Where are the lymph nodes located on the face. IV

What you need to know if you're tired of waking up with a puffy face or puffy eyes

There are at least 2 reasons why you need to know the location of the lymph nodes on the head and neck.

First– if you get tired of waking up with a swollen face/swollen eyes.

Second- so as not to damage them during massage or other manipulations on the face.

Diagram of lymph drainage from the head and neck

So, let's draw an analogy with the sewerage system at home. What happens when it gets clogged? Dirty water stagnates in the tank, begins to smell unpleasant, “bloom” ...

On our face, such blockage can be caused either by strong muscle blocks that impede the flow of lymph, or by non-working lymph nodes.

Stagnation of lymph causes swelling on the face and neck, the effect of a water-soaked face. Since the lymph removes the metabolic products of cells and tissues, the "bloom" of stagnant water is immediately reflected on the face - through the network of lymphatic capillaries, dirt is thrown onto the skin in the form of rashes, acne, eczema.

Do you need it? If not. Then the explanation of this scheme is for you.

Superficial lymph nodes of the head and neck - right side view in 3/4 turn.

1. Submental lymph nodes (nodi lymphatici submentales).

2. Submandibular lymph nodes (nodi lymphatici submandibulares).

3. Facial buccal lymph nodes (nodi lymphatici faciales/buccinatorii/).

4. Mandibular lymph nodes (nodi lymphatici mandibulares).

5. Superficial cervical lymph nodes (nodi lymphatici cervicales superficiales).

6. Deep cervical lymph nodes (nodi lymphatici cervicales profundi).

7. Supraclavicular lymph nodes (nodi lymphatici supraclaviculares).

8. Occipital lymph nodes (nodi lymphatici occipitales).

9. Mastoid lymph nodes (nodi lymphatici mastoidei).

10. Parotid lymph nodes (nodi lymphatici parotidei).

Pink- areas of lymphatic anastomoses, where bilateral or cross-metastasis of tumors is possible.

Bonus! An amazing massage that relieves swelling of the face:

It is necessary to spend it in the evening (before going to bed) and in the morning (immediately after waking up).

The technology is very simple: you need to gently press your palms on your eyes, forehead, jaws (as in the picture below):

In each position you need to linger for at least 10 seconds.

The effectiveness of this massage is that it, thereby removing swelling.

After the massage, wash your face with cold and warm water alternately.

Before carrying out any manipulations, consult your doctor!

P.S. And remember, just by changing your consciousness - together we change the world! © econet

The location of the lymph nodes in the neck is such as to purify the lymph, preventing infection of nearby organs with infection, bacteria. The nodes of the neck fulfill their purpose by clearing the lymph.

The lymph nodes on the neck - these are one of the (glands) included in. Lymph, a transparent liquid, flows through the capillaries, vessels, trunks throughout the body, capturing foreign substances, nuclides and similar formations that have entered them from the blood and tissues. On the way, inflamed places of the body may meet, festering wounds and many other organs infected with infection or bacteria that will also be taken over by the lymph.

Purpose

Lymph begins its journey in the lymphatic system when a person walks. From the feet, when walking, a clear liquid called lymph rises to the head. The system does not have its own engine. Therefore, the lymph returns to by gravity, making a full circle around the body of people. Around the vital organs of a person are located, including the lymph nodes in the neck, which are part of the lymphatic system. In the lymph nodes, the lymph is cleansed of bacteria, infections, in order to prevent infection of the areas near the glands, including in the neck.

Gang locations

There are 300 cervical lymph nodes. The location scheme makes it possible to see where the lymph nodes are located in the neck. The diagrams show that the location of the lymph nodes in the neck in people in the region of the cervical vertebrae. By classification, they are divided into groups:

• anterior cervical (anterior) and posterior cervical;
• and chin;
• supraclavicular;

The anatomy of the location of the glands on the neck can be seen in the diagrams.

Front

The anterior cervical lymph nodes, located above and below the sternocleidomastoid muscle, in front of the internal jugular vein, are located in an arrangement that allows the head to tilt and turn. These are superficial jugular nodes. They are small, but there are many. The anterior cervical purifies the lymph entering the pharynx, throat, tonsils and thyroid gland.

In turn, if you look at the figure, it is clear that among the anterior glands there are groups of preglottal, thyroid, paratracheal and pretracheal. These are deep knots.

