淋巴系統(tǒng)LymphaticSystem淋巴管道：毛細(xì)淋巴管、淋巴管、淋巴干、淋巴導(dǎo)管

lymph

vessel淋巴器官：淋巴結(jié)、脾、胸腺、扁桃體lymphaticorgan淋巴組織：含大量淋巴細(xì)胞（彌散的和淋巴小結(jié)）

lymphatictissue組成功能輔助靜脈回流產(chǎn)生淋巴細(xì)胞過濾淋巴液參與免疫應(yīng)答7/28/20231人體淋巴系統(tǒng)1回收蛋白質(zhì)運(yùn)輸脂肪及營養(yǎng)物質(zhì)2清除組織中的紅細(xì)胞細(xì)菌和異物3調(diào)節(jié)血漿和組織液間的液體平衡4產(chǎn)生淋巴細(xì)胞和漿細(xì)胞參與免疫反應(yīng)淋巴回流7/28/20232人體淋巴系統(tǒng)LymphnodesTheLymphaticSystem淋巴系統(tǒng)ACapVLymphatic-CapillaryLymphaticLymphatictrunksLymphaticducts（淋巴結(jié)）（淋巴干）（淋巴導(dǎo)管）（毛細(xì)淋巴管）7/28/20233人體淋巴系統(tǒng)Aassistantsystemtothevein輔助靜脈系統(tǒng)回流7/28/20234人體淋巴系統(tǒng)CompositionLymphaticvessels淋巴管道Lymphaticcapillary毛細(xì)淋巴管Lymphvessels淋巴管

Lymphatictrunks(9)淋巴干

Lymphaticducts(2)淋巴導(dǎo)管

thoracicduct

胸導(dǎo)管

rightlymphaticduck右淋巴導(dǎo)管Lymphaticorgans

淋巴器官Lymphnodes淋巴結(jié)spleen脾thymus胸腺

tonsil扁桃體,

Lymphatictissues

淋巴組織7/28/20235人體淋巴系統(tǒng)Featuresofstructure:

BlindendSinglelayerofoverlappingendothelialcellsMorepermeablethanthatofbloodcapillaryAbsentfromavascularstructures,brain,spinalcordsplenicpulpandbonemarrowLymphaticvessels淋巴管道Lymphaticcapillary

毛細(xì)淋巴管

盲端單層重疊內(nèi)皮細(xì)胞比毛細(xì)血管通透性更強(qiáng)腦，脊髓，脾髓，骨髓無此結(jié)構(gòu)軟骨、上皮、牙釉質(zhì)、角膜與晶狀體等亦無此結(jié)構(gòu)7/28/20236人體淋巴系統(tǒng)Lymphaticvessel淋巴管

FeaturesofstructureThreelayeredwallsimilarto,butthinnerthanvein,MorenumerousvalvesthaninveinInterposedbylymphnodeatintervalalongthecourseArrangedinsuperficialanddeepsetsLymphaticvessels淋巴管道類似三層墻，比靜脈細(xì)瓣膜遠(yuǎn)多于靜脈中間有淋巴結(jié)插入分淺、深兩種淋巴管7/28/20237人體淋巴系統(tǒng)Lymphatictrunks淋巴干

rightandleftjugulartrunks

(頸干)rightandleftsubclavian

trunks

（鎖骨下干）rightandleftbronchomediastinal

trunks

（支氣管縱隔干）rightandleftlumbartrunks

（腰干）intestinaltrunk（腸干）Lymphaticvessels淋巴管道7/28/20238人體淋巴系統(tǒng)Rightlymphaticduct

右淋巴導(dǎo)管Formedbyunionofrightjugular,subclavian,andbronchomediastinaltrunksEndsbyenteringtherightvenousangle右靜脈角Receiveslymphfromrighthalfofhead,neck,thoraxandrightupperlimbLymphaticducts淋巴導(dǎo)管

Lymphaticvessels淋巴管道由右頸干，鎖骨下干，支氣管縱膈干聯(lián)合構(gòu)成收集右半腦，頸部，胸，右上肢的淋巴液7/28/20239人體淋巴系統(tǒng)Thoracicduct

