Flashcards in Lymphatic Drainage of the Upper Limb Deck (44):
What does the lymphatic system function to do?
Drain tissue fluid, plasma proteins and other cellular debris back into the blood stream. Involved in immune defence
What is the collection of substances known as once it’s entered the lymphatic vessels?
What happens to lymph?
It is filtered by lymph nodes and directed into the venous system
What do the superficial lymphatic vessels of the upper limb arise from?
Initially the lymphatic plexuses in the skin of the hand
What are lymphatic plexuses?
Networks of lymphatic capillaries beginning in the extracellular spaces
Where to the superficial lymphatic vessels of the arm ascend?
Up the arm, in close proximity to the major superficial veins
Where do the vessels shadowing the basilic vein go?
They enter the cubital lymph nodes
Where are the cubital lymph nodes found?
Medially to the vein, and proximally to the medial epicondyle of the humerus
What happens to vessels carrying on from the cubital lymph nodes?
They continue up the arm, terminating in the lateral axillary lymph nodes
Where do the vessels shadowing the cephalic vein go?
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
What do the deep lymphatic vessels of the upper limb follow?
The major deep veins- radial, ulnar and brachial
How do the deep lymphatic vessels of the upper limb terminate?
In the humeral axillary lymph nodes
What do the deep lymphatic vessels of the upper limb function to do?
Drain lymph from joint capsules, periosteum, tendons and muscles
Where may some additional lymph nodes be found?
Along the ascending path of deep vessels
Where are the majority of upper lymph nodes located?
In the axilla
What groups can the axillary lymph nodes be divided into?
How many pectoral lymph nodes are there?
Where are the pectoral lymph nodes located?
In the medial wall of the axilla
Where do the pectoral lymph nodes receive lymph from?
Primarily the anterior thoracic wall, including most of the breast
How man subscapular lymph nodes are there?
Where are the subscapular lymph nodes located?
Along the posterior axillary fold and subscapular blood vessels
Where do subscapular lymph nodes receive lymph from?
The posterior thoracic wall and scapular region
How many humeral lymph nodes are there?
Where are the humeral lymph nodes located?
In the lateral wall of the axilla, posterior to the axillary vein
Where do the humeral lymph nodes receive lymph from?
Receive the majority of lymph drained from the upper limb
How many central lymph nodes are there?
How big are the central lymph nodes?
Where are the central lymph nodes located?
Near the base of the axilla (deep to the pectoralis minor, close to the 2nd part of the axillary artery)
Where do the central lymph nodes receive lymph from?
Via efferent vessels, from the pectoral, subscapular and humeral axillary lymph node groups
Where are the apical lymph nodes located?
In the apex of the axilla, close to the axillary vein and 1st part of the axillary artery
Where do the apical lymph nodes receive lymph from?
Efferent vessels of the central axillary lymph nodes, therefore from all axillary lymph node groups
From those lymphatic vessels accompanying the cephalic vein
Where to efferent vessels from the apical axillary nodes travel?
Through the cervico-axillary canal
What happens once efferent vessels from the apical axillary nodes have gone through the cervico-axillary canal?
They converge to form the subclavian lymphatic trunk
What does right subclavian lymphatic trunk do?
Continues to form the right lymphatic duct, and enters the right venous angle directly
What is the right venous angle?
Junction of the internal jugular and subclavian veins
What does the left subclavian lymphatic trunk do?
Drains directly into the thoracic duct
What can cause enlargement of axillary lymph nodes?
Infection of the upper limb, resulting in lymphangitis
Infections of the pectoral region and breast
Metastasis of breast cancers
What is lymphangitis?
Inflammation of lymphatic vessels with tender, enlarged lymph nodes
What is usually affected first in lymphangitis?
The humeral group of lymph nodes
What can be seen in lymphangitis?
Red, warm and tender streaks visible in the skin of the upper limb
What is often a vital tool for staging breast cancers?
Removal and analysis of the axillary lymph nodes
What can interruption of lymphatic drainage from the upper limb result in?
What is lymphoedema?
A condition whereby accumulated lymph in the subcutaneous tissue leads to painful swelling of the upper limb