淋巴系統LymphaticSystem淋巴管道：毛細淋巴管、淋巴管、淋巴干、淋巴導管

lymph

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

lymphatictissue組成功能輔助靜脈回流產生淋巴細胞過濾淋巴液參與免疫應答7/28/20231人體淋巴系統1回收蛋白質運輸脂肪及營養物質2清除組織中的紅細胞細菌和異物3調節血漿和組織液間的液體平衡4產生淋巴細胞和漿細胞參與免疫反應淋巴回流7/28/20232人體淋巴系統LymphnodesTheLymphaticSystem淋巴系統ACapVLymphatic-CapillaryLymphaticLymphatictrunksLymphaticducts（淋巴結）（淋巴干）（淋巴導管）（毛細淋巴管）7/28/20233人體淋巴系統Aassistantsystemtothevein輔助靜脈系統回流7/28/20234人體淋巴系統CompositionLymphaticvessels淋巴管道Lymphaticcapillary毛細淋巴管Lymphvessels淋巴管

Lymphatictrunks(9)淋巴干

Lymphaticducts(2)淋巴導管

thoracicduct

胸導管

rightlymphaticduck右淋巴導管Lymphaticorgans

淋巴器官Lymphnodes淋巴結spleen脾thymus胸腺

tonsil扁桃體,

Lymphatictissues

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

BlindendSinglelayerofoverlappingendothelialcellsMorepermeablethanthatofbloodcapillaryAbsentfromavascularstructures,brain,spinalcordsplenicpulpandbonemarrowLymphaticvessels淋巴管道Lymphaticcapillary

毛細淋巴管

盲端單層重疊內皮細胞比毛細血管通透性更強腦，脊髓，脾髓，骨髓無此結構軟骨、上皮、牙釉質、角膜與晶狀體等亦無此結構7/28/20236人體淋巴系統Lymphaticvessel淋巴管

FeaturesofstructureThreelayeredwallsimilarto,butthinnerthanvein,MorenumerousvalvesthaninveinInterposedbylymphnodeatintervalalongthecourseArrangedinsuperficialanddeepsetsLymphaticvessels淋巴管道類似三層墻，比靜脈細瓣膜遠多于靜脈中間有淋巴結插入分淺、深兩種淋巴管7/28/20237人體淋巴系統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Rightlymphaticduct

右淋巴導管Formedbyunionofrightjugular,subclavian,andbronchomediastinaltrunksEndsbyenteringtherightvenousangle右靜脈角Receiveslymphfromrighthalfofhead,neck,thoraxandrightupperlimbLymphaticducts淋巴導管

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

胸導管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合構成穿過膈上的主動脈裂孔，沿著脊柱前方，在胸主動脈和奇靜脈之間上升進入胸腔7/28/202310人體淋巴系統Travelsupward,veeringtotheleftatthelevelofT5Attheroofoftheneck,itturnslaterallyandarchesforwardsanddescendstoentertheleftvenousangleJustbeforetermination,itreceivestheleftjugular,subclavianandronchomediastinaltrunksLymphaticvessels淋巴管道Thoracicduct

胸導管進入胸腔順時針轉入第五胸椎左側到達頸根部，轉至側面呈弧形彎入左靜脈角進入左靜脈角前，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Thoracicduct

胸導管Justbeforetermination,itreceivestheleftjugular,subclavianandbronchomediastinaltrunksDrainslymphfromlowerlimbs,pelviccavity,abdominalcavity,leftsideofthorax,andleftsideofthehead,neckandleftupperlimbLymphaticvessels淋巴管道胸導管引流下肢、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Lymphnode淋巴結FeaturesBean-shapedbodiesWithafferentlymphvessels輸入淋巴管

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

isthelymphnodewherethelymphoftheorganorpartofthebodydraingetofirstly

SentinelLymphNode前哨淋巴結(inclinic)

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

頭部的淋巴引流

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

頸部的淋巴引流Anteriorcervicallymphnodes頸前淋巴結SuperficialanteriorcervicallymphnodesDeepanteriorcervicallymphnodesLateralcervicallymphnode

頸外側淋巴結Superficiallateralcervicallymphnodes－liealongtheexternaljugularveinDeep

lateralcervicallymphnodes頸前淺淋巴結頸前深淋巴結頸外側淺淋巴結——頸外靜脈排列頸外側深淋巴結7/28/202317人體淋巴系統Deeplateralcervicallymphnodes頸外側深淋巴結extendalongtheinternaljugularveinfromthebaseofskulltotherootofneckdivideintoSuperiordeeplateralcervicallymphnodes頸外側上深淋巴結Inferiordeeplateralcervicallymphnodes頸外側下深淋巴結Lymphdrainageofneck

頸部的淋巴引流沿頸內靜脈擴展從顱底至頸根部7/28/202318人體淋巴系統Deeplateralcervicallymphnodes頸外側深淋巴結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Superiordeeplateralcervicallymphnodes

頸外側上深淋巴結Jugulodigastriclymphnode

頸內靜脈二腹肌淋巴結:liesatthejunctionofposteriorbellyofdigastricandinternaljugularveinInferiordeeplateralcervicallymphnodes

頸外側下深淋巴結Juguloomohyoidlymphnode

頸內靜脈肩胛舌骨肌淋巴結:liesatthejunctionoftheintermediatetendonofomohyoidandinternaljugularveinSupraclavicularlymphnodes

鎖骨上淋巴結:liealongthesubclavianarteryLymphdrainageofneck

頸部的淋巴引流7/28/202320人體淋巴系統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和腋淋巴結Deeplymphaticvessels深淋巴管伴隨深靜脈注入腋淋巴結

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

胸部的淋巴引流ThelymphaticdrainageofthoracicwallToaxillarylymphnodesToparasternallymphnodes胸骨旁淋巴結

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

胸部的淋巴引流lymphnodesofthethoraciccontents

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

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

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

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

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

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

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

腹部的淋巴引流7/28/202328人體淋巴系統Thelymphaticdrainageofpelvis盆部的淋巴引流Internaliliaclymphnode髂內淋巴結SurroundinternaliliacvesselsReceivelymphfrompelvicviscera,perineum,buttockandbackofthighExternaliliaclymphnodes

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

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

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

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

會陰andlowerlimbwiththeexceptionofregiondrainedbypopliteal

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

Locatearoundtheproximalendoffemoralv.Receivelymphfromdeeplymphaticvesselsoflowerlimbandtheefferentlymphaticvesselsofsuperfici