Lymphatics of the Thorax - Listed Alphabetically
|
| Structure |
Location |
Afferents from |
Efferents to |
Regions drained |
Notes |
| anterior mediastinal nodes |
along the course of the brachiocephalic vessels and
aorta |
lymphatic vessels from the anterior mediastinum and
middle mediastinum |
bronchomediastinal trunk |
thymus, anterior respiratory diaphragm, pericardium,
part of the heart |
anterior mediastinal nodes are from 2 to 5 in number |
| axillary nodes |
axilla |
cubital nodes; lymphatic vessels from the upper limb,
thoracic wall and subscapular region |
efferents vessels form the subclavian trunk, some
drainage to inferior deep cervical nodes |
upper limb, most of the mammary gland, some of the
anterolateral chest wall, posterior thoracic wall and scapular region |
axillary nodes number from 20 to 30 and are organized
in five groups based on their position within the axilla: 1) pectoral
nodes, along the lateral border of the pectoralis major m.; 2) lateral
nodes, located along the distal axillary v.; 3) central nodes, centrally
located along axillary v.; 4) subscapular nodes, located along the
subscapular v. and its tributaries; 5) apical nodes, located at the apex
of axilla |
| axillary nodes, apical |
apex of the axilla |
lateral axillary nodes; central axillary nodes;
subscapular axillary nodes; pectoral nodes; accessory lymphatic vessels
from the mammary gland; lymphatic vessels accompanying the cephalic v. |
subclavian lymphatic trunk; deep cervical lymph nodes |
upper limb, most of the mammary gland, some of the
anterolateral chest wall, posterior thoracic wall and scapular region
| apical axillary nodes are 6- 12 in number; this is the
highest node group in the axilla and all other node groups drain through
these nodes; a very important group of nodes in cases of metastatic
spread of breast cancer; connections to deep cervical nodes may result
in spread of breast cancer through the deep neck |
| axillary nodes, central |
in the fat of the axilla |
lateral axillary nodes; pectoral nodes; subscapular
nodes; lymphatic vessels from the mammary gland and upper limb |
apical axillary nodes |
upper limb, most of the mammary gland, some of the
anterolateral chest wall, posterior thoracic wall and scapular region |
central axillary nodes are 4 or 5 in number; they are
involved in cancer of the mammary gland |
| axillary nodes, lateral |
along the distal axillary v. |
cubital nodes; lymphatic vessels of the arm |
central axillary nodes, apical axillary nodes |
upper limb |
lateral axillary nodes become inflamed during upper
limb infections; also known as: brachial nodes |
| axillary nodes, subscapular |
along the course of the subscapular vessels |
lymphatic vessels from the skin of the back and back of
the neck; lymphatic vessels from the muscles of the scapular region |
central axillary nodes |
skin of the back and back of the neck; muscles of the
scapular and subscapular regions |
subscapular axillary nodes are 5 or 6 in number; also
known as: posterior axillary nodes |
| bronchomediastinal trunk |
along the course of the brachiocephalic v. |
union of efferents from the paratracheal nodes,
parasternal nodes and anterior mediastinal nodes |
left: thoracic duct; right: right lymphatic duct |
thoracic wall and viscera; medial part of the mammary
gland |
right bronchomediastinal trunk receives lymph from the
lower lobe of the left lung; bronchomediastinal trunk may drain directly
into the venous system on either side |
| bronchopulmonary nodes |
hilum of the lung |
pulmonary nodes |
tracheobronchial nodes |
lung |
bronchopulmonary nodes are also known as: hilar nodes |
| cisterna chyli |
between the abdominal aorta and the inferior vena cava
anterior to the body of the L1 or L2 vertebra |
right and & left lumbar trunks; possibly the
intestinal trunk |
thoracic duct |
all of the body below the respiratory diaphragm; all of
the abdominal and pelvic viscera |
cisterna chyli is an enlargement of the lower end of
the thoracic duct; it occurs in about 25% of individuals |
| hilar nodes |
at hilum of lung |
pulmonary nodes |
tracheobronchial nodes |
lung |
also known as: bronchopulmonary nodes |
| infraclavicular nodes |
along the cephalic v. in the deltopectoral groove |
lymphatic vessels from the superficial upper limb |
apical axillary nodes |
skin and superficial fascia of the upper limb |
infraclavicular nodes may become inflamed during
infections of the superficial tissues of the upper limb |
| intercostal nodes |
near the heads of the ribs |
lymphatic vessels from the intercostal space |
cisterna chyli/thoracic duct, jugulosubclavian duct |
intercostal space and posterolateral thoracic wall |
usually two nodes occur in each intercostal space |
| mediastinal nodes, anterior |
along the course of the brachiocephalic vessels and
aorta |
lymphatic vessels from the anterior mediastinum and
middle mediastinum |
bronchomediastinal trunk |
thymus, anterior respiratory diaphragm, pericardium,
part of the heart |
anterior mediastinal nodes are from 2 to 5 in number |
| mediastinal nodes, posterior |
along azygos system of veins and esophagus |
viscera of the posterior mediastinum and chest wall |
thoracic duct, inferior tracheobronchial nodes,
superior tracheobronchial nodes |
posterior mediastinum, posterior aspect of the heart
and pericardium, posterior part of the respiratory diaphragm |
posterior mediastinal nodes drain primarily to the
thoracic duct |
| parasternal nodes |
lateral border of sternum, along the course of the
internal thoracic vessels |
anterior phrenic nodes, lymphatic vessels from the
anterior thoracic wall |
larger lymphatic vessels in the root of the neck |
medial side of the mammary gland; medial part of the
anterior chest wall and muscles |
parasternal nodes constitute an important drainage
pattern in cases of cancer of the mammary gland; one or two parasternal
nodes may be found in the anterior end of intercostal spaces 1-6; also
known as: sternal nodes |
| paratracheal nodes |
coursing along the lateral surface of the trachea and
esophagus |
superior tracheobronchial nodes |
bronchomediastinal trunk |
lungs, trachea, upper esophagus, the part of the larynx
below the vocal folds |
paratracheal nodes are an important group of nodes in
cases of pulmonary infection or lung cancer; also known as: tracheal
nodes |
| pectoral nodes |
along the lateral border of the pectoralis major m.
