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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）lym

phatictissue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11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2Lymphnodes

TheLymphaticSystem淋巴系统ACapVLymphatic-CapillaryLymphaticLymphatictrunksLymphaticducts（淋巴结）（淋巴干）（淋巴导管）（毛细淋巴管）3•Aass

istantsystemtothevein辅助静脉系统回流4Composition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5Featuresofstructure:•Blindend•Singlelayerofoverlappingendothelialcells•Moreperm

eablethanthatofbloodcapillary•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6Lymphaticvessel淋巴管Featuresofstruc

ture❑Threelayeredwallsimilarto,butthinnerthanvein,❑Morenumerousvalvesthaninvein❑Interposedbylymphnodeati

ntervalalongthecourse❑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7Lymphatictrunks淋巴干rightandlef

tjugulartrunks(颈干)rightandleftsubclaviantrunks（锁骨下干）rightandleftbronchomediastinaltrunks（支气管纵隔干）rightandleftlumbartr

unks（腰干）intestinaltrunk（肠干）Lymphaticvessels淋巴管道8Rightlymphaticduct右淋巴导管◼Formedbyunionofrightjugular,subclavian,a

ndbronchomediastinaltrunks◼Endsbyenteringtherightvenousangle右静脉角◼Receiveslymphfromrighthalfofhead,neck,thoraxandrightupperlimbLymphaticducts淋巴导管Lymp

haticvessels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Thoracicduct胸导管•BeginsinfrontofL1asadilatedsac,thecisternachyli乳糜池

,whichformedbyjoiningofleftandrightlumbartrunksandintestinaltrunk•Enterthoraciccavitybypassingthroug

htheaortichiatusofthediaphragmandascendsalongonthefrontofthevertebralcolumn,betweenthoracicaortaandazy

gosveinLymphaticvessels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•Travelsupward,veeringtotheleftatt

helevelofT5•Attheroofoftheneck,itturnslaterallyandarchesforwardsanddescendstoentertheleftvenousangle•Justbeforetermin

ation,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11Thoracicduct胸导管•Justbeforetermination,itrecei

vestheleftjugular,subclavianandbronchomediastinaltrunks•Drainslymphfromlowerlimbs,pelviccavity,abdominalcavity,leftsideofthorax,andleft

sideofthehead,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12Lymphnode淋巴结Features❑Bean-shapedbodies❑W

ithafferentlymphvessels输入淋巴管(enteringattheperiphery)andefferentlymphvessels输出淋巴管(emergingatthehilus)❑Arrange

dingroups,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13•RegionalLymphNode局部

淋巴结isthelymphnodewherethelymphoftheorganorpartofthebodydraingetofirstly•SentinelLymphNode前哨淋巴结(inclinic)Lymphnode淋巴结14Lymphdrainageofthebo

dy15Ⅰ.Lymphdrainageofthehead头部的淋巴引流Lymphnodesofhead•Locatedatjunctionofheadandneck•Consistofoccipital,mastoid,parotid,submandibular,submentallymp

hnodes•Drainintodeepcervicallymphnodes•Submandibularlymphnode下颌下淋巴结liesnearthesubmandibulargland,receivelymphaticvesselsfromtheface,nose

andmouth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16Lymphdrainageofneck颈部的淋巴引流•Anteriorcervicallymphnodes颈前淋巴结–S

uperficialanteriorcervicallymphnodes–Deepanteriorcervicallymphnodes•Lateralcervicallymphnode颈外侧淋巴结–Superficiallateralcerv

icallymphnodes－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17Deeplateralc

ervicallymphnodes颈外侧深淋巴结•extendalongtheinternaljugularveinfromthebaseofskulltotherootofneck•divideintoSuperiordeeplateralcervicallymphnodes颈外侧上深淋巴结In

feriordeeplateralcervicallymphnodes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18Deeplateralcervicallymphnodes颈外侧深淋巴结•receivelymphaticvesselsf

romhead,neck,tongue,larynx,cervicalpartsofesophagusandtrachea,thyroidgland,upperpartsofthethoracicwal

landbreast•efferentvesselsformthejugulartrunk→thoracicduct(left)→rightlymphaticduct(right)Lymphdrainageofneck颈部的淋巴引流19•Superiordeeplatera

lcervicallymphnodes颈外侧上深淋巴结–Jugulodigastriclymphnode颈内静脉二腹肌淋巴结:liesatthejunctionofposteriorbellyofdigastri

candinternaljugularvein•Inferiordeeplateralcervicallymphnodes颈外侧下深淋巴结–Juguloomohyoidlymphnode颈内静脉肩胛舌骨肌淋巴结:liesattheju

nctionoftheintermediatetendonofomohyoidandinternaljugularvein–Supraclavicularlymphnodes锁骨上淋巴结:liealongthesubclavianarteryLymphdrainageofneck颈部的淋巴引流

20Thelymphaticdrainageofupperlimb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•lymp

hnodes–Cubitallymphnode滑车上淋巴结–Axillarylymphnode腋淋巴结21Axillarylymphnodes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.subclaviantrunk2

2Thelymphaticdrainageofthorax胸部的淋巴引流Thelymphaticdrainageofthoracicwall•Toaxillarylymphnodes•Toparasternallymphnodes胸骨旁淋巴结

