UAMS Department of Neurobiology and Developmental Sciences - Lymphatics of the Thorax

Gross Anatomy


Lymphatics of the Thorax - Listed Alphabetically

Structure Location Afferents from Efferents to Regions drained Notes
anterior mediastinal nodes along the course of the brachiocephalic vessels and aorta lymphatic vessels from the anterior mediastinum and middle mediastinum bronchomediastinal trunk thymus, anterior respiratory diaphragm, pericardium, part of the heart anterior mediastinal nodes are from 2 to 5 in number
axillary nodes axilla cubital nodes; lymphatic vessels from the upper limb, thoracic wall and subscapular region efferents vessels form the subclavian trunk, some drainage to inferior deep cervical nodes upper limb, most of the mammary gland, some of the anterolateral chest wall, posterior thoracic wall and scapular region axillary nodes number from 20 to 30 and are organized in five groups based on their position within the axilla: 1) pectoral nodes, along the lateral border of the pectoralis major m.; 2) lateral nodes, located along the distal axillary v.; 3) central nodes, centrally located along axillary v.; 4) subscapular nodes, located along the subscapular v. and its tributaries; 5) apical nodes, located at the apex of axilla
axillary nodes, apical apex of the axilla lateral axillary nodes; central axillary nodes; subscapular axillary nodes; pectoral nodes; accessory lymphatic vessels from the mammary gland; lymphatic vessels accompanying the cephalic v. subclavian lymphatic trunk; deep cervical lymph nodes upper limb, most of the mammary gland, some of the anterolateral chest wall, posterior thoracic wall and scapular region apical axillary nodes are 6- 12 in number; this is the highest node group in the axilla and all other node groups drain through these nodes; a very important group of nodes in cases of metastatic spread of breast cancer; connections to deep cervical nodes may result in spread of breast cancer through the deep neck
axillary nodes, central in the fat of the axilla lateral axillary nodes; pectoral nodes; subscapular nodes; lymphatic vessels from the mammary gland and upper limb apical axillary nodes upper limb, most of the mammary gland, some of the anterolateral chest wall, posterior thoracic wall and scapular region central axillary nodes are 4 or 5 in number; they are involved in cancer of the mammary gland
axillary nodes, lateral along the distal axillary v. cubital nodes; lymphatic vessels of the arm central axillary nodes, apical axillary nodes upper limb lateral axillary nodes become inflamed during upper limb infections; also known as: brachial nodes
axillary nodes, subscapular along the course of the subscapular vessels lymphatic vessels from the skin of the back and back of the neck; lymphatic vessels from the muscles of the scapular region central axillary nodes skin of the back and back of the neck; muscles of the scapular and subscapular regions subscapular axillary nodes are 5 or 6 in number; also known as: posterior axillary nodes
bronchomediastinal trunk along the course of the brachiocephalic v. union of efferents from the paratracheal nodes, parasternal nodes and anterior mediastinal nodes left: thoracic duct; right: right lymphatic duct thoracic wall and viscera; medial part of the mammary gland right bronchomediastinal trunk receives lymph from the lower lobe of the left lung; bronchomediastinal trunk may drain directly into the venous system on either side
bronchopulmonary nodes hilum of the lung pulmonary nodes tracheobronchial nodes lung bronchopulmonary nodes are also known as: hilar nodes
cisterna chyli between the abdominal aorta and the inferior vena cava anterior to the body of the L1 or L2 vertebra right and & left lumbar trunks; possibly the intestinal trunk thoracic duct all of the body below the respiratory diaphragm; all of the abdominal and pelvic viscera cisterna chyli is an enlargement of the lower end of the thoracic duct; it occurs in about 25% of individuals
hilar nodes at hilum of lung pulmonary nodes tracheobronchial nodes lung also known as: bronchopulmonary nodes
infraclavicular nodes along the cephalic v. in the deltopectoral groove lymphatic vessels from the superficial upper limb apical axillary nodes skin and superficial fascia of the upper limb infraclavicular nodes may become inflamed during infections of the superficial tissues of the upper limb
