So, if we now look at the female reproductive organs and their lymphatic drainage, this is interesting because it's very similar to what we spoke about a moment or two ago.

    04:57 So, the external genitalia is going to drain into the superficial inguinal lymph nodes.

    05:01 So, that is synonymous pretty much with the testicle, for example.

    05:05 And then the vagina and the uterus are going to actually be draining into the deep inguinal lymph nodes.

    05:10 So this is why again, removing the testicle passes through the ante abdominal wall superficial inguinal nodes.

    05:17 And this is similar this time for the external genitalia in the female.

    05:21 The vagina and the uterine cervix pass through to the deep inguinal lymph nodes.

    05:25 The uterus and the fallopian tube by the external iliac lymph nodes and also the internal lymph nodes as well.

    05:33 The sacral lymph nodes position most posterior will also have a contribution coming from the pelvic organs in the female so the uterus, fallopian tube, cervix, etc, etc, will pass into this sacral region.

    05:45 The ovaries will also give rise to their lymphatic drainage and that will pass into the lymph nodes associated with the pelvis.

    05:52 These all pass up and similar to what we saw in the male reproductive organs lymphatic drainage.

    05:58 They will pass to the lateral aortic lymph nodes.

    About the Lecture

    The lecture Lymphatic Drainage of the Abdominopelvic Organs by James Pickering, PhD is from the course Lymphatics and Nerves of Abdominopelvic Region.

    Included Quiz Questions

    1. Splenic lymph nodes
    2. Intermediate mesenteric lymph nodes
    3. Juxtaintestinal lymph nodes
    4. Right colic lymph nodes
    5. Ileocolic lymph nodes
    1. Left colic lymph nodes
    2. Middle colic lymph nodes
    3. Right colic lymph nodes
    4. Ileocolic lymph nodes
    5. Intermediate mesenteric lymph nodes
    1. Superficial inguinal lymph nodes
    2. Common iliac lymph nodes
    3. Obturator lymph nodes
    4. External iliac lymph nodes
    5. Deep inguinal lymph nodes

    Author of lecture Lymphatic Drainage of the Abdominopelvic Organs

     James Pickering, PhD

    James Pickering, PhD

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