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1、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,C
2、omposition,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:BlindendSinglelayerofoverlappingendothelialcellsMorep
3、ermeablethanthatofbloodcapillaryAbsentfromavascularstructures,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,Morenume
4、rousvalvesthaninveinInterposedbylymphnodeatintervalalongthecourseArrangedinsuperficialanddeepsets,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)rightandleftlumba
5、rtrunks(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
6、,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,Lympha
7、ticvessels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,Lympha
8、ticvessels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,neckandl
9、eftupperlimb,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,alongthebloodvesselsortheflexuralsideofthejointDividedintosuperficialanddeepgrou
10、ps,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,par
11、otid,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
12、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extendalongtheinternaljugularve
13、infromthebaseofskulltotherootofneckdivideintoSuperiordeeplateralcervicallymphnodes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,
14、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:liesatthejunctionofposteriorbellyofdigastricandinternaljugularvein
15、Inferiordeeplateralcervicallymphnodes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,LymphaticvesselsSuper
16、ficiallymphaticvessels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.subsca
17、pularln.,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,lymphnodesofthethor
18、aciccontentslymphnodesoftrachea,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alongeachsideo
19、fthetrachea,Anteriormediastinallymphnode纵隔前淋巴结liesanteriortothelargebloodvesselsofthoraciccavityandpericardium;theefferentsunitewiththoseofparatracheallymphnodes,toformtherightandleftbronchomediastinaltrunks支气管纵隔干.Theleftbronchomediastinaltrunkterminatesinthoracicduct,andrightintherightlymphticductP
20、osteriormediastinallymphnodes纵隔后淋巴结liealongtheesophagusandthoracicaorta,Thelymphaticdrainageofthorax胸部的淋巴引流,Thelymphaticdrainageofabdomen腹部的淋巴引流,LymphaticdrainageofabdominalwallToaxillarylymphnodefromregionaboveumbilicusTosuperficialinguinallymphnodefromregionbelowumbilicusTolumbarlymphnodefrompostw
21、allofabdomen,axillarylymphnode,superficialinguinallymphnode,LymphaticdrainageofabdominalvisceraLumbarlymphnodes腰淋巴结Lieonposteriorabdominalwall,alongtheabdominalaortaandinferiorvenacavaReceivelymphfromkidneys,suprarenalglands,testes,ovarirs,fundusofuterus,ovary,andcommoniliacnodesTheirefferentvesself
22、ormtherightandleftlumbartrunks,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formedbyefferentvesselofcelia
23、c,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LiealongexternaliliacarteryReceivelymphfro
24、mlowerlimbandsomepartsofpelvicviscera,Thelymphaticdrainageofpelvis盆部的淋巴引流,Sacrallymphnode骶淋巴结locatealongmiddlesacrala.andlateralsacrala.Receivelymphfromposteriorpelvicwall,rectum,prostateoruterusCommoniliaclymphnode髂总淋巴结LiealongcommoniliacarteryReceiveafferentsfromalltheabovenodesEfferentspasstolumb
25、arlymphnode,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
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