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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）lymphatictiss

ue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2LymphnodesTheLymphaticSystem淋巴系统ACapVLymphatic-

CapillaryLymphaticLymphatictrunksLymphaticducts（淋巴结）（淋巴干）（淋巴导管）（毛细淋巴管）3•Aassistantsystemtothevein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rightlymph

aticduck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•Singlela

yerofoverlappingendothelialcells•Morepermeablethanthatofbloodcapillary•Absentfromavascularstructures,brain,spinalcordsple

nicpulpandbonemarrowLymphaticvessels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Featureso

fstructure❑Threelayeredwallsimilarto,butthinnerthanvein,❑Morenumerousvalvesthaninvein❑Interposedbylymphnodeatintervalalongthecourse❑Arrangedin

superficialanddeepsetsLymphaticvessels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rightandleftjugula

rtrunks(颈干)rightandleftsubclaviantrunks（锁骨下干）rightandleftbronchomediastinaltrunks（支气管纵隔干）rightandleftlumbartrunks（腰干）intestinaltrunk（肠干）Ly

mphaticvessels淋巴管道8Rightlymphaticduct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9Thoracicduct胸导管•BeginsinfrontofL1asadilatedsac,thecisternachyli乳糜池,whichformedbyjoiningofleftandr

ightlumbartrunksandintestinaltrunk•Enterthoraciccavitybypassingthroughtheaortichiatusofthediaphragmandascends

alongonthefrontofthevertebralcolumn,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10•Travelsupward,veeringtotheleftatthelevelofT5•Attheroofoftheneck,itturnslaterallyandarchesforwardsanddescendstoenter

theleftvenousangle•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11Thoracicduct胸导管•Justbeforetermination,itreceivestheleftjugular,subclavianandbronc

homediastinaltrunks•Drainslymphfromlowerlimbs,pelviccavity,abdominalcavity,leftsideofthorax,andleftsideofthehead,neckandleftupperlimbLymphaticvess

els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❑Withafferentlymphvessels输入淋巴管(enteringattheperiphery)andefferently

mphvessels输出淋巴管(emergingatthehilus)❑Arrangedingroups,alongthebloodvesselsortheflexuralsideofthejoint❑Dividedintosupe

rficialanddeepgroups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isthelymphnodewherethelymphoftheorganorpartofthebodydrainget

ofirstly•SentinelLymphNode前哨淋巴结(inclinic)Lymphnode淋巴结14Lymphdrainageofthebody15Ⅰ.Lymphdrainageofthehead头部的淋巴引流Lymphnodesofhead•Locateda

tjunctionofheadandneck•Consistofoccipital,mastoid,parotid,submandibular,submentallymphnodes•Drainintodeepcervicallymphnod

es•Submandibularlymphnode下颌下淋巴结liesnearthesubmandibulargland,receivelymphaticvesselsfromtheface,noseandmou

th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•An

teriorcervicallymphnodes颈前淋巴结–Superficialanteriorcervicallymphnodes–Deepanteriorcervicallymphnodes•Lateralcer

vicallymphnode颈外侧淋巴结–Superficiallateralcervicallymphnodes－liealongtheexternaljugularvein–Deeplateralcervi

callymphnodes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17Deeplateralcervicallymphnodes颈外侧深淋巴结•extendalongtheinternaljugularveinfromthebaseofskulltothe

rootofneck•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18Deeplateralcervicallymphnodes颈外侧深淋巴结•receivelymphaticvesselsfromhead,neck,tongue,larynx,cervicalpartso

fesophagusandtrachea,thyroidgland,upperpartsofthethoracicwallandbreast•efferentvesselsformthejugulartrunk→thora

cicduct(left)→rightlymphaticduct(right)Lymphdrainageofneck颈部的淋巴引流19•Superiordeeplateralcervicallymphnodes颈外侧上深淋巴结–Jugulodigastriclymphnode颈内静脉二

腹肌淋巴结:liesatthejunctionofposteriorbellyofdigastricandinternaljugularvein•Inferiordeeplateralcervicall

ymphnodes颈外侧下深淋巴结–Juguloomohyoidlymphnode颈内静脉肩胛舌骨肌淋巴结:liesatthejunctionoftheintermediatetendonofomohyoidandinter

naljugularvein–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•lym

phnodes–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.subclaviantrunk22Thelymphat

icdrainageofthorax胸部的淋巴引流Thelymphaticdrainageofthoracicwall•Toaxillarylymphnodes•Toparasternallymphnodes胸骨旁淋巴结(alonginternalthoracicvessels)•To

intercostalslymphnodes肋间淋巴结fromdeeperstructures23Thelymphaticdrainageofthorax胸部的淋巴引流lymphnodesofthethoraciccontentslymphnod

esoftrachea,bronchiandlungs•Pulmonarylymphnodes肺淋巴结lieintheanglesofbifurcationofbranchinglobarbronchi•