Probing the cervical node is difficult, it is impossible to find them, since they are small. In an adult, they are smaller than in children.

Inflamed lymph node on the neck on the left or right. We need to find out what happened:

• Inflamed tonsils.
• Got an infection in the mouth.
• The bacteria got into Airways.

The reason could be:

• decreased immunity;
• lack of vitamins;
• freezing of the body;
• stressful situations of a long nature;
• insect bites;
• ear inflammation.

There was a bump on the front of the neck. Often it is not painful. The anatomy of the appearance of the bump is as follows: depending on the infectious lymph node, the first to catch the infection, the bump can be in front, on the side or under the chin.

The submandibular glands are the first to fight infections of the pharynx, mouth, and throat. Change usually takes place at the micro level. The neck remains unchanged. When infection or viruses enter the gland, the node swells.

The neck can be seen with a bump under the chin. If the lump is on the neck when the glands have returned to normal, then the doctor can answer whether lymphadenitis has developed into a chronic stage.

Glands at the back of the neck

Inflammation of the lymph nodes in the back of the neck is a sign of some kind of disease: an organ or an infection in the body. Posterior cervical lymph nodes located between the clavicle and mastoid region temporal bone protect the respiratory tract from infection. With swelling of the glands at the back of the head, inflammation of the lymph nodes in the back of the neck can occur.

Lymph nodes in the neck, the location, which is behind, can be seen if we consider the diagram.

Chin

Lymph in this area flows from the chin to the submandibular glands. The chin glands are located below the chin, cleaning the lower lip, the tip of the tongue, and the central incisors.

Submandibular

Submandibular or submandibular cervical lymph nodes are located under the jawbone on the sides.

The lymph flow goes from the lower oral cavity through the pharynx to the region of the tonsils. In addition, lymph flows from the lower teeth, excluding the central incisors, to the maxillary molars, including the anterior small ones.

The draining lymphatic vessels of the skin go to the submandibular and anterior nodes of the neck from the middle part of the face. Through the submandibular pass and from the lower part of the face.

The figure is a left side view showing lymph draining away from the tongue.

Supraclavicular

If you look at the drawing in the section, we will see the supraclavicular nodes and the subclavian trunk. in the pits near the junction of the clavicle with the sternum. They control the flow of lymph from the abdominal and thoracic areas.

The nodes that are responsible for the flow of lymph from the abdominal region are known as Vichrov's nodes and are considered the main ones. Since these nodes transport the incoming lymph back to the venous circulation through the left subclavian vein, they are prone to creating painful neoplasms such as infection in the arm, lymphadenitis, and breast cancer.

ear

Are there ear glands? The side view figure answers this question. To the left of the group of parotid nodes, there are several ear glands at the base of the neck. With otitis media, the lymph nodes in the front of the neck and on the left side become inflamed, inflammation of the nodes on the front surface of the neck and submandibular may occur. The pain will be felt in the neck and give to.

Occipital

The occipital nodes are located on the back of the neck. If in children under 5 years of age the occipital nodes have slightly increased in size, but the tumor subsides quickly, there are no symptoms of the disease. You don't need to see a doctor. This is the work of the lymph nodes in the back of the head, successfully coping with the infection. Such a process is considered the norm, since at this time immunity is formed.

Deep

There are also lateral (lateral) cervical nodes: superficial and deep. Deep ones are more numerous and deserve special attention. The location of the lymph nodes in the neck is responsible for the movement of lymph. Deep cervical glands move lymph along the neck through the carotid vagina, pharynx, esophagus, and trachea.

Deep cervical lymph nodes are divided into two groups: primary and secondary:

• The primary ones provide the movement of the lymph flow along the way - the head, the back of the neck, the thyroid gland, the pharynx, the esophagus, the trachea, the nose, palate and tongue. At the same time, lymph is taken from deep primary nodes on the neck, neck muscles.
• The second group is responsible for the lymph flow from the chest, part of the arms and the surface of the liver. Receives lymph from deep primary glands on the neck and neck muscles.

There is also a group of deep cervical nodes: lateral jugular, anterior jugular; jugular: jugular-bigastric and jugular-scapular-hyoid. The jugular-bigastric is the deepest. It can be felt only with inflammation of the tongue, tonsils, pharynx. The jugular-scapular-hyoid is located between the internal jugular vein and the scapular-hyoid muscle.

The figure clearly shows how each location of the gland groups is located.

What is a tonsillar lymph node?