intercostal nodes near the heads of the ribs lymphatic vessels from the intercostal space cisterna chyli/thoracic duct, jugulosubclavian duct intercostal space and posterolateral thoracic wall usually two nodes occur in each intercostal space
mediastinal nodes, anterior along the course of the brachiocephalic vessels and aorta lymphatic vessels from the anterior mediastinum and middle mediastinum bronchomediastinal trunk thymus, anterior respiratory diaphragm, pericardium, part of the heart anterior mediastinal nodes are from 2 to 5 in number
mediastinal nodes, posterior along azygos system of veins and esophagus viscera of the posterior mediastinum and chest wall thoracic duct, inferior tracheobronchial nodes, superior tracheobronchial nodes posterior mediastinum, posterior aspect of the heart and pericardium, posterior part of the respiratory diaphragm posterior mediastinal nodes drain primarily to the thoracic duct
parasternal nodes lateral border of sternum, along the course of the internal thoracic vessels anterior phrenic nodes, lymphatic vessels from the anterior thoracic wall larger lymphatic vessels in the root of the neck medial side of the mammary gland; medial part of the anterior chest wall and muscles parasternal nodes constitute an important drainage pattern in cases of cancer of the mammary gland; one or two parasternal nodes may be found in the anterior end of intercostal spaces 1-6; also known as: sternal nodes
paratracheal nodes coursing along the lateral surface of the trachea and esophagus superior tracheobronchial nodes bronchomediastinal trunk lungs, trachea, upper esophagus, the part of the larynx below the vocal folds paratracheal nodes are an important group of nodes in cases of pulmonary infection or lung cancer; also known as: tracheal nodes
pectoral nodes along the lateral border of the pectoralis major m. along the course of the lateral thoracic vessels lymphatic vessels from the mammary gland and anterolateral thoracic wall central axillary nodes anterolateral thoracic wall and muscles; most of the mammary gland an important group of nodes to examine during a breast physical exam; also known as: anterior axillary nodes
phrenic nodes on the thoracic surface of the respiratory diaphragm lymphatic vessels from the diaphragm, liver and thoracic wall lumbar nodes, posterior mediastinal nodes superior surface of the liver, respiratory diaphragm phrenic nodes drain two structures that are very closely related in developmental origin - the liver and diaphragm (septum transversum); three subgroups of phrenic nodes are recognized: anterior, middle and posterior
posterior mediastinal nodes along azygos system of veins and esophagus viscera of the posterior mediastinum and chest wall thoracic duct, inferior tracheobronchial nodes, superior tracheobronchial nodes posterior mediastinum, posterior aspect of the heart and pericardium, posterior part of the respiratory diaphragm posterior mediastinal nodes drain primarily to the thoracic duct
pulmonary nodes within the lung parenchyma lymphatic vessels from the parenchyma of the lung bronchopulmonary (hilar) nodes lung parenchyma, bronchial tree within the lungs pulmonary nodes are located along the larger bronchi of the lung
sternal nodes lateral border of sternum, along the course of the internal thoracic vessels anterior phrenic nodes, lymphatic vessels from the anterior thoracic wall larger lymphatic vessels in the root of the neck medial side of the mammary gland; medial part of the anterior chest wall and muscles sternal nodes constitute an important drainage pattern in cases of cancer of the mammary gland; one or two sternal nodes may be found in the anterior end of intercostal spaces 1-6; also known as: parasternal nodes
subclavian trunk along the course of the subclavian v. apical axillary nodes; infraclavicular nodes drains into the junction of the internal jugular v. and the subclavian v. upper limb, most of breast, anterolateral chest wall subclavian lymphatic trunk occasionally drains into the thoracic duct on the left side; on the right it occasionally drains into the right lymphatic duct
supraclavicular nodes in and around carotid sheath below level of omohyoid superior deep cervical nodes, transverse cervical nodes, spinal accessory nodes efferents form the jugular lymphatic trunk head and neck also known as: inferior deep cervical nodes
thoracic duct between the esophagus anteriorly and the thