Friday, November 5, 2010

Lymphatic Drainage in Axillary Lymph Nodes

The lymphatic vessels of the upper limb, most of those from the breast, and the cutaneous vessels of the trunk above the level of the umbilicus drain into the axillary nodes.

Lymphatics from the fingers accompany the cephalic and basilic veins and enter the lateral axillary and deltopectoral (or infraclavicular) nodes .

Axillary Nodes. These important nodes are arbitrarily divided into five groups:
1. The lateral nodes lie behind the axillary vein and drain the upper limb.

2. The pectoral nodes, at the inferior border of the pectoralis minor, drain most of the breast.

3. The posterior, or subscapular, nodes, in the posterior axillary fold, drain the posterior shoulder.

4. The central nodes, near the base of the axilla, receive the lymph from the preceding three groups. They form the group most likely to be palpable (against the lateral thoracic wall).

5. The apical nodes lie medial to the axillary vein and superior to the pectoralis minor. The apical nodes receive the lymph from all the other groups and sometimes directly from the breast. They drain into two or three subclavian trunks, which enter the jugular-subclavian venous confluence, or join a common lymphatic duct, or empty into lower, deep cervical nodes.
Diagram of the lymphatic drainage of the upper limb and breast. The supratrochlear and deltopectoral nodes receive many superficial lymphatic vessels. The axillary nodes are indicated by capital letters. The lateral nodes drain the upper limb. The subareolar plexus drains by collecting trunks into the axillary nodes. The pectoral nodes drain most of the breast. The apical nodes receive the lymph from the other axillary groups. Retropectoral (R) and transpectoral (T) routes are also shown.

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