人体淋巴系统

Introductionoflymphology,原版：山东大学医学院人体解剖教研室补充增加中文2012.5,淋巴系统LymphaticSystem,1回收蛋白质运输脂肪及营养物质2清除组织中的红细胞细菌和异物3调节血浆和组织液间的液体平衡4产生淋巴细胞和浆细胞参与免疫反应,淋巴回流,Lymphnodes,TheLymphaticSystem淋巴系统,Lymphatic-Capillary,Lymphatic,Lymphatictrunks,Lymphaticducts,（淋巴结）,（淋巴干）,（淋巴导管）,（毛细淋巴管）,Aassistantsystemtothevein辅助静脉系统回流,Composition,Lymphaticvessels淋巴管道Lymphaticcapillary毛细淋巴管Lymphvessels淋巴管Lymphatictrunks(9)淋巴干Lymphaticducts(2)淋巴导管thoracicduct胸导管rightlymphaticduck右淋巴导管Lymphaticorgans淋巴器官Lymphnodes淋巴结spleen脾thymus胸腺tonsil扁桃体,Lymphatictissues淋巴组织,Featuresofstructure:BlindendSinglelayerofoverlappingendothelialcellsMorepermeablethanthatofbloodcapillaryAbsentfromavascularstructures,brain,spinalcordsplenicpulpandbonemarrow,Lymphaticvessels淋巴管道,Lymphaticcapillary毛细淋巴管,盲端,单层重叠内皮细胞,比毛细血管通透性更强,脑，脊髓，脾髓，骨髓无此结构,软骨、上皮、牙釉质、角膜与晶状体等亦无此结构,Lymphaticvessel淋巴管,FeaturesofstructureThreelayeredwallsimilarto,butthinnerthanvein,MorenumerousvalvesthaninveinInterposedbylymphnodeatintervalalongthecourseArrangedinsuperficialanddeepsets,Lymphaticvessels淋巴管道,类似三层墙，比静脉细,瓣膜远多于静脉,中间有淋巴结插入,分浅、深两种淋巴管,Lymphatictrunks淋巴干,rightandleftjugulartrunks(颈干)rightandleftsubclaviantrunks（锁骨下干）rightandleftbronchomediastinaltrunks（支气管纵隔干）rightandleftlumbartrunks（腰干）intestinaltrunk（肠干）,Lymphaticvessels淋巴管道,Rightlymphaticduct右淋巴导管Formedbyunionofrightjugular,subclavian,andbronchomediastinaltrunksEndsbyenteringtherightvenousangle右静脉角Receiveslymphfromrighthalfofhead,neck,thoraxandrightupperlimb,Lymphaticducts淋巴导管,Lymphaticvessels淋巴管道,由右颈干，锁骨下干，支气管纵膈干联合构成,收集右半脑，颈部，胸，右上肢的淋巴液,Thoracicduct胸导管BeginsinfrontofL1asadilatedsac,thecisternachyli乳糜池,whichformedbyjoiningofleftandrightlumbartrunksandintestinaltrunkEnterthoraciccavitybypassingthroughtheaortichiatusofthediaphragmandascendsalongonthefrontofthevertebralcolumn,betweenthoracicaortaandazygosvein,Lymphaticvessels淋巴管道,起源于第一腰椎前方的乳糜池，由左右腰干和肠干联合构成,穿过膈上的主动脉裂孔，沿着脊柱前方，在胸主动脉和奇静脉之间上升进入胸腔,Travelsupward,veeringtotheleftatthelevelofT5Attheroofoftheneck,itturnslaterallyandarchesforwardsanddescendstoentertheleftvenousangleJustbeforetermination,itreceivestheleftjugular,subclavianandronchomediastinaltrunks,Lymphaticvessels淋巴管道,Thoracicduct胸导管,进入胸腔顺时针转入第五胸椎左侧,到达颈根部，转至侧面呈弧形弯入左静脉角,进入左静脉角前，收集左颈干，左锁骨下干，左支气管纵膈干的淋巴液,Thoracicduct胸导管,Justbeforetermination,itreceivestheleftjugular,subclavianandbronchomediastinaltrunksDrainslymphfromlowerlimbs,pelviccavity,abdominalcavity,leftsideofthorax,andleftsideofthehead,neckandleftupperlimb,Lymphaticvessels淋巴管道,胸导管引流下肢、盆腔、腹腔、左上肢、左胸部和左头颈部的淋巴,Lymphnode淋巴结,FeaturesBean-shapedbodiesWithafferentlymphvessels输入淋巴管(enteringattheperiphery)andefferentlymphvessels输出淋巴管(emergingatthehilus)Arrangedingroups,alongthebloodvesselsortheflexuralsideofthejointDividedintosuperficialanddeepgroups,沿着血管或者关节屈处分布成群的淋巴结,分为浅部和深部淋巴结群,RegionalLymphNode局部淋巴结isthelymphnodewherethelymphoftheorganorpartofthebodydraingetofirstlySentinelLymphNode前哨淋巴结(inclinic),Lymphnode淋巴结,Lymphdrainageofthebody,.Lymphdrainageofthehead头部的淋巴引流,LymphnodesofheadLocatedatjunctionofheadandneckConsistofoccipital,mastoid,parotid,submandibular,submentallymphnodesDrainintodeepcervicallymphnodesSubmandibularlymphnode下颌下淋巴结liesnearthesubmandibulargland,receivelymphaticvesselsfromtheface,noseandmouth,头颈交界处排列,由枕淋巴结，乳突淋巴结，腮腺淋巴结，下颌下淋巴结，颏下淋巴结组成,流入颈部淋巴结,位于下颌下腺附近，接收面，鼻，和嘴的淋巴管,Lymphdrainageofneck颈部的淋巴引流,Anteriorcervicallymphnodes颈前淋巴结SuperficialanteriorcervicallymphnodesDeepanteriorcervicallymphnodesLateralcervicallymphnode颈外侧淋巴结SuperficiallateralcervicallymphnodesliealongtheexternaljugularveinDeeplateralcervicallymphnodes,颈前浅淋巴结,颈前深淋巴结,颈外侧浅淋巴结颈外静脉排列,颈外侧深淋巴结,Deeplateralcervicallymphnodes颈外侧深淋巴结extendalongtheinternaljugularveinfromthebaseofskulltotherootofneckdivideintoSuperiordeeplateralcervicallymphnodes颈外侧上深淋巴结Inferiordeeplateralcervicallymphnodes颈外侧下深淋巴结,Lymphdrainageofneck颈部的淋巴引流,沿颈内静脉扩展从颅底至颈根部,Deeplateralcervicallymphnodes颈外侧深淋巴结receivelymphaticvesselsfromhead,neck,tongue,larynx,cervicalpartsofesophagusandtrachea,thyroidgland,upperpartsofthethoracicwallandbreastefferentvesselsformthejugulartrunkthoracicduct(left)rightlymphaticduct(right),Lymphdrainageofneck颈部的淋巴引流,Superiordeeplateralcervicallymphnodes颈外侧上深淋巴结Jugulodigastriclymphnode颈内静脉二腹肌淋巴结:liesatthejunctionofposteriorbellyofdigastricandinternaljugularveinInferiordeeplateralcervicallymphnodes颈外侧下深淋巴结Juguloomohyoidlymphnode颈内静脉肩胛舌骨肌淋巴结:liesatthejunctionoftheintermediatetendonofomohyoidandinternaljugularveinSupraclavicularlymphnodes锁骨上淋巴结:liealongthesubclavianartery,Lymphdrainageofneck颈部的淋巴引流,Thelymphaticdrainageofupperlimb上肢的淋巴引流,LymphaticvesselsSuperficiallymphaticvessels浅淋巴管伴随浅静脉注入滑车上淋巴结和腋淋巴结Deeplymphaticvessels深淋巴管伴随深静脉注入腋淋巴结lymphnodesCubitallymphnode滑车上淋巴结Axillarylymphnode腋淋巴结,Axillarylymphnodes腋淋巴结,Theaxillarylymphnodesmeybedividedintolateralln.外侧淋巴结pectoralln.胸肌淋巴结subscapularln.肩胛下淋巴结centralln.中央淋巴结apicalln.尖淋巴结,lateralln.pectoralln.subscapularln.,centralln.,apicalln.,subclaviantrunk,Thelymphaticdrainageofthorax胸部的淋巴引流,ThelymphaticdrainageofthoracicwallToaxillarylymphnodesToparasternallymphnodes胸骨旁淋巴结(alonginternalthoracicvessels)Tointercostalslymphnodes肋间淋巴结fromdeeperstructures,Thelymphaticdrainageofthorax胸部的淋巴引流,lymphnodesofthethoraciccontentslymphnodesoftrachea,bronchiandlungsPulmonarylymphnodes肺淋巴结lieintheanglesofbifurcationofbranchinglobarbronchiBronchopulmonaryhilarlymphnodes支气管肺门淋巴结lieinthehilusofthelungTracheobronchiallymphnodes气管支气管淋巴结situatedaboveorbelowthebifurcationoftracheaParatracheallymphnodes气管旁淋巴结alongeachsideofthetrachea,Anteriormediastinallymphnode纵隔前淋巴结liesanteriortothelargebloodvesselsofthoraciccavityandpericardium;theefferentsunitewiththoseofparatracheallymphnodes,toformtherightandleftbronchomediastinaltrunks支气管纵隔干.Theleftbronchomediastinaltrunkterminatesinthoracicduct,andrightintherightlymphticductPosteriormediastinallymphnodes纵隔后淋巴结liealongtheesophagusandthoracicaorta,Thelymphaticdrainageofthorax胸部的淋巴引流,Thelymphaticdrainageofabdomen腹部的淋巴引流,LymphaticdrainageofabdominalwallToaxillarylymphnodefromregionaboveumbilicusTosuperficialinguinallymphnodefromregionbelowumbilicusTolumbarlymphnodefrompostwallofabdomen,axillarylymphnode,superficialinguinallymphnode,LymphaticdrainageofabdominalvisceraLumbarlymphnodes腰淋巴结Lieonposteriorabdominalwall,alongtheabdominalaortaandinferiorvenacavaReceivelymphfromkidneys,suprarenalglands,testes,ovarirs,fundusofuterus,ovary,andcommoniliacnodesTheirefferentvesselformtherightandleftlumbartrunks,Thelymphaticdrainageofabdomen腹部的淋巴引流,Celiaclymphnodes腹腔淋巴结situatedaroundtheceliactrunkSuperiormesentericlymphnode肠系膜上淋巴结situatedaroundsuperiormesenterica.Inferiormesentericlymphnode肠系膜下淋巴结situatedaroundinferiormesenterica.Intestinaltrunk腹腔干formedbyefferentvesselofceliac,superiorandinferiormesentericlymphnodes,Thelymphaticdrainageofabdomen腹部的淋巴引流,Thelymphaticdrainageofpelvis盆部的淋巴引流,Internaliliaclymphnode髂内淋巴结SurroundinternaliliacvesselsReceivelymphfrompelvicviscera,perineum,buttockandbackofthighExternaliliaclymphnodes髂外淋巴结LiealongexternaliliacarteryReceivelymphfromlowerlimbandsomepartsofpelvicviscera,Thelymphaticdrainageofpelvis盆部的淋巴引流,Sacrallymphnode骶淋巴结locatealongmiddlesacrala.andlateralsacrala.Receivelymphfromposteriorpelvicwall,rectum,prostateoruterusCommoniliaclymphnode髂总淋巴结LiealongcommoniliacarteryReceiveafferentsfromalltheabovenodesEfferentspasstolumbarlymphnode,lymphdrainageoflowerlimb下肢的淋巴,lymphaticvesselsSuperficiallymphaticDeeplymphaticLymphnodesSuperficiallymphnode腹股沟浅淋巴结Deeplymphnode腹股沟深淋巴结,lymphdrainageoflowerlimb下肢的淋巴,Superficiallymphnode腹股沟浅淋巴结maybedividedintotwogroupsUppergroup:belowtheinguinallig.腹股沟韧带Lowergroup:aroundtheterminalpartofgreatsaphenousv.大隐静脉Receivelymphfromlowerpartofabdominalwall,perineum会阴andlowerlimbwiththeexceptionofregiondrainedbypoplitealln.腘淋巴结,lymphdrainageoflowerlimb下肢的淋巴,deeplymphnode腹股沟深淋巴结Locatearoundtheproximalendoffemoralv.Receivelymphfromdeep