U01.02.003 Lymphatic drainage associations

Lymphatic drainage involves the transport of lymph fluid through lymph nodes and vessels, playing a key role in immune defense. Specific lymph node clusters are associated with drainage of distinct anatomical regions, and pathological conditions can affect these clusters. Below is a comprehensive overview of lymphatic drainage associations, including common diseases and relevant lymph node groups.

Lymph Node Clusters and Drainage

Lymph Node Cluster	Region Drained	Associated Diseases
Cervical, Supraclavicular	Head and neck	Upper respiratory tract infections, Infectious mononucleosis, Kawasaki disease
Mediastinal	Trachea, esophagus	Pulmonary tuberculosis (TB), Sarcoidosis (bilateral), Primary lung cancer, Granulomatous disease
Axillary	Upper limb, breast, the skin above the umbilicus	Mastitis, Metastasis (especially breast cancer)
Hilar	Lungs	Pulmonary conditions (e.g., tuberculosis, lung cancer)
Celiac	Liver, stomach, spleen, pancreas, upper duodenum	Hepatic and gastric pathologies
Superior Mesenteric	Lower duodenum, jejunum, ileum, colon up to splenic flexure	Gastrointestinal diseases
Inferior Mesenteric	Colon from splenic flexure to upper rectum	Colon-related pathologies
Para-aortic	Testes, ovaries, kidneys, uterus	Metastasis to testes or ovaries, renal or uterine pathologies
Internal Iliac	Upper limb, breast, the skin above umbilicus	Pelvic organ diseases, prostate cancer
External Iliac	Lower rectum to anal canal (above the pectinate line), bladder, vagina (middle third), cervix, prostate	Cervical and uterine pathologies
Superficial Inguinal	Lower limb, scrotum, vulva, perianal region	Inguinal lymphadenopathy, pelvic or lower limb infections
Popliteal	Posterior leg and foot	Infections or diseases affecting the lower limb

Lymph Node Clusters and Drainage

Lymphatic Ducts

Right Lymphatic Duct: Drains the right side of the body above the diaphragm into the junction of the right subclavian and internal jugular vein.
Thoracic Duct: Drains lymph from below the diaphragm and the left thorax and upper limb into the junction of the left subclavian and internal jugular veins. Rupture of the thoracic duct can lead to chylothorax, a condition in which lymphatic fluid accumulates in the pleural cavity.

Points to Remember

Cervical lymph nodes: Commonly involved in head and neck infections.
Axillary lymph nodes: Significant for breast cancer metastasis.
Mediastinal lymph nodes: Commonly affected in lung cancer and sarcoidosis.
Thoracic duct rupture: This can result in chylothorax.
Inguinal lymph nodes: Often involved in lower limb or genital infections.

Bibliography

Schwartz, R. L. (2019). Lymphatic System Overview. Medical Immunology, 4th ed.
Wilson, H. (2020). Lymph Node Pathologies and Diagnostic Approaches. Journal of Clinical Immunology.
Kumar, V. (2018). Basic Pathology of Lymphatic Disorders. Textbook of Pathology.

USMLE Step 1 Review Series

Curriculum

U01.02.003 Lymphatic drainage associations

Lymph Node Clusters and Drainage

Lymphatic Ducts

Points to Remember

Bibliography

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