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

atedaboveorbelowthebifurcationoftrachea•Paratracheallymphnodes气管旁淋巴结－alongeachsideofthetracheaParatracheallymphnodes24•Anteriormediastinally

mphnode纵隔前淋巴结liesanteriortothelargebloodvesselsofthoraciccavityandpericardium;theefferentsunitewiththoseofparatracheally

mphnodes,toformtherightandleftbronchomediastinaltrunks支气管纵隔干.Theleftbronchomediastinaltrunkterminatesinthoracicduct,andrightintheri

ghtlymphticduct•Posteriormediastinallymphnodes纵隔后淋巴结liealongtheesophagusandthoracicaortaThelymphaticdrainageofthorax胸部的淋巴引流25Thelympha

ticdrainageofabdomen腹部的淋巴引流Lymphaticdrainageofabdominalwall•Toaxillarylymphnodefromregionaboveumbilicus•Tosuperficialinguinally

mphnodefromregionbelowumbilicus•Tolumbarlymphnodefrompostwallofabdomenaxillarylymphnodesuperficialinguinallymphnode26Lymphaticdr

ainageofabdominalviscera•Lumbarlymphnodes腰淋巴结–Lieonposteriorabdominalwall,alongtheabdominalaortaandinferiorvenacava–Receivelymphfromkidney

s,suprarenalglands,testes,ovarirs,fundusofuterus,ovary,andcommoniliacnodes–Theirefferentvesselformtherightan

dleftlumbartrunksThelymphaticdrainageofabdomen腹部的淋巴引流27•Celiaclymphnodes腹腔淋巴结－situatedaroundtheceliactrunk•Superiormesenter

iclymphnode肠系膜上淋巴结－situatedaroundsuperiormesenterica.•Inferiormesentericlymphnode肠系膜下淋巴结－situatedaroundinfe

riormesenterica.•Intestinaltrunk腹腔干－formedbyefferentvesselofceliac,superiorandinferiormesentericlymphnodesThelympha

ticdrainageofabdomen腹部的淋巴引流28Thelymphaticdrainageofpelvis盆部的淋巴引流Internaliliaclymphnode髂内淋巴结•Surroundinternal

iliacvessels•Receivelymphfrompelvicviscera,perineum,buttockandbackofthighExternaliliaclymphnodes髂外淋巴结•Liealongexterna

liliacartery•Receivelymphfromlowerlimbandsomepartsofpelvicviscera29Thelymphaticdrainageofpelvis盆部的淋巴引流Sacrall

ymphnode骶淋巴结locatealongmiddlesacrala.andlateralsacrala.Receivelymphfromposteriorpelvicwall,rectum,prostateorute

rusCommoniliaclymphnode髂总淋巴结•Liealongcommoniliacartery•Receiveafferentsfromalltheabovenodes•Efferentspasstolumbarlymphnode30lym

phdrainageoflowerlimb下肢的淋巴•lymphaticvessels–Superficiallymphatic–Deeplymphatic•Lymphnodes–Superficiallymphnode•腹股沟浅淋巴结–Deeply

mphnode•腹股沟深淋巴结31lymphdrainageoflowerlimb下肢的淋巴Superficiallymphnode腹股沟浅淋巴结maybedividedintotwogroups–Uppergroup:belo

wtheinguinallig.腹股沟韧带–Lowergroup:aroundtheterminalpartofgreatsaphenousv.大隐静脉–Receivelymphfromlowerpartofabdominalwall,perineum会阴

andlowerlimbwiththeexceptionofregiondrainedbypoplitealln.腘淋巴结32lymphdrainageoflowerlimb下肢的淋巴deeplymphnode腹股沟深淋巴结–Locat

earoundtheproximalendoffemoralv.–Receivelymphfromdeeplymphaticvesselsoflowerlimbandtheefferentlymphaticvesselso

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

fattyconnectivetissueofpoplitealfossa•Receivesuperficiallymphaticvesselsfromposterolateralpartofcalf小腿,andfromdeeplymphaticvesselsaccompanyinganteri

orandposteriortibiala.•Efferentspasstothedeepinguinalln.腹股沟深淋巴结lymphdrainageoflowerlimb下肢的淋巴3435Celiaclymphnod

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

FeaturesDiaphragmaticsurfaceVisceralsurface-SplenicHilumAnteriorextremityPosteriorextremitySuperiorborder-SplenicNotchInfer

iorborderFunction3839Thymus胸腺FeatruesConsistsoftwoelongatedlobesIslargeorganinthefetusOccupiesthethoraciccavitybehindthesternumSecretelymph

opoietin40Clinicinformation4142