These are glands located in the corners of the jaw. There are several tonsillar nodes, they protect the body from diseases, especially infectious, bacterial ones. Inflammation occurs with respiratory diseases such as tonsillitis, tracheitis and similar infectious diseases.

1) Tonsilary (jugulodigastric) lymph nodes are located in the jugular region of the neck

In chronic tonsillitis, the condition is often similar to the condition during the listed diseases.

Jugular fossa (suprasternal fossa)

Hollow in the lower part of the neck. V-shaped depression, limited laterally by the sternocleidomastoid muscles. The outflow of blood from the head and neck to the heart is carried out by several veins located in the jugular fossa.

Delfiano

This is a zone in the jugular fossa associated with the mucous membrane in the lower part of the larynx, pharynx and the thymus gland, which regulates the human immune system. Impact on the zone increases the body's resistance to infectious diseases by improving blood circulation in the thymus (thymus gland).

Dimensions

There is no unambiguous solution to this issue. The textbooks indicate the size of 1 cm. Based on practice, medical workers consider 1 cm to be the norm. However, there are opinions of oncologists who believe that the lymph node should be smaller. So, for the elbows, this size will be normal less than 0.5 cm; for inguinal - 1.5 cm. In healthy children, axillary, cervical and inguinal - 1.6 cm.

Causes of inflammation

Treatment

For lymph nodes, you need to consult a doctor and follow his recommendations. To eliminate the viruses that caused, doctors prescribe antiviral drugs. In case of infection, the patient is prescribed antibiotics:

• Ampicillin - adults and children.
• Clindymycin.

Also apply:

• Antibacterial drugs.
• Anti-inflammatory.
• Painkillers.
• Immunomodulators.

It is impossible to heat a painful place in the area of ​​\u200b\u200bthe inflamed gland, the result may be sepsis, life-threatening. You can not rub the sore spot. It is better to put a cooling compress.

Skin cysts, which are the causes of bumps on the neck, are removed surgically.

Lymph nodes are part of immune system and lymphatic, which is a natural filter that delays the penetration of infections and bacteria into the body. The fight against infection, bacteria, the elimination of toxins, the restoration of injured tissues occurs due to cellular formations and an anatomically reasonable structure of the body.

The lymphatic system cleanses the body only when a person moves. Moreover, with continuous movement for a long time. In order for the lymph nodes to be healthy and cleanse the body, people need to walk more.

From the organs of the head, lymph flows through the lymphatic vessels to small groups of lymph nodes lying on the border of the head and neck. From these nodes, the lymph through the vessels is directed to the superficial and deep lymph nodes of the neck, into which lymph flows from the organs of the neck.

The efferent lymphatic vessels of a large group of lateral deep cervical nodes are formed on each side of the neck along the jugular (lymphatic) trunk, which flow into the venous angle or into one of the veins that form it on the corresponding side. In the classic version, the jugular trunks flow to the right - into the right lymphatic duct, and on the left - into the final section of the thoracic duct.

Lymph nodes of the head:

1. Occipital, nodi lymphatici occipitales , lie both outside the superficial sheet of the fascia of the neck behind the attachment of the sternocleidomastoid muscle, and from the inner surface on the splenius muscle of the head. Lymph from the soft tissues of the scalp flows into these nodes. From the occipital lymph nodes, lymph flows into the deep cervical lymph nodes.

2. Mastoid (behind the ear), nodi lymphatici mastoidei (retroauriculares) , lie behind the auricle on the mastoid process and receive lymph from the auricle and the skin of the parietal region. From these nodes, the efferent lymphatic vessels carry lymph to the parotid, superficial, and lateral deep cervical lymph nodes.

3. Parotid superficial and deep, nodi lymphatici parotidei superficiales et profundi , lie in the region of the salivary gland of the same name. The nodes located on the surface of the gland are called superficial, and those in the parenchyma of the gland are called deep. Lymph flows into them from the skin of the frontal and parietal regions of the head, from the auricle, external auditory canal, auditory tube and tympanic membrane, upper lip and the parotid salivary gland. From these nodes, through their efferent vessels, lymph enters the superficial and lateral deep cervical lymph nodes.

4. pharyngeal, nodi lymphatici retrotropharyngeales , lie on the prevertebral plate of the cervical fascia, from the sides and behind the pharynx. They drain lymph from the walls of the pharynx, the mucous membrane of the nasal cavity, the paranasal (paranasal) sinuses, from the tonsils and palate, the auditory tube and the tympanic cavity of the middle ear. From these nodes, lymph flows into the lateral deep cervical lymph nodes.

