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General Surgery

Lymphatic System

Built from Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery

What’s inside

11 sections · 110 slides

  1. 01

    Overview

    • Scope of this topic
    • General plan of the lymphatic system

    2 slides

  2. 02

    History

    • Anatomic and surgical history of the lymphatic system
    • Anatomic and Surgical History of the Lymphatic System
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)
    • Anatomic and Surgical History of the Lymphatic System (continued)

    20 slides

  3. 03

    Embryogenesis

    • Origin of the lymph sacs
    • Sequence of lymph sac formation
    • Formation of the lymphatic network
    • Histogenesis of the lymph node
    • Development of the lymphatic vessels
    • Development of the definitive thoracic duct
    • Oblique thoracic course of the definitive thoracic duct
    • Origin and lineage of lymphocytes

    8 slides

  4. 04

    Congenital anomalies

    • Congenital lymphoedema and cystic dilatation
    • Anomalies of the Lymphatic System
    • Cystic hygroma
    • Lymphangiomas by age and pulmonary lymphangiectasia

    4 slides

  5. 05

    Cisterna chyli

    • Is the cisterna chyli a constant structure?
    • Working definition and dimensions of the cisterna chyli
    • Tributaries of the cisterna chyli
    • Formation of the cisterna chyli
    • Imaging of a giant cisterna chyli

    5 slides

  6. 06

    Thoracic duct

    • Dimensions and drainage territory of the thoracic duct
    • Territory drained by the thoracic duct
    • Tributaries of the thoracic duct
    • Three parts and posterior mediastinal relations
    • Thoracic course of the duct
    • Cervical relations and termination of the thoracic duct
    • Valves at the duct-vein junction
    • Consequences of thoracic duct injury and ligation
    • Variability in the terminations of the thoracic duct
    • Patterns of duct entry into the venous system
    • Shimada and Sato classification of terminal endings
    • Type A-1 termination at the venous angle
    • Type A-2 termination by two trunks
    • Type A-3 with trunks to subclavian vein and venous angle
    • Type B-1 with two trunks to the internal jugular vein
    • Type B-2 with three terminal trunks
    • Type C-1 with an external jugular insertion
    • Type C-2 with external and internal jugular insertions
    • Type D with four terminal trunks
    • Jacobsson's autopsy series of the thoracic duct
    • Four types of origin of the thoracic duct
    • Nine types of cervical part of the thoracic duct
    • Sites of venous opening in the left neck
    • Calibre of the thoracic duct along its course
    • Valves and constrictions of the thoracic duct

    25 slides

  7. 07

    Right lymphatic duct

    • Formation of the right lymphatic duct
    • Right bronchomediastinal trunk
    • Lymphatic junctions at the right venous angle
    • Terminal lymph trunks of the right side

    4 slides

  8. 08

    Histology and physiology

    • Structure of the lymph capillary
    • Anchoring filaments and interstitial fluid entry
    • Pathway of lymph from interstitium to vein
    • Valves and daily lymph volume
    • Alternative lymphaticovenous connections
    • Number and distribution of lymph nodes
    • Gross structure of the lymph node
    • Cortex and germinal centres
    • Medulla, medullary cords and sinuses
    • Frontal section of a lymph node
    • Lymph node structure from capsule to hilum

    11 slides

  9. 09

    Nodes and malignant disease

    • Lymph nodes as filters of malignant cells
    • Failure of nodal containment
    • Clinical significance of lymph node enlargement
    • Castleman's disease

    4 slides

  10. 10

    Anatomic complications

    • Mechanisms of thoracic duct injury
    • Volume and consequences of chyle leak
    • Management of cervical chyle fistula
    • Conservative and operative closure of chyle fistula
    • Chylothorax and its management
    • Chylous ascites and paediatric chylothorax
    • Acquired lymphangiectasis
    • Kondoleon operation for elephantiasis

    8 slides

  11. 11

    Summary

    • Key anatomical facts
    • Key clinical points
    • Sources cited in the text
    • Sources cited in the text (continued)
    • Sources cited in the text (continued)
    • Sources cited in the text (continued)
    • Sources cited in the text (continued)
    • Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
    • Join our WhatsApp groups

    9 slides