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1、淋巴系统 Lymphatic System,1,淋巴系统 Lymphatic System 淋巴管道：毛,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,2,1 回收蛋白质运输脂肪及营养物质淋巴回流2,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）,3,Lymph nodesThe Lympha
2、tic Syste,A assistant system to the vein 辅助静脉系统回流,4,A assistant system to the vein,Composition,Lymphatic vessels 淋巴管道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
3、tonsil扁桃体,Lymphatic tissues 淋巴组织,5,CompositionLymphatic vessels 淋,Features of structure:Blind endSingle layer of overlapping endothelial cellsMore permeable than that of blood capillaryAbsent from avascular structures,brain,spinal cord splenic pulp and bone marrow,Lymphatic vessels 淋巴管道,Lymphatic ca
4、pillary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,6,Features of structure:Lymphat,Lymphatic vessel 淋巴管,Features of structureThree layered wall similar to,but thinner than vein,More numerous valves than in veinInterposed by lymph node at interval along the courseArranged in su
5、perficial 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,7,Lymphatic vessel 淋巴管Features,Lymphatic trunks 淋巴干,right and left jugular trunks(颈干)right and left subclavian trunks（锁骨下干）right and left bronchomediastinal trunks（支气管纵隔干）right and left lumbar trunks（腰干）intestinal t
6、runk（肠干）,Lymphatic vessels 淋巴管道,8,Lymphatic trunks 淋巴干 right and,Right lymphatic duct 右淋巴导管Formed by union of right jugular,subclavian,and bronchomediastinal trunksEnds by entering the right venous angle右静脉角Receives lymph from right half of head,neck,thorax and right upper limb,Lymphatic ducts 淋巴导管,
7、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,9,Right lymphatic duct 右淋巴导管Lymp,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 intestinal trunkEnter thoracic cavity by passing through the aort
8、ic 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,10,Thoracic duct 胸导管Lymphatic ves,Travels upward,veering to the left at the level of T5At the
9、 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
10、巴液,11,Travels upward,veering to the,Thoracic duct 胸导管,Just before termination,it receives the left jugular,subclavian and bronchomediastinal trunksDrains lymph from lower limbs,pelvic cavity,abdominal cavity,left side of thorax,and left side of the head,neck and left upper limb,Lymphatic vessels 淋巴管
11、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,12,Thoracic duct 胸导管Just before t,Lymph node 淋巴结,FeaturesBean-shaped bodiesWith 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 jointDivi
12、ded into superficial 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,13,Lymph node 淋巴结Features沿着血管或者关节,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,14,Regional Lymph Node局部淋巴结 is th,Ly
13、mph drainage of the body,15,Lymph drainage of the body 15,.Lymph drainage of the head头部的淋巴引流,Lymph nodes of headLocated at junction of head and neckConsist of occipital,mastoid,parotid,submandibular,submental lymph nodesDrain into deep cervical lymph nodes Submandibular lymph node 下颌下淋巴结 lies near t
14、he 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,16,.Lymph drainage of the head头,Lymph drainage of neck颈部的淋巴引流,Anterior cervical lymph nodes颈前淋巴结Superficial anterior cervical lymph nodesDeep anterior
15、cervical lymph nodesLateral cervical lymph node 颈外侧淋巴结Superficial lateral cervical lymph nodeslie along the external jugular veinDeep lateral 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,17,Lymph drainage of neck颈部的淋巴引流,Deep lateral cervical lymph nodes颈外侧深淋巴结extend along the internal ju
16、gular vein from the base of skull to the root of neckdivide 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,Lymph drainage of neck颈部的淋巴引流,沿颈内静脉扩展 从颅底至颈根部,18,Deep lateral cervical lymph no,Deep lateral cervical lymph nodes颈外侧深淋巴结receive lymph
17、atic vessels from head,neck,tongue,larynx,cervical parts of esophagus and trachea,thyroid gland,upper parts of the thoracic wall and breastefferent vessels form the jugular trunk thoracic duct(left)right lymphatic duct(right),Lymph drainage of neck颈部的淋巴引流,19,Deep lateral cervical lymph no,Superior d
18、eep 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 veinInferior deep lateral cervical lymph nodes 颈外侧下深淋巴结Juguloomohyoid lymph node 颈内静脉肩胛舌骨肌淋巴结:lies at the junction of the intermediate tendon of om
19、ohyoid and internal jugular veinSupraclavicular lymph nodes 锁骨上淋巴结:lie along the subclavian artery,Lymph drainage of neck颈部的淋巴引流,20,Superior deep lateral cervical,The lymphatic drainage of upper limb 上肢的淋巴引流,Lymphatic vesselsSuperficial lymphatic vessels 浅淋巴管 伴随浅静脉 注入滑车上淋巴结和腋淋巴结Deep lymphatic vessel
20、s 深淋巴管 伴随深静脉 注入腋淋巴结 lymph nodesCubital lymph node滑车上淋巴结Axillary lymph node腋淋巴结,21,The lymphatic drainage of uppe,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 ln.pectoral ln.subs
21、capular ln.,central ln.,apical ln.,subclavian trunk,22,Axillary lymph nodes 腋淋巴结The a,The lymphatic drainage of thorax胸部的淋巴引流,The lymphatic drainage of thoracic wallTo axillary lymph nodesTo parasternal lymph nodes胸骨旁淋巴结(along internal thoracic vessels)To intercostals lymph nodes肋间淋巴结 from deeper st
22、ructures,23,The lymphatic drainage of thor,The lymphatic drainage of thorax胸部的淋巴引流,lymph nodes of the thoracic contents lymph nodes of trachea,bronchi and lungsPulmonary lymph nodes肺淋巴结lie in the angles of bifurcation of branching lobar bronchiBronchopulmonary hilar lymph nodes支气管肺门淋巴结lie in the hil
23、us of the lungTracheobronchial lymph nodes气管支气管淋巴结situated above or below the bifurcation of tracheaParatracheal lymph nodes 气管旁淋巴结along each side of the trachea,Paratracheal lymph nodes,24,The lymphatic drainage of thor,Anterior mediastinal lymph node纵隔前淋巴结 lies anterior to the large blood vessels
24、of thoracic cavity and pericardium;the efferents unite with those of paratracheal lymph nodes,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 ductPosterior mediastinal lymph nodes纵隔后淋巴结 lie alon
25、g the esophagus and thoracic aorta,The lymphatic drainage of thorax胸部的淋巴引流,25,Anterior mediastinal lymph nod,The lymphatic drainage of abdomen 腹部的淋巴引流,Lymphatic drainage of abdominal wallTo axillary lymph node from region above umbilicusTo superficial inguinal lymph node from region below umbilicusT
26、o lumbar lymph node from post wall of abdomen,axillary lymph node,superficial inguinal lymph node,26,The lymphatic drainage of abdo,Lymphatic drainage of abdominal visceraLumbar lymph nodes 腰淋巴结Lie on posterior abdominal wall,along the abdominal aorta and inferior vena cavaReceive lymph from kidneys
27、,suprarenal glands,testes,ovarirs,fundus of uterus,ovary,and common iliac nodesTheir efferent vessel form the right and left lumbar trunks,The lymphatic drainage of abdomen 腹部的淋巴引流,27,Lymphatic drainage of abdomina,Celiac lymph nodes 腹腔淋巴结 situated around the celiac trunk Superior mesenteric lymph n
28、ode 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 of celiac,superior and inferior mesenteric lymph nodes,The lymphatic drainage of abdomen 腹部的淋巴引流,28,Celiac lymph nodes 腹腔淋巴结,T
29、he lymphatic drainage of pelvis 盆部的淋巴引流,Internal iliac lymph node 髂内淋巴结Surround internal iliac vesselsReceive lymph from pelvic viscera,perineum,buttock and back of thighExternal iliac lymph nodes 髂外淋巴结Lie along external iliac arteryReceive lymph from lower limb and some parts of pelvic viscera,29,T
30、he lymphatic drainage of pelv,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 uterusCommon iliac lymph node髂总淋巴结Lie along common iliac arteryReceive afferents from all the abo
31、ve nodesEfferents pass to lumbar lymph node,30,The lymphatic drainage of pelv,lymph drainage of lower limb下肢的淋巴,lymphatic vesselsSuperficial lymphaticDeep lymphaticLymph nodesSuperficial lymph node腹股沟浅淋巴结Deep lymph node腹股沟深淋巴结,31,lymph drainage of lower limb下肢,lymph drainage of lower limb下肢的淋巴,Super
32、ficial lymph node腹股沟浅淋巴结may be divided into two groupsUpper 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 popliteal ln.腘淋巴结,32,lymph dra
33、inage of lower limb下肢,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
34、iliac ln.髂外淋巴结,33,lymph drainage of lower limb下肢,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 dee
35、p inguinal ln.腹股沟深淋巴结,lymph drainage of lower limb下肢的淋巴,34,Popliteal ln.腘淋巴结lymph drainag,35,35,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,36,Celiac lymph nodesSuperior mes,37,37,Spleen 脾,Location Left epigastric regionbetween 9th-11th ribin line
36、 of 10th ribFeaturesDiaphragmatic surfaceVisceral surface-Splenic Hilum Anterior extremityPosterior extremitySuperior border-Splenic Notch Inferior borderFunction,38,Spleen 脾Location 38,39,39,Thymus 胸腺,Featrues Consists of two elongated lobesIs large organ in the fetusOccupies the thoracic cavity behind the sternumSecrete lymphopoietin,40,Thymus 胸腺Featrues 40,Clinic information,41,Clinic information41,42,42,
