人体淋巴系统

Introductionoflymphology原版：山东大学医学院人体解剖教研室补充增加中文2012.5淋巴系统LymphaticSystem淋巴管道：毛细淋巴管、淋巴管、淋巴干、淋巴导管lymphvessel淋巴器官：淋巴结、脾、胸腺、扁桃体lymphaticorgan淋巴组织：含大量淋巴细胞（弥散的和淋巴小结）lymphatictissue组成功能辅助静脉回流产生淋巴细胞过滤淋巴液参与免疫应答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LymphnodesTheLymphaticSystem淋巴系统ACapVLymphatic-CapillaryLymphaticLymphatictrunksLymphaticducts（淋巴结）（淋巴干）（淋巴导管）（毛细淋巴管）•Aassistantsystemtothevein辅助静脉系统回流CompositionLymphaticvessels淋巴管道–Lymphaticcapillary毛细淋巴管–Lymphvessels淋巴管–Lymphatictrunks(9)淋巴干–Lymphaticducts(2)淋巴导管thoracicduct胸导管rightlymphaticduck右淋巴导管Lymphaticorgans淋巴器官–Lymphnodes淋巴结–spleen脾–thymus胸腺–tonsil扁桃体,Lymphatictissues淋巴组织Featuresofstructure:•Blindend•Singlelayerofoverlappingendothelialcells•Morepermeablethanthatofbloodcapillary•Absentfromavascularstructures,brain,spinalcordsplenicpulpandbonemarrowLymphaticvessels淋巴管道Lymphaticcapillary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Lymphaticvessel淋巴管FeaturesofstructureThreelayeredwallsimilarto,butthinnerthanvein,MorenumerousvalvesthaninveinInterposedbylymphnodeatintervalalongthecourseArrangedinsuperficialanddeepsetsLymphaticvessels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Lymphatictrunks淋巴干rightandleftjugulartrunks(颈干)rightandleftsubclaviantrunks（锁骨下干）rightandleftbronchomediastinaltrunks（支气管纵隔干）rightandleftlumbartrunks（腰干）intestinaltrunk（肠干）Lymphaticvessels淋巴管道Rightlymphaticduct右淋巴导管Formedbyunionofrightjugular,subclavian,andbronchomediastinaltrunksEndsbyenteringtherightvenousangle右静脉角Receiveslymphfromrighthalfofhead,neck,thoraxandrightupperlimbLymphaticducts淋巴导管Lymphaticvessels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Thoracicduct胸导管•BeginsinfrontofL1asadilatedsac,thecisternachyli乳糜池,whichformedbyjoiningofleftandrightlumbartrunksandintestinaltrunk•Enterthoraciccavitybypassingthroughtheaortichiatusofthediaphragmandascendsalongonthefrontofthevertebralcolumn,betweenthoracicaortaandazygosveinLymphaticvessels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•Travelsupward,veeringtotheleftatthelevelofT5•Attheroofoftheneck,itturnslaterallyandarchesforwardsanddescendstoentertheleftvenousangle•Justbeforetermination,itreceivestheleftjugular,subclavianandronchomediastinaltrunksLymphaticvessels淋巴管道Thoracicduct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巴液Thoracicduct胸导管•Justbeforetermination,itreceivestheleftjugular,subclavianandbronchomediastinaltrunks•Drainslymphfromlowerlimbs,pelviccavity,abdominalcavity,leftsideofthorax,andleftsideofthehead,neckandleftupperlimbLymphaticvessels淋巴管道胸导管引流下肢、盆腔、腹腔、左上肢、左胸部和左头颈部的淋巴Lymphnode淋巴结FeaturesBean-shapedbodiesWithafferentlymphvessels输入淋巴管(enteringattheperiphery)andefferentlymphvessels输出淋巴管(emergingatthehilus)Arrangedingroups,alongthebloodvesselsortheflexuralsideofthejointDividedintosuperficialanddeepgroups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•RegionalLymphNode局部淋巴结isthelymphnodewherethelymphoftheorganorpartofthebodydraingetofirstly•SentinelLymphNode前哨淋巴结(inclinic)Lymphnode淋巴结LymphdrainageofthebodyⅠ.Lymphdrainageofthehead头部的淋巴引流Lymphnodesofhead•Locatedatjunctionofheadandneck•Consistofoccipital,mastoid,parotid,submandibular,submentallymphnodes•Drainintodeepcervicallymphnodes•Submandibularlymphnode下颌下淋巴结liesnearthesubmandibulargland,receivelymphaticvesselsfromtheface,noseandmouth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Lymphdrainageofneck颈部的淋巴引流•Anteriorcervicallymphnodes颈前淋巴结–Superficialanteriorcervicallymphnodes–Deepanteriorcervicallymphnodes•Lateralcervicallymphnode颈外侧淋巴结–Superficiallateralcervicallymphnodes－liealongtheexternaljugularvein–Deeplateralcervicallymphnodes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Deeplateralcervicallymphnodes颈外侧深淋巴结•extendalongtheinternaljugularveinfromthebaseofskulltotherootofneck•divideintoSuperiordeeplateralcervicallymphnodes颈外侧上深淋巴结Inferiordeeplateralcervicallymphnodes颈外侧下深淋巴结Lymphdrainageofneck颈部的淋巴引流沿颈内静脉扩展从颅底至颈根部Deeplateralcervicallymphnodes颈外侧深淋巴结•receivelymphaticvesselsfromhead,neck,tongue,larynx,cervicalpartsofesophagusandtrachea,thyroidgland,upperpartsofthethoracicwallandbreast•efferentvesselsformthejugulartrunk→thoracicduct(left)→rightlymphaticduct(right)Lymphdrainageofneck颈部的淋巴引流•Superiordeeplateralcervicallymphnodes颈外侧上深淋巴结–Jugulodigastriclymphnode颈内静脉二腹肌淋巴结:liesatthejunctionofposteriorbellyofdigastricandinternaljugularvein•Inferiordeeplateralcervicallymphnodes颈外侧下深淋巴结–Juguloomohyoidlymphnode颈内静脉肩胛舌骨肌淋巴结:liesatthejunctionoftheintermediatetendonofomohyoidandinternaljugularvein–Supraclavicularlymphnodes锁骨上淋巴结:liealongthesubclavianarteryLymphdrainageofneck颈部的淋巴引流Thelymphaticdrainageofupperlimb上肢的淋巴引流•Lymphaticvessels–Superficiallymphaticvessels浅淋巴管伴随浅静脉注入滑车上淋巴结和腋淋巴结–Deeplymphaticvessels深淋巴管伴随深静脉注入腋淋巴结•lymphnodes–Cubitallymphnode滑车上淋巴结–Axillarylymphnode腋淋巴结Axillarylymphnodes腋淋巴结Theaxillarylymphnodesmeybedividedintolateralln.外侧淋巴结pectoralln.胸肌淋巴结subscapularln.肩胛下淋巴结centralln.中央淋巴结apicalln.尖淋巴结lateralln.pectoralln.subscapularln.centralln.apicalln.subclaviantrunkThelymphaticdrainageofthorax胸部的淋巴引