along the course of the lateral thoracic vessels |
lymphatic vessels from the mammary gland and
anterolateral thoracic wall |
central axillary nodes |
anterolateral thoracic wall and muscles; most of the
mammary gland
| an important group of nodes to examine during a breast
physical exam; also known as: anterior axillary nodes |
| phrenic nodes |
on the thoracic surface of the respiratory diaphragm |
lymphatic vessels from the diaphragm, liver and
thoracic wall |
lumbar nodes, posterior mediastinal nodes |
superior surface of the liver, respiratory diaphragm |
phrenic nodes drain two structures that are very
closely related in developmental origin - the liver and diaphragm (septum
transversum); three subgroups of phrenic nodes are recognized: anterior,
middle and posterior |
| posterior mediastinal nodes |
along azygos system of veins and esophagus |
viscera of the posterior mediastinum and chest wall |
thoracic duct, inferior tracheobronchial nodes,
superior tracheobronchial nodes |
posterior mediastinum, posterior aspect of the heart
and pericardium, posterior part of the respiratory diaphragm |
posterior mediastinal nodes drain primarily to the
thoracic duct |
| pulmonary nodes |
within the lung parenchyma |
lymphatic vessels from the parenchyma of the lung |
bronchopulmonary (hilar) nodes |
lung parenchyma, bronchial tree within the lungs |
pulmonary nodes are located along the larger bronchi of
the lung |
| sternal nodes |
lateral border of sternum, along the course of the
internal thoracic vessels |
anterior phrenic nodes, lymphatic vessels from the
anterior thoracic wall |
larger lymphatic vessels in the root of the neck |
medial side of the mammary gland; medial part of the
anterior chest wall and muscles |
sternal nodes constitute an important drainage pattern
in cases of cancer of the mammary gland; one or two sternal nodes may be
found in the anterior end of intercostal spaces 1-6; also known as:
parasternal nodes |
| subclavian trunk |
along the course of the subclavian v. |
apical axillary nodes; infraclavicular nodes |
drains into the junction of the internal jugular v. and
the subclavian v. |
upper limb, most of breast, anterolateral chest wall |
subclavian lymphatic trunk occasionally drains into the
thoracic duct on the left side; on the right it occasionally drains into
the right lymphatic duct |
| supraclavicular nodes |
in and around carotid sheath below level of omohyoid |
superior deep cervical nodes, transverse cervical nodes,
spinal accessory nodes |
efferents form the jugular lymphatic trunk |
head and neck |
also known as: inferior deep cervical nodes |
| thoracic duct |
between the esophagus anteriorly and the thoracic
vertebral bodies posteriorly |
formed by the union of the lumbar lymph trunks,
sometimes dilated to form a cisterna chyli |
junction of the left subclavian v. and the left
internal jugular v. |
all of the body and limbs below the respiratory
diaphragm; the left side of the chest, left upper limb and the left side
of the head and neck above the diaphragm |
thoracic duct is the largest lymphatic vessel; it
passes through the aortic hiatus on the right side of aorta; it swings
to the left side of the esophagus at the T4-T5 intervertebral disc (at
the level of the sternal angle) |
| thymus |
root of the neck and superior mediastinum posterior to
sternum |
none |
parasternal nodes |
essential for normal development of the immune system
maturation |
thymus involutes at puberty and is mostly replaced by a
mass of fat |
| tracheobronchial nodes |
along the trachea, around the tracheal bifurcation and
primary bronchi |
lymphatic vessels from the lung |
bronchomediastinal lymph trunk |
lungs, visceral pleura, bronchi, thoracic part of
trachea, left side of heart, esophagus, posterior mediastinum |
tracheobronchial nodes may be divided into five groups:
paratracheal (tracheal), superior tracheobronchial, inferior
tracheobronchial, bronchopulmonary (hilar), pulmonary |
| tracheobronchial nodes, inferior |
inferior to tracheal bifurcation |
bronchopulmonary nodes, left side inferior
tracheobronchial nodes drain into right inferior tracheobronchial nodes |
right superior tracheobronchial nodes |
lower lobes of the lungs; middle mediastinum; posterior
mediastinum |
left inferior tracheobronchial nodes drain to the right
side |
| tracheobronchial nodes, superior |
superolateral to the tracheal bifurcation |
bronchopulmonary (hilar) nodes |
paratracheal (tracheal) nodes |
lungs, middle mediastinum, posterior mediastinum |
inferior tracheobronchial nodes drain lymph from the
lower lobe of the left lung to the right superior tracheobronchial nodes |
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