5. Submandibular, nodi lymphatici submandibulares , lie in the submandibular triangle in front and behind the salivary gland of the same name and receive lymph through the efferent lymphatic vessels from:

1) mandibular lymph nodes, nodi lymphatici mandibulares , unstable and lie in the subcutaneous tissue of the outer surface of the lower jaw, near facial a-and and veins;

2) facial (buccal) lymph nodes, nodi lymphatici faciales (buccinatorii) . Fickle and lie in the subcutaneous tissue of the cheeks near the facial vessels;

Lymph flows into the submandibular nodes from the skin of the face, soft tissues of the eyelids, nose, lips, cheeks, tongue, gums, submandibular and sublingual salivary glands.

6. Submental lymph nodes, nodi lymphatici submentales , are located on the geniohyoid muscle from the chin to the body of the hyoid bone, between the anterior bellies of the digastric muscles.

Lymph nodes of the neck:

In relation to the superficial plate of the cervical fascia and to the large vessels of the neck, its lymph nodes are divided into superficial and deep.

Superficial cervical lymph nodes, nodi lymphatici cervicales superficiales , are located outward from the superficial plate of the cervical fascia near the external jugular vein and in the back of the neck, less often on the trapezius muscle and near the anterior jugular vein.

Deep cervical lymph nodes, nodi lymphatici cervicales profundi , are concentrated in the anterior and lateral regions of the neck. Anterior deep lymph nodes include:

1. preglottal, nodi lymphatici prelaryngeales ;

2. thyroid, nodi lymphatici thyroidei ;

3. pretracheal, nodi lymphatici pretracheales ;

4. paratracheal, nodi lymphatici paratracheales .

In the lateral region of the neck, up to 70 lymph nodes belonging to different groups are concentrated. A very large group of nodes - lateral deep cervical, nodi lymphatici cervicales laterales profundi . Most of them are located directly near the internal jugular vein, so they are also called internal jugular. 1-8 nodes are localized at the anterior branch of the accessory nerve and the superficial branch of the transverse a-and neck. Lymph from these nodes flows into other groups of lateral deep cervical lymph nodes, which are located along the internal jugular vein from the outer base of the skull to its junction with the subclavian vein. The largest nodes of these groups are the jugular - digastric node, nodus jugulodigastricus , and jugular - scapular - hyoid node, nodus juguloomohyoideus to which lymph is directed from the tongue.

The efferent lymphatic vessels of this group of nodes form a jugular trunk on each side of the neck, truncus jugularis .

The lymph nodes of the head include:
parotid nodes(nodi lymphatici parotidei):

Superficial and deep, occipital (nodi lymphatici occipitales),

mastoid (nodi lymphatici mastoidei),

submandibular (nodi lymphatici submandibulares),

chin (nodi lymphatici submentales)

facial lymph nodes.

The lymphatic vessels of the occipital region carry lymph to the occipital nodes. From the auricle and the posterior parts of the parietal and occipital regions, the lymphatic vessels of the head are sent to the mastoid nodes. Lymph from the forehead, anterior parietal and temporal regions, tympanic membrane, external auditory canal, part of the auricle and part of the eyelids enters the parotid lymph nodes. From these nodes, the efferent vessels convey lymph to the lymph nodes of the neck. In the submandibular nodes, lymph is collected from the bones and soft tissues of the face. In the mental nodes, lymphatic drainage from the lower lip and chin is carried out.

Lymphatic vessels and nodes of the head and neck:
1 - lymphatic vessels of the head;
2 - occipital lymph nodes;
3 - parotid lymph nodes;
4 - mastoid nodes;
5 - submandibular lymph nodes;
6 - chin lymph nodes;
7 - deep cervical lymph nodes;
8 - superficial cervical lymph nodes;
9 - jugular trunk;
10 - axillary lymph nodes;
11 - central lymph nodes;
12 - lymphatic vessels of the mammary gland

Lymph nodes in the neck are divided into anterior and lateral groups. Each group is in turn subdivided into superficial and deep lymph nodes of the neck (nodi lymphatici cervicales superficiales et profundi).

Anterior superficial the lymph nodes of the neck are located near the anterior jugular vein and are concentrated on the superficial fascia.
Front deep nodes are located next to the organs from which they collect lymph, and have the same names (for example, preglottal, pretracheal, thyroid, etc.). group lateral deep nodes are supraclavicular and pharyngeal lymph nodes (nodi lymphatici retropharyngei), as well as anterior and lateral jugular nodes located near the internal jugular vein.

The deep nodes of the neck receive lymph from the nasal cavity, mouth, part of the pharynx and middle ear, which first passes through the occipital nodes. The lymphatic vessels of the tongue end in the lingual lymph nodes (nodi lymphatici linguales). From the lingual nodes, lymph enters the submandibular and mental nodes, and from there to the retropharyngeal and deep cervical nodes. From the deep cervical nodes, lymphatic vessels begin, passing on each side and accompanying the internal jugular vein. These vessels form the right and left jugular trunks (tranci jugulares dexter et sinister). The left one flows into the thoracic duct, and the right one into the right lymphatic duct.

The immune system

The immune system - this is the totality of all lymphoid organs and accumulations of lymphatic cells in the body.

Synonymous with the immune system is the lymphatic system.

Lymphoid organs are functional tissue formations in which immune cells are formed and where they acquire immune specificity.

Among the organs of the immune system, there are:

1. Central: thymus gland (thymus), bone marrow, bursa (in birds).

2. Peripheral: blood, lymph, spleen, lymph nodes.

3. The system of lymphoepithelial formations: accumulations of lymphoid tissue of the mucous membranes of the gastrointestinal tract, respiratory and genitourinary tract.

CENTRAL ORGANS OF THE IMMUNE SYSTEM

The bone marrow is both a hematopoietic organ and an organ of the immune system. The total mass of the bone marrow is 2.5 - 3 kg. Allocate red and yellow bone marrow.

According to the functional purpose in the red bone marrow, there are myeloid(hemocytopoietic) and lymphoid tissues from which blood cells, monocytes and B-lymphocytes are formed.
The yellow bone marrow is represented mainly by adipose tissue, which has replaced the reticular one. Blood-forming elements in the yellow brain are absent. But with large blood loss, in place of the yellow bone marrow, foci of hematopoiesis may reappear due to stem cells received with blood.

The thymus (thymus, thymus) is located directly behind the sternum. It is formed earlier than other organs of the immune system (already at the 6th week of pregnancy), but by the age of 15 it undergoes a reverse development, in adults it is almost completely replaced by fatty tissue. Penetrating from the bone marrow into the thymus, the stem cell, under the influence of hormones, first turns into the so-called thymocyte (the cell is the precursor of the T-lymphocyte), and then, penetrating into the spleen or lymph nodes, it turns into a mature, immunologically active T-lymphocyte. Most of the T-lymphocytes become the so-called T-killers (killers). A smaller part performs a regulatory function: T-helpers (helpers) increase immunological reactivity, T-suppressors (suppressors), on the contrary, reduce it. Unlike B-lymphocytes, T-lymphocytes (mainly T-helpers), with the help of their receptors, are able to recognize not just someone else's, but also their own, that is, a foreign antigen should be presented most often by macrophages in combination with the body's own proteins. In the thymus, along with the formation of T-lymphocytes, thymosin and thymopoietin are produced - hormones that ensure the differentiation of T-lymphocytes and play a certain role in cellular immune responses.
It consists of two lobes of different shape and size, which are tightly pressed against each other. Outside, it is covered with a capsule of connective tissue. In the depths of the organ, strands, partitions depart from it. They divide the entire tissue, the glands into small lobules. In the thymus, the outer darker cortical substance dominated by lymphocytes, and central, light cerebral substance containing glandular cells. The cellular composition of the thymus is completely renewed in 4-6 days. About 5% of newly formed lymphocytes migrate from the thymus to peripheral lymphoid tissues. For most of the other cells that form in the thymus, it also becomes the "grave" of the cells die within 3-4 days. The cause of death has not been deciphered.

Branchiogenic glands. Thyroid

Endocrine glands(gll. endocrinae) perform specific function- hormonal regulation of the most important physiological processes: reproduction, growth, metabolism.

Among the endocrine glands, there are thyroid gland(gll. thyroidea),parathyroid glands(gll. parathyroideae),pituitary(hypophysis),pineal gland(gl. pineale),adrenal glands(gll. suprarenales),endocrine pancreas And gonads(Fig. 270).

