人体淋巴系统.ppt

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Superficiallateralcervicallymphnodes liealongtheexternaljugularveinDeeplateralcervicallymphnodes 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 upperpartsofthethoracicwallandbreastefferentvesselsformthejugulartrunk thoracicduct 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