(alonginternalthoracicvessels)•Tointercostalslymphnodes肋间淋巴结fromdeeperstructures23Thelymphaticdrainageofthorax胸部的淋巴引流lymphnodesofthethoracicconte

ntslymphnodesoftrachea,bronchiandlungs•Pulmonarylymphnodes肺淋巴结lieintheanglesofbifurcationofbranchinglobarb

ronchi•Bronchopulmonaryhilarlymphnodes支气管肺门淋巴结－lieinthehilusofthelung•Tracheobronchiallymphnodes气管支气管淋巴结－situatedaboveorbelowthebifurcationoftr

achea•Paratracheallymphnodes气管旁淋巴结－alongeachsideofthetracheaParatracheallymphnodes24•Anteriormediastinallymphnode纵隔前淋巴结liesanterio

rtothelargebloodvesselsofthoraciccavityandpericardium;theefferentsunitewiththoseofparatracheallymphnodes,toformtherightand

leftbronchomediastinaltrunks支气管纵隔干.Theleftbronchomediastinaltrunkterminatesinthoracicduct,andrightinthe

rightlymphticduct•Posteriormediastinallymphnodes纵隔后淋巴结liealongtheesophagusandthoracicaortaThelymphaticdrainageofthora

x胸部的淋巴引流25Thelymphaticdrainageofabdomen腹部的淋巴引流Lymphaticdrainageofabdominalwall•Toaxillarylymphnodefromregionaboveumbilicus•Tosu

perficialinguinallymphnodefromregionbelowumbilicus•Tolumbarlymphnodefrompostwallofabdomenaxillarylymphnodesuperficialinguinallymphnode26L

ymphaticdrainageofabdominalviscera•Lumbarlymphnodes腰淋巴结–Lieonposteriorabdominalwall,alongtheabdominalaortaandinfe

riorvenacava–Receivelymphfromkidneys,suprarenalglands,testes,ovarirs,fundusofuterus,ovary,andcommoniliacnodes–Theirefferentve

sselformtherightandleftlumbartrunksThelymphaticdrainageofabdomen腹部的淋巴引流27•Celiaclymphnodes腹腔淋巴结－situate

daroundtheceliactrunk•Superiormesentericlymphnode肠系膜上淋巴结－situatedaroundsuperiormesenterica.•Inferiormesent

ericlymphnode肠系膜下淋巴结－situatedaroundinferiormesenterica.•Intestinaltrunk腹腔干－formedbyefferentvesselofceliac,superiorandinferiorm

esentericlymphnodesThelymphaticdrainageofabdomen腹部的淋巴引流28Thelymphaticdrainageofpelvis盆部的淋巴引流Internaliliaclymphnode髂内淋巴结

•Surroundinternaliliacvessels•Receivelymphfrompelvicviscera,perineum,buttockandbackofthighExternaliliaclymphnodes髂外淋巴结•Liealo

ngexternaliliacartery•Receivelymphfromlowerlimbandsomepartsofpelvicviscera29Thelymphaticdrainageofpelvis盆部的淋巴引流Sacrallymphnode骶淋巴结locatealongmiddl

esacrala.andlateralsacrala.Receivelymphfromposteriorpelvicwall,rectum,prostateoruterusCommoniliaclymphnode髂总淋巴结•Liealongcommoniliacartery•Receivea

fferentsfromalltheabovenodes•Efferentspasstolumbarlymphnode30lymphdrainageoflowerlimb下肢的淋巴•lymphaticvessels–Superficiallymphatic–Deeplymphati

c•Lymphnodes–Superficiallymphnode•腹股沟浅淋巴结–Deeplymphnode•腹股沟深淋巴结31lymphdrainageoflowerlimb下肢的淋巴Superficiallymphnode腹股沟浅淋巴结maybedivide

dintotwogroups–Uppergroup:belowtheinguinallig.腹股沟韧带–Lowergroup:aroundtheterminalpartofgreatsaphenousv.大隐静脉–Receivelym

phfromlowerpartofabdominalwall,perineum会阴andlowerlimbwiththeexceptionofregiondrainedbypoplitealln.腘淋巴结32lymphdrainageoflowerlimb下肢的淋巴deepl

ymphnode腹股沟深淋巴结–Locatearoundtheproximalendoffemoralv.–Receivelymphfromdeeplymphaticvesselsoflowerlimbandtheefferentlymphaticvesselsof

superficialinguinalln.腹股沟浅淋巴结–Theirefferentlymphaticvesselsemptyintoexternaliliacln.髂外淋巴结33–Poplitealln.腘淋巴结•Embeddedinthe

fattyconnectivetissueofpoplitealfossa•Receivesuperficiallymphaticvesselsfromposterolateralpartofcalf小腿,andfromdeeplymphaticvesselsaccompanying

anteriorandposteriortibiala.•Efferentspasstothedeepinguinalln.腹股沟深淋巴结lymphdrainageoflowerlimb下肢的淋巴3435CeliaclymphnodesSuperiormesentericlym

phnode肠系膜上淋巴结Inferiormesentericlymphnode肠系膜下淋巴结3637Spleen脾LocationLeftepigastricregionbetween9th-11thribinlineof10thribFeaturesDiaphragmatics

urfaceVisceralsurface-SplenicHilumAnteriorextremityPosteriorextremitySuperiorborder-SplenicNotchInferiorborderFunction3839Thymus胸腺FeatruesCo

nsistsoftwoelongatedlobesIslargeorganinthefetusOccupiesthethoraciccavitybehindthesternumSecretelymphopoietin40Clinicinfor

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