胸導(dǎo)管BeginsinfrontofL1asadilatedsac,thecisterna

chyli

乳糜池,whichformedbyjoiningofleftandrightlumbartrunksandintestinaltrunkEnterthoraciccavitybypassingthroughtheaortichiatusofthediaphragmandascendsalongonthefrontofthevertebralcolumn,betweenthoracicaortaandazygosveinLymphaticvessels淋巴管道起源于第一腰椎前方的乳糜池，由左右腰干和腸干聯(lián)合構(gòu)成穿過膈上的主動(dòng)脈裂孔，沿著脊柱前方，在胸主動(dòng)脈和奇靜脈之間上升進(jìn)入胸腔7/28/202310人體淋巴系統(tǒng)Travelsupward,veeringtotheleftatthelevelofT5Attheroofoftheneck,itturnslaterallyandarchesforwardsanddescendstoentertheleftvenousangleJustbeforetermination,itreceivestheleftjugular,subclavianandronchomediastinaltrunksLymphaticvessels淋巴管道Thoracicduct

胸導(dǎo)管進(jìn)入胸腔順時(shí)針轉(zhuǎn)入第五胸椎左側(cè)到達(dá)頸根部，轉(zhuǎn)至側(cè)面呈弧形彎入左靜脈角進(jìn)入左靜脈角前，收集左頸干，左鎖骨下干，左支氣管縱膈干的淋巴液7/28/202311人體淋巴系統(tǒng)Thoracicduct

胸導(dǎo)管Justbeforetermination,itreceivestheleftjugular,subclavianandbronchomediastinaltrunksDrainslymphfromlowerlimbs,pelviccavity,abdominalcavity,leftsideofthorax,andleftsideofthehead,neckandleftupperlimbLymphaticvessels淋巴管道胸導(dǎo)管引流下肢、盆腔、腹腔、左上肢、左胸部和左頭頸部的淋巴7/28/202312人體淋巴系統(tǒng)Lymphnode淋巴結(jié)FeaturesBean-shapedbodiesWithafferentlymphvessels輸入淋巴管

(enteringattheperiphery)andefferentlymphvessels輸出淋巴管(emergingatthehilus)Arrangedingroups,alongthebloodvesselsortheflexuralsideofthejointDividedintosuperficialanddeepgroups沿著血管或者關(guān)節(jié)屈處分布成群的淋巴結(jié)分為淺部和深部淋巴結(jié)群7/28/202313人體淋巴系統(tǒng)RegionalLymphNode局部淋巴結(jié)

isthelymphnodewherethelymphoftheorganorpartofthebodydraingetofirstly

SentinelLymphNode前哨淋巴結(jié)(inclinic)

Lymphnode淋巴結(jié)7/28/202314人體淋巴系統(tǒng)Lymphdrainageofthebody7/28/202315人體淋巴系統(tǒng)Ⅰ.Lymphdrainageofthehead

頭部的淋巴引流

LymphnodesofheadLocatedatjunctionofheadandneckConsistofoccipital,mastoid,parotid,submandibular,submentallymphnodesDrainintodeepcervicallymphnodesSubmandibularlymphnode下頜下淋巴結(jié)liesnearthesubmandibulargland,receivelymphaticvesselsfromtheface,noseandmouth頭頸交界處排列由枕淋巴結(jié)，乳突淋巴結(jié)，腮腺淋巴結(jié)，下頜下淋巴結(jié)，頦下淋巴結(jié)組成流入頸部淋巴結(jié)位于下頜下腺附近，接收面，鼻，和嘴的淋巴管7/28/202316人體淋巴系統(tǒng)Lymphdrainageofneck

頸部的淋巴引流Anteriorcervicallymphnodes頸前淋巴結(jié)SuperficialanteriorcervicallymphnodesDeepanteriorcervicallymphnodesLateralcervicallymphnode

頸外側(cè)淋巴結(jié)Superficiallateralcervicallymphnodes－liealongtheexternaljugularveinDeep

lateralcervicallymphnodes頸前淺淋巴結(jié)頸前深淋巴結(jié)頸外側(cè)淺淋巴結(jié)——頸外靜脈排列頸外側(cè)深淋巴結(jié)7/28/202317人體淋巴系統(tǒng)Deeplateralcervicallymphnodes頸外側(cè)深淋巴結(jié)extendalongtheinternaljugularveinfromthebaseofskulltotherootofneckdivideintoSuperiordeeplateralcervicallymphnodes頸外側(cè)上深淋巴結(jié)Inferiordeeplateralcervicallymphnodes頸外側(cè)下深淋巴結(jié)Lymphdrainageofneck

頸部的淋巴引流沿頸內(nèi)靜脈擴(kuò)展從顱底至頸根部7/28/202318人體淋巴系統(tǒng)Deeplateralcervicallymphnodes頸外側(cè)深淋巴結(jié)receivelymphaticvesselsfromhead,neck,tongue,larynx,cervicalpartsofesophagusandtrachea,thyroidgland,upperpartsofthethoracicwallandbreastefferentvesselsformthejugulartrunk→thoracicduct(left)→

rightlymphaticduct

(right)Lymphdrainageofneck

頸部的淋巴引流7/28/202319人體淋巴系統(tǒng)Superiordeeplateralcervicallymphnodes

頸外側(cè)上深淋巴結(jié)Jugulodigastriclymphnode

頸內(nèi)靜脈二腹肌淋巴結(jié):liesatthejunctionofposteriorbellyofdigastricandinternaljugularveinInferiordeeplateralcervicallymphnodes

頸外側(cè)下深淋巴結(jié)Juguloomohyoidlymphnode

頸內(nèi)靜脈肩胛舌骨肌淋巴結(jié):liesatthejunctionoftheintermediatetendonofomohyoidandinternaljugularveinSupraclavicularlymphnodes

鎖骨上淋巴結(jié):liealongthesubclavianarteryLymphdrainageofneck

頸部的淋巴引流7/28/202320人體淋巴系統(tǒng)Thelymphaticdrainageofupperlimb上肢的淋巴引流LymphaticvesselsSuperficiallymphaticvessels淺淋巴管伴隨淺靜脈注入滑車上淋巴結(jié)和腋淋巴結(jié)Deeplymphaticvessels深淋巴管伴隨深靜脈注入腋淋巴結(jié)

lymphnodesCubitallymphnode滑車上淋巴結(jié)Axillarylymphnode腋淋巴結(jié)7/28/202321人體淋巴系統(tǒng)Axillarylymphnodes腋淋巴結(jié)Theaxillarylymphnodesmeybedividedintolateralln.外側(cè)淋巴結(jié)pectoralln.胸肌淋巴結(jié)subscapularln.肩胛下淋巴結(jié)centralln.中央淋巴結(jié)apicalln.尖淋巴結(jié)lateralln.pectoralln.subscapularln.centralln.apicalln.subclaviantrunk7/28/202322人體淋巴系統(tǒng)Thelymphaticdrainageofthorax

胸部的淋巴引流ThelymphaticdrainageofthoracicwallToaxillarylymphnodesToparasternallymphnodes胸骨旁淋巴結(jié)

(alonginternalthoracicvessels)Tointercostalslymphnodes肋間淋巴結(jié)fromdeeperstructures7/28/202323人體淋巴系統(tǒng)Thelymphaticdrainageofthorax

胸部的淋巴引流lymphnodesofthethoraciccontents

lymphnodesoftrachea,bronchiandlungsPulmonarylymphnodes肺淋巴結(jié)lieintheanglesofbifurcationofbranchinglobarbronchiBronchopulmonaryhilarlymphnodes支氣管肺門淋巴結(jié)－lieinthehilusofthelungTracheobronchiallymphnodes氣管支氣管淋巴結(jié)－situatedaboveorbelowthebifurcationoftracheaParatracheallymphnodes

氣管旁淋巴結(jié)－alongeachsideofthetracheaParatracheallymphnodes7/28/202324人體淋巴系統(tǒng)Anteriormediastinallymphnode縱隔前淋巴結(jié)liesanteriortothelargebloodvesselsofthoraciccavityandpericardium;theefferentsunitewiththoseofparatracheallymphnodes,toformtherightandleftbronchomediastinaltrunks

支氣管縱隔干.Theleftbronchomediastinaltrunkterminatesinthoracicduct,andrightintherightlymphticductPosteriormediastinallymphnodes縱隔后淋巴結(jié)liealongtheesophagusandthoracicaortaThelymphaticdrainageofthorax

胸部的淋巴引流7/28/202325人體淋巴系統(tǒng)Thelymphaticdrainageofabdomen

腹部的淋巴引流LymphaticdrainageofabdominalwallToaxillarylymphnodefromregionaboveumbilicusTosuperficialinguinallymphnodefromregionbelowumbilicusTolumbarlymphnodefrompostwallofabdomenaxillarylymphnodesuperficialinguinallymphnode7/28/202326人體淋巴系統(tǒng)LymphaticdrainageofabdominalvisceraLumbarlymphnodes

腰淋巴結(jié)Lieonposteriorabdominalwall,alongtheabdominalaortaandinferiorvenacavaReceivelymphfromkidneys,suprarenalglands,testes,ovarirs,fundusofuterus,ovary,andcommoniliacnodesTheirefferentvesselformtherightandleftlumbartrunksThelymphaticdrainageofabdomen

腹部的淋巴引流7/28/202327人體淋巴系統(tǒng)Celiaclymphnodes腹腔淋巴結(jié)－situatedaroundtheceliactrunkSuperiormesentericlymphnode腸系膜上淋巴結(jié)－situatedaroundsuperiormesenterica.Inferiormesentericlymphnode腸系膜下淋巴結(jié)－situatedaroundinferiormesenterica.Intestinaltrunk腹腔干－formedbyefferentvesselofceliac,superiorandinferiormesentericlymphnodesThelymphaticdrainageofabdomen

腹部的淋巴引流7/28/202328人體淋巴系統(tǒng)Thelymphaticdrainageofpelvis盆部的淋巴引流Internaliliaclymphnode髂內(nèi)淋巴結(jié)SurroundinternaliliacvesselsReceivelymphfrompelvicviscera,perineum,buttockandbackofthighExternaliliaclymphnodes

髂外淋巴結(jié)LiealongexternaliliacarteryReceivelymphfromlowerlimbandsomepartsofpelvicviscera7/28/202329人體淋巴系統(tǒng)Thelymphaticdrainageofpelvis盆部的淋巴引流Sacrallymphnode

骶淋巴結(jié)locatealongmiddlesacrala.andlateralsacrala.Receivelymphfromposteriorpelvicwall,rectum,prostateoruterusCommoniliaclymphnode髂總淋巴結(jié)LiealongcommoniliacarteryReceiveafferentsfromalltheabovenodesEfferentspasstolumbarlymphnode7/28/202330人體淋巴系統(tǒng)lymphdrainageoflowerlimb下肢的淋巴lymphaticvesselsSuperficiallymphaticDeeplymphaticLymphnodesSuperficiallymphnode腹股溝淺淋巴結(jié)Deeplymphnode腹股溝深淋巴結(jié)

7/28/202331人體淋巴系統(tǒng)lymphdrainageoflowerlimb下肢的淋巴Superficiallymphnode腹股溝淺淋巴結(jié)

maybedividedintotwogroupsUppergroup:belowtheinguinallig.腹股溝韌帶Lowergroup:aroundtheterminalpartofgreatsaphenousv.大隱靜脈Receivelymphfromlowerpartofabdominalwall,perineum

會(huì)陰andlowerlimbwiththeexceptionofregiondrainedbypopliteal

ln.腘淋巴結(jié)7/28/202332人體淋巴系統(tǒng)lymphdrainageoflowerlimb下肢的淋巴deeplymphnode腹股溝深淋巴結(jié)

Locatearoundtheproximalendoffemoralv.Receivelymphfromdeeplymphaticvesselsoflowerlimbandtheefferentlymphaticvesselsofsuperfici