Lymphatic system - an integral part of the vascular system that drains tissues by forming lymph and conducting it into the venous bed (additional drainage system).

Up to 2 liters of lymph are produced per day, which corresponds to 10% of the volume of fluid that is not reabsorbed after filtration in the capillaries.

Lymph is a fluid that fills the vessels of the lymphatic channel and nodes. It, like blood, belongs to the tissues of the internal environment and performs trophic and protective functions in the body. In its properties, despite the great similarity with blood, lymph differs from it. At the same time, lymph is not identical to the tissue fluid from which it is formed.

Lymph consists of plasma and formed elements. Its plasma contains proteins, salts, sugar, cholesterol and other substances. The protein content in the lymph is 8-10 times less than in the blood. 80% of the formed elements of the lymph are lymphocytes, and the remaining 20% ​​are the share of other white blood cells. There are no normal erythrocytes in the lymph.

Functions of the lymphatic system:

Tissue drainage.

Ensuring continuous fluid circulation and metabolism in human organs and tissues. Prevents the accumulation of fluid in the tissue space with increased filtration in the capillaries.

Lymphopoiesis.

Transports fats away from the site of absorption in the small intestine.

Removal from the interstitial space of substances and particles that are not reabsorbed in the blood capillaries.

Spread of infection and malignant cells (tumor metastasis)

Factors that ensure the movement of lymph

Filtration pressure (due to the filtration of fluid from the blood capillaries into the intercellular space).

Permanent formation of lymph.

Availability of valves.

Contraction of surrounding skeletal muscles and muscle elements internal organs(squeeze the lymphatic vessels and the lymph moves in the direction determined by the valves).

The location of large lymphatic vessels and trunks near the blood vessels (the pulsation of the artery squeezes the walls of the lymphatic vessels and helps the lymph flow).

Suction action chest and negative pressure in the brachiocephalic veins.

Smooth muscle cells in the walls of lymphatic vessels and trunks .

Table 7

Similarities and differences in the structure of the lymphatic and venous systems

Lymph capillaries- thin-walled vessels, the diameter of which (10-200 microns) exceeds the diameter of blood capillaries (8-10 microns). The lymphatic capillaries are characterized by tortuosity, the presence of constrictions and expansions, lateral protrusions, the formation of lymphatic "lakes" and "lacunae" at the confluence of several capillaries.

The wall of the lymphatic capillaries is built from a single layer of endothelial cells (there is a basement membrane in the blood capillaries outside the endothelium).

Lymph capillaries No in the substance and membranes of the brain, cornea and lens of the eyeball, spleen parenchyma, bone marrow, cartilage, epithelium of the skin and mucous membranes, placenta, pituitary gland.

Lymphatic postcapillaries- an intermediate link between the lymphatic capillaries and blood vessels. The transition of the lymphatic capillary to the lymphatic postcapillary is determined by the first valve in the lumen (the valves of the lymphatic vessels are paired folds of the endothelium and the underlying basement membrane lying opposite each other). Lymphatic postcapillaries have all the functions of capillaries, but lymph flows through them in only one direction.

Lymphatic vessels are formed from networks of lymphatic postcapillaries (capillaries). The transition of a lymphatic capillary into a lymphatic vessel is determined by a change in the structure of the wall: in it, along with endothelium, there are smooth muscle cells and adventitia, and in the lumen - valves. Therefore, lymph can flow through the vessels in only one direction. The area of ​​the lymphatic vessel between the valves is currently referred to by the term "lymphangion" (Fig. 58).

Rice. 58. Lymphangion - morphofunctional unit of a lymphatic vessel:

1 - segment of the lymphatic vessel with valves.

Depending on the localization above or below the superficial fascia, the lymphatic vessels are divided into superficial and deep. Superficial lymphatic vessels lie in the subcutaneous adipose tissue above the superficial fascia. Most of them follow to the lymph nodes located near the superficial veins.

There are also intraorganic and extraorganic lymphatic vessels. Due to the existence of numerous anastomoses, intraorganic lymphatic vessels form wide-looped plexuses. The lymphatic vessels emerging from these plexuses accompany the arteries, veins and exit the organ. Extraorganic lymphatic vessels are sent to nearby groups of regional lymph nodes, usually accompanying blood vessels, more often veins.

On the path of the lymphatic vessels are located The lymph nodes. This determines that foreign particles, tumor cells, etc. linger in one of the regional lymph nodes. The exceptions are some lymphatic vessels of the esophagus and, in isolated cases, some vessels of the liver, which flow into the thoracic duct, bypassing the lymph nodes.

Regional lymph nodes organ or tissue - these are the lymph nodes that are the first in the path of the lymphatic vessels that carry lymph from this area of ​​​​the body.

lymph trunks- These are large lymphatic vessels that are no longer interrupted by lymph nodes. They collect lymph from several areas of the body or several organs.

There are four permanent paired lymph trunks in the human body.

jugular trunk(right and left) is represented by one or more vessels of small length. It is formed from the efferent lymphatic vessels of the lower lateral deep cervical lymph nodes located in a chain along the internal jugular vein. Each of them drains lymph from the organs and tissues of the corresponding sides of the head and neck.

subclavian trunk(right and left) is formed from the fusion of the efferent lymphatic vessels of the axillary lymph nodes, mainly the apical ones. It collects lymph from the upper limb, from the walls of the chest and mammary gland.

Bronchomediastinal trunk(right and left) is formed mainly from the efferent lymphatic vessels of the anterior mediastinal and upper tracheobronchial lymph nodes. It carries lymph away from the walls and organs of the chest cavity.

The efferent lymphatic vessels of the upper lumbar lymph nodes form the right and left lumbar trunks, which divert lymph from the lower limb, walls and organs of the pelvis and abdomen.

Inconsistent intestinal lymphatic trunk occurs in about 25% of cases. It is formed from the efferent lymphatic vessels of the mesenteric lymph nodes and flows into the initial (abdominal) part of the thoracic duct with 1-3 vessels.

Lymphatic trunks flow into two ducts: the thoracic duct (Fig. 59) and the right lymphatic duct, which flow into the veins of the neck in the so-called venous angle formed by the union of the subclavian and internal jugular veins. The thoracic lymphatic duct flows into the left venous angle, through which lymph flows from 3/4 of the human body: from the lower extremities, pelvis, abdomen, left half of the chest, neck and head, left upper limb. The right lymphatic duct flows into the right venous angle, through which lymph is brought from 1/4 of the body: from the right half of the chest, neck, head, from the right upper limb.

thoracic duct (ductus thoracicus) has a length of 30-45 cm, is formed at the level of the XI thoracic -1 lumbar vertebrae by the fusion of the right and left lumbar trunks (trunci lumbales dexter et sinister). Sometimes at the beginning of the thoracic duct has extension (cisterna chyli). The thoracic duct is formed in the abdominal cavity and passes into the chest cavity through the aortic opening of the diaphragm, where it is located between the aorta and the right medial crus of the diaphragm, the contractions of which help to push the lymph into the thoracic part of the duct. At the level of the VII cervical vertebra, the thoracic duct forms an arc and, having rounded the left subclavian artery, flows into the left venous angle or the veins that form it. At the mouth of the duct there is a semilunar valve that prevents the penetration of blood from the vein into the duct. The left bronchomediastinal trunk (truncus bronchomediastinalis sinister), which collects lymph from the left half of the chest, flows into the upper part of the thoracic duct, as well as the left subclavian trunk (truncus subclavius ​​sinister), which collects lymph from the left upper limb and the left jugular trunk (truncus jugularis sinister), which carries lymph from the left side of the head and neck.

Right lymphatic duct (ductus lymphaticus dexter) 1-1.5 cm long, formed at the confluence of the right subclavian trunk (truncus subclavius ​​dexter), which carries lymph from the right upper limb, the right jugular trunk (truncus jugularis dexter), which collects lymph from the right half of the head and neck, and the right bronchomediastinal trunk (truncus bronchomediastinalis dexter), which brings lymph from the right half of the chest. However, more often the right lymphatic duct is absent, and the trunks forming it flow into the right venous angle on their own.

Lymph nodes of certain areas of the body.

Head and neck

There are many groups of lymph nodes in the head region (Fig. 60): occipital, mastoid, facial, parotid, submandibular, submental, etc. Each group of nodes receives lymphatic vessels from the area closest to its location.

So, the submandibular nodes lie in the submandibular triangle and collect lymph from the chin, lips, cheeks, teeth, gums, palate, lower eyelid, nose, submandibular and sublingual salivary glands. In the parotid lymph nodes located on the surface and in the thickness of the gland of the same name, lymph flows from the forehead, temple, upper eyelid, auricle, walls of the external auditory canal.

