Lymphatic Drainage of the Upper Limb

Question 1

What does the lymphatic system function to do?

Answer 1

Drain tissue fluid, plasma proteins and other cellular debris back into the blood stream. Involved in immune defence

Question 2

What is the collection of substances known as once it’s entered the lymphatic vessels?

Answer 2

Lymph

Question 3

What happens to lymph?

Answer 3

It is filtered by lymph nodes and directed into the venous system

Question 4

What do the superficial lymphatic vessels of the upper limb arise from?

Answer 4

Initially the lymphatic plexuses in the skin of the hand

Question 5

What are lymphatic plexuses?

Answer 5

Networks of lymphatic capillaries beginning in the extracellular spaces

Question 6

Where to the superficial lymphatic vessels of the arm ascend?

Answer 6

Up the arm, in close proximity to the major superficial veins

Question 7

Where do the vessels shadowing the basilic vein go?

Answer 7

They enter the cubital lymph nodes

Question 8

Where are the cubital lymph nodes found?

Answer 8

Medially to the vein, and proximally to the medial epicondyle of the humerus

Question 9

What happens to vessels carrying on from the cubital lymph nodes?

Answer 9

They continue up the arm, terminating in the lateral axillary lymph nodes

Question 10

Where do the vessels shadowing the cephalic vein go?

Answer 10

Generally, they cross the proximal part of the arm and shoulder to enter the apical axially lymph nodes, though some exceptions instead enter the more superficial deltopectoral lymph nodes

Question 11

What do the deep lymphatic vessels of the upper limb follow?

Answer 11

The major deep veins- radial, ulnar and brachial

Question 12

How do the deep lymphatic vessels of the upper limb terminate?

Answer 12

In the humeral axillary lymph nodes

Question 13

What do the deep lymphatic vessels of the upper limb function to do?

Answer 13

Drain lymph from joint capsules, periosteum, tendons and muscles

Question 14

Where may some additional lymph nodes be found?

Answer 14

Along the ascending path of deep vessels

Question 15

Where are the majority of upper lymph nodes located?

Answer 15

In the axilla

Question 16

What groups can the axillary lymph nodes be divided into?

Answer 16

Pectoral (anterior)
 Subscapular (posterior)
 Humeral (lateral)
 Central
 Apical

Question 17

How many pectoral lymph nodes are there?

Answer 17

03-May

Question 18

Where are the pectoral lymph nodes located?

Answer 18

In the medial wall of the axilla

Question 19

Where do the pectoral lymph nodes receive lymph from?

Answer 19

Primarily the anterior thoracic wall, including most of the breast

Question 20

How man subscapular lymph nodes are there?

Answer 20

06-Jul

Question 21

Where are the subscapular lymph nodes located?

Answer 21

Along the posterior axillary fold and subscapular blood vessels

Question 22

Where do subscapular lymph nodes receive lymph from?

Answer 22

The posterior thoracic wall and scapular region

Question 23

How many humeral lymph nodes are there?

Answer 23

04-Jun

Question 24

Where are the humeral lymph nodes located?

Answer 24

In the lateral wall of the axilla, posterior to the axillary vein

Question 25

Where do the humeral lymph nodes receive lymph from?

Answer 25

Receive the majority of lymph drained from the upper limb

Question 26

How many central lymph nodes are there?

Answer 26

03-Apr

Question 27

How big are the central lymph nodes?

Answer 27

Large

Question 28

Where are the central lymph nodes located?

Answer 28

Near the base of the axilla (deep to the pectoralis minor, close to the 2nd part of the axillary artery)

Question 29

Where do the central lymph nodes receive lymph from?

Answer 29

Via efferent vessels, from the pectoral, subscapular and humeral axillary lymph node groups

Question 30

Where are the apical lymph nodes located?

Answer 30

In the apex of the axilla, close to the axillary vein and 1st part of the axillary artery

Question 31

Where do the apical lymph nodes receive lymph from?

Answer 31

Efferent vessels of the central axillary lymph nodes, therefore from all axillary lymph node groups
From those lymphatic vessels accompanying the cephalic vein

Question 32

Where to efferent vessels from the apical axillary nodes travel?

Answer 32

Through the cervico-axillary canal

Question 33

What happens onceefferent vessels from the apical axillary nodes have gone through the cervico-axillary canal?

Answer 33

They converge to form the subclavian lymphatic trunk

Question 34

What does right subclavian lymphatic trunk do?

Answer 34

Continues to form the right lymphatic duct, and enters the right venous angle directly

Question 35

What is the right venous angle?

Answer 35

Junction of the internal jugular and subclavian veins

Question 36

What does the left subclavian lymphatic trunk do?

Answer 36

Drains directly into the thoracic duct

Question 37

What can cause enlargement of axillary lymph nodes?

Answer 37

Infection of the upper limb, resulting in lymphangitis
Infections of the pectoral region and breast
Metastasis of breast cancers

Question 38

What is lymphangitis?

Answer 38

Inflammation of lymphatic vessels with tender, enlarged lymph nodes

Question 39

What is usually affected first in lymphangitis?

Answer 39

The humeral group of lymph nodes

Question 40

What can be seen in lymphangitis?

Answer 40

Red, warm and tender streaks visible in the skin of the upper limb

Question 41

What is often a vital tool for staging breast cancers?

Answer 41

Removal and analysis of the axillary lymph nodes

Question 42

What can interruption of lymphatic drainage from the upper limb result in?

Answer 42

Lymphoedema

Question 43

What is lymphoedema?

Answer 43

A condition whereby accumulated lymph in the subcutaneous tissue leads to painful swelling of the upper limb

Question 44

What is at risk of damage during an axillary lymph node dissection?

Answer 44

The long thoracic nerve or thoracodorsal nerve