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1、淋巴系统 Lymphatic System,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,Lymph nodes,The Lymphatic System 淋巴系统,Lymphatic-Capillary,Lymphatic,Lymphatic trunks,Lymphatic ducts,（淋巴结）,（淋巴干）,（淋巴导管）,（毛细淋巴管）,A assistant system to the vein 辅助静脉系统回流,Composition,Lymphatic vessels 淋巴管道
2、Lymphatic capillary毛细淋巴管 Lymph vessels淋巴管 Lymphatic trunks (9)淋巴干 Lymphatic ducts(2)淋巴导管 thoracic duct 胸导管 right lymphatic duck右淋巴导管 Lymphatic organs 淋巴器官 Lymph nodes 淋巴结 spleen 脾 thymus胸腺 tonsil扁桃体, Lymphatic tissues 淋巴组织,Features of structure: Blind end Single layer of overlapping endothelial cell
3、s More permeable than that of blood capillary Absent from avascular structures, brain, spinal cord splenic pulp and bone marrow,Lymphatic vessels 淋巴管道,Lymphatic capillary 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,Lymphatic vessel 淋巴管,Features of structure Three layered wall
4、similar to, but thinner than vein, More numerous valves than in vein Interposed by lymph node at interval along the course Arranged in superficial and deep sets,Lymphatic vessels 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,Lymphatic trunks 淋巴干,right and left jugular trunks (颈干) right and left subclav
5、ian trunks （锁骨下干） right and left bronchomediastinal trunks （支气管纵隔干） right and left lumbar trunks （腰干） intestinal trunk（肠干）,Lymphatic vessels 淋巴管道,Right lymphatic duct 右淋巴导管 Formed by union of right jugular, subclavian, and bronchomediastinal trunks Ends by entering the right venous angle右静脉角 Receive
6、s lymph from right half of head, neck, thorax and right upper limb,Lymphatic ducts 淋巴导管,Lymphatic vessels 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,Thoracic duct 胸导管 Begins in front of L1 as a dilated sac, the cisterna chyli 乳糜池, which formed by joining of left and right lumbar trunks and intesti
7、nal trunk Enter thoracic cavity by passing through the aortic hiatus of the diaphragm and ascends along on the front of the vertebral column, between thoracic aorta and azygos vein,Lymphatic vessels 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,Travels upward, veering to the le
8、ft at the level of T5 At the roof of the neck, it turns laterally and arches forwards and descends to enter the left venous angle Just before termination, it receives the left jugular, subclavian and ronchomediastinal trunks,Lymphatic vessels 淋巴管道,Thoracic duct 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
9、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,Thoracic duct 胸导管,Just before termination, it receives the left jugular, subclavian and bronchomediastinal trunks Drains lymph from lower limbs, pelvic cavity, abdominal cavity, left side of thorax, and left side of the head, neck and left upper limb,Lymphatic vesse
10、ls 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,Lymph node 淋巴结,Features Bean-shaped bodies With afferent lymph vessels输入淋巴管 (entering at the periphery) and efferent lymph vessels输出淋巴管(emerging at the hilus) Arranged in groups, along the blood vessels or the flexural side of the joint Divided into superficial
11、and deep groups,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,Regional Lymph Node局部淋巴结 is the lymph node where the lymph of the organ or part of the body drainge to firstly Sentinel Lymph Node前哨淋巴结(in clinic),Lymph node 淋巴结,Lymph drainage of the body,.Lymph drainage of the head 头部的淋巴引流,Lymph nodes of head Located
12、at junction of head and neck Consist of occipital, mastoid, parotid, submandibular, submental lymph nodes Drain into deep cervical lymph nodes Submandibular lymph node 下颌下淋巴结 lies near the submandibular gland, receive lymphatic vessels from the face, nose and mouth,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
13、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,Lymph drainage of neck 颈部的淋巴引流,Anterior cervical lymph nodes颈前淋巴结 Superficial anterior cervical lymph nodes Deep anterior cervical lymph nodes Lateral cervical lymph node 颈外侧淋巴结 Superficial lateral cervical lymph nodeslie along the external jugular vein Deep late
14、ral cervical lymph nodes,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,Deep lateral cervical lymph nodes颈外侧深淋巴结 extend along the internal jugular vein from the base of skull to the root of neck divide into Superior deep lateral cervical lymph nodes颈外侧上深淋巴结 Inferior deep lateral cervical lymph nodes颈外侧下深淋巴结,Ly
15、mph drainage of neck 颈部的淋巴引流,沿颈内静脉扩展 从颅底至颈根部,Deep lateral cervical lymph nodes颈外侧深淋巴结 receive lymphatic vessels from head, neck, tongue, larynx, cervical parts of esophagus and trachea, thyroid gland, upper parts of the thoracic wall and breast efferent vessels form the jugular trunk thoracic duct(l
16、eft) right lymphatic duct (right),Lymph drainage of neck 颈部的淋巴引流,Superior deep lateral cervical lymph nodes 颈外侧上深淋巴结 Jugulodigastric lymph node 颈内静脉二腹肌淋巴结: lies at the junction of posterior belly of digastric and internal jugular vein Inferior deep lateral cervical lymph nodes 颈外侧下深淋巴结 Juguloomohyoi
17、d lymph node 颈内静脉肩胛舌骨肌淋巴结: lies at the junction of the intermediate tendon of omohyoid and internal jugular vein Supraclavicular lymph nodes 锁骨上淋巴结: lie along the subclavian artery,Lymph drainage of neck 颈部的淋巴引流,The lymphatic drainage of upper limb 上肢的淋巴引流,Lymphatic vessels Superficial lymphatic ves
18、sels 浅淋巴管 伴随浅静脉 注入滑车上淋巴结和腋淋巴结 Deep lymphatic vessels 深淋巴管 伴随深静脉 注入腋淋巴结 lymph nodes Cubital lymph node滑车上淋巴结 Axillary lymph node腋淋巴结,Axillary lymph nodes 腋淋巴结,The axillary lymph nodes mey be divided into lateral ln.外侧淋巴结 pectoral ln.胸肌淋巴结 subscapular ln.肩胛下淋巴结 central ln.中央淋巴结 apical ln.尖淋巴结,lateral
19、ln. pectoral ln. subscapular ln.,central ln.,apical ln.,subclavian trunk,The lymphatic drainage of thorax 胸部的淋巴引流,The lymphatic drainage of thoracic wall To axillary lymph nodes To parasternal lymph nodes胸骨旁淋巴结 (along internal thoracic vessels) To intercostals lymph nodes肋间淋巴结 from deeper structures
20、,The lymphatic drainage of thorax 胸部的淋巴引流,lymph nodes of the thoracic contents lymph nodes of trachea, bronchi and lungs Pulmonary lymph nodes肺淋巴结lie in the angles of bifurcation of branching lobar bronchi Bronchopulmonary hilar lymph nodes支气管肺门淋巴结lie in the hilus of the lung Tracheobronchial lymph
21、nodes气管支气管淋巴结situated above or below the bifurcation of trachea Paratracheal lymph nodes 气管旁淋巴结along each side of the trachea,Anterior mediastinal lymph node纵隔前淋巴结 lies anterior to the large blood vessels of thoracic cavity and pericardium; the efferents unite with those of paratracheal lymph nodes,
22、 to form the right and left bronchomediastinal trunks 支气管纵隔干. The left bronchomediastinal trunk terminates in thoracic duct, and right in the right lymphtic duct Posterior mediastinal lymph nodes纵隔后淋巴结 lie along the esophagus and thoracic aorta,The lymphatic drainage of thorax 胸部的淋巴引流,The lymphatic
23、drainage of abdomen 腹部的淋巴引流,Lymphatic drainage of abdominal wall To axillary lymph node from region above umbilicus To superficial inguinal lymph node from region below umbilicus To lumbar lymph node from post wall of abdomen,axillary lymph node,superficial inguinal lymph node,Lymphatic drainage of
24、abdominal viscera Lumbar lymph nodes 腰淋巴结 Lie on posterior abdominal wall, along the abdominal aorta and inferior vena cava Receive lymph from kidneys, suprarenal glands, testes, ovarirs, fundus of uterus, ovary, and common iliac nodes Their efferent vessel form the right and left lumbar trunks,The
25、lymphatic drainage of abdomen 腹部的淋巴引流,Celiac lymph nodes 腹腔淋巴结 situated around the celiac trunk Superior mesenteric lymph node 肠系膜上淋巴结 situated around superior mesenteric a. Inferior mesenteric lymph node 肠系膜下淋巴结 situated around inferior mesenteric a. Intestinal trunk 腹腔干 formed by efferent vessel o
26、f celiac, superior and inferior mesenteric lymph nodes,The lymphatic drainage of abdomen 腹部的淋巴引流,The lymphatic drainage of pelvis 盆部的淋巴引流,Internal iliac lymph node 髂内淋巴结 Surround internal iliac vessels Receive lymph from pelvic viscera, perineum, buttock and back of thigh External iliac lymph nodes
27、髂外淋巴结 Lie along external iliac artery Receive lymph from lower limb and some parts of pelvic viscera,The lymphatic drainage of pelvis 盆部的淋巴引流,Sacral lymph node 骶淋巴结 locate along middle sacral a. and lateral sacral a. Receive lymph from posterior pelvic wall ,rectum,prostate or uterus Common iliac ly
28、mph node髂总淋巴结 Lie along common iliac artery Receive afferents from all the above nodes Efferents pass to lumbar lymph node,lymph drainage of lower limb下肢的淋巴,lymphatic vessels Superficial lymphatic Deep lymphatic Lymph nodes Superficial lymph node 腹股沟浅淋巴结 Deep lymph node 腹股沟深淋巴结,lymph drainage of low
29、er limb下肢的淋巴,Superficial lymph node腹股沟浅淋巴结 may be divided into two groups Upper group: below the inguinal lig.腹股沟韧带 Lower group: around the terminal part of great saphenous v.大隐静脉 Receive lymph from lower part of abdominal wall,perineum 会阴and lower limb with the exception of region drained by poplit
30、eal ln.腘淋巴结,lymph drainage of lower limb下肢的淋巴,deep lymph node 腹股沟深淋巴结 Locate around the proximal end of femoral v. Receive lymph from deep lymphatic vessels of lower limb and the efferentlymphatic vessels of superficial inguinal ln.腹股沟浅淋巴结 Their efferent lymphatic vessels empty into external iliac l
31、n.髂外淋巴结,Popliteal ln.腘淋巴结 Embedded in the fatty connective tissue of popliteal fossa Receive superficial lymphatic vessels from posterolateral part of calf小腿, and from deep lymphatic vessels accompanying anterior and posterior tibial a. Efferents pass to the deep inguinal ln.腹股沟深淋巴结,lymph drainage o
32、f lower limb 下肢的淋巴,Celiac lymph nodes,Superior mesenteric lymph node 肠系膜上淋巴结,Inferior mesenteric lymph node 肠系膜下淋巴结,Spleen 脾,Location Left epigastric region between 9th-11th rib in line of 10th rib Features Diaphragmatic surface Visceral surface - Splenic Hilum Anterior extremity Posterior extremity Superior border- Splenic Notch Inferior border Function,Thymus 胸腺,Featrues Consists of two elongated lobes Is large organ in the fetus Occupies the thoracic cavity behind the sternum Secrete lymphopoietin,