Fig.60. Lymphatic system of the head and neck.

1 - anterior ear lymph nodes; 2 - rear ear lymph nodes; 3 - occipital lymph nodes; 4 - lower ear lymph nodes; 5 - buccal lymph nodes; 6 - chin lymph nodes; 7 - posterior submandibular lymph nodes; 8 - anterior submandibular lymph nodes; 9 - lower submandibular lymph nodes; 10 - superficial cervical lymph nodes

There are two main groups of lymph nodes in the neck: deep and superficial cervical. Deep cervical lymph nodes in large numbers accompany the internal jugular vein, and superficial lie near the external jugular vein. In these nodes, mainly in the deep cervical ones, there is an outflow of lymph from almost all the lymphatic vessels of the head and neck, including the efferent vessels of other lymph nodes in these areas.

Upper limb

There are two main groups of lymph nodes on the upper limb: elbow and axillary. Elbow nodes lie in cubital fossa and receive lymph from part of the vessels of the hand and forearm. Through the efferent vessels of these nodes, the lymph flows into the axillary nodes. Axillary lymph nodes are located in the fossa of the same name, one part of them lies superficially in the subcutaneous tissue, the other - in depth near the axillary arteries and veins. Lymph flows into these nodes from the upper limb, as well as from the mammary gland, from the superficial lymphatic vessels of the chest and the upper part of the anterior abdominal wall.

chest cavity

In the chest cavity, the lymph nodes are located in the anterior and posterior mediastinum (anterior and posterior mediastinal), near the trachea (peritracheal), in the bifurcation of the trachea (tracheobronchial), in the hilum of the lung (bronchopulmonary), in the lung itself (pulmonary), and also on the diaphragm. (upper diaphragmatic), near the heads of the ribs (intercostal), near the sternum (peripheral), etc. Lymph flows from the organs and partially from the walls of the chest cavity into these nodes.

lower limb

On the lower extremity, the main groups of lymph nodes are popliteal and inguinal. The popliteal nodes are located in the fossa of the same name near the popliteal arteries and veins. These nodes receive lymph from part of the lymphatic vessels of the foot and lower leg. The efferent vessels of the popliteal nodes carry lymph mainly to the inguinal nodes.

Inguinal lymph nodes are divided into superficial and deep. Superficial inguinal nodes lie below the inguinal ligament under the skin of the thigh on top of the fascia, and deep inguinal nodes lie in the same area, but under the fascia near the femoral vein. Lymph flows into the inguinal lymph nodes from the lower limb, as well as from the lower half of the anterior abdominal wall, perineum, from the superficial lymphatic vessels of the gluteal region and lower back. From the inguinal lymph nodes, lymph flows to the external iliac nodes, which are related to the nodes of the pelvis.

In the pelvis, the lymph nodes are located, as a rule, along the course of the blood vessels and have a similar name (Fig. 61). So, the external iliac, internal iliac and common iliac nodes lie near the arteries of the same name, and the sacral nodes lie on the pelvic surface of the sacrum, near the median sacral artery. Lymph from the pelvic organs flows mainly to the internal iliac and sacral lymph nodes.

Rice. 61. Lymph nodes of the pelvis and the vessels connecting them.

1 - uterus; 2 - right common iliac artery; 3 - lumbar lymph nodes; 4 - iliac lymph nodes; 5 - inguinal lymph nodes

abdominal cavity

There are a large number of lymph nodes in the abdominal cavity. They are located along the course of the blood vessels, including the vessels passing through the gates of the organs. So, along the course of the abdominal aorta and the inferior vena cava near the lumbar spine, up to 50 lymph nodes (lumbar). in the mesentery small intestine up to 200 nodes lie along the branches of the superior mesenteric artery (superior mesenteric). There are also lymph nodes: celiac (near the celiac trunk), left gastric (along the greater curvature of the stomach), right gastric (along the lesser curvature of the stomach), hepatic (in the region of the gate of the liver), etc. Lymph from the organs flows into the lymph nodes of the abdominal cavity, located in this cavity, and partly from its walls. Lymph from the lower extremities and pelvis also enters the lumbar lymph nodes. It should be noted that the lymphatic vessels of the small intestine are called milky, since lymph flows through them, containing fat absorbed in the intestine, which gives the lymph the appearance of a milky emulsion - hilus (hilus - milky juice).