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System

Lymphatic system

Not medically reviewed · Content last updated · 1 min read ·

This is the date the draft was written, not a medical review date.

The lymphatic system drains interstitial fluid back to the venous circulation and houses the cells of adaptive immunity. It also absorbs dietary lipids from the gut as chyle.

Terminologia Anatomica (Latin): Systema lymphoideum

Components

It consists of lymphatic capillaries, collecting vessels, lymph nodes, and the thoracic and right lymphatic ducts, with primary lymphoid organs (bone marrow, thymus) and secondary organs (lymph nodes, spleen, mucosa-associated lymphoid tissue including tonsils). Lymph from most of the body drains via the thoracic duct into the left venous angle.

Function

Lymph return maintains tissue fluid balance and carries antigens to lymph nodes, where B and T lymphocytes mount immune responses. The spleen filters blood and removes aged red cells, and the thymus is the site of T-cell maturation.

Clinical correlations

Lymphadenopathy, lymphoedema, lymphoma, splenomegaly, and metastatic spread through regional nodes are the principal clinical correlates. Examination of node groups and knowledge of regional drainage guide cancer staging and infection assessment.

Common exam points

  • Thoracic duct begins at the cisterna chyli, ascends through the aortic hiatus and drains into the left venous angle.
  • Right lymphatic duct drains the right upper quadrant of the body.
  • Nodal groups: cervical, axillary, inguinal, para-aortic, with their drainage fields.
  • Primary versus secondary lymphoid organs.
  • Spleen: location in the left hypochondrium, relation to ribs 9 to 11, and risk of rupture after trauma.

References

  1. Drake RL, Vogl AW, Mitchell AWM. Gray's Anatomy for Students. Elsevier — Tier 3 (textbook)
  2. Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. Wolters Kluwer, 8th edition (2018) — Tier 3 (textbook)
  3. Hall JE, Hall ME. Guyton and Hall Textbook of Medical Physiology. Elsevier, 14th edition (2020) — Tier 3 (textbook)
  4. Pawlina W. Histology: A Text and Atlas. Wolters Kluwer, 8th edition (2020) — Tier 3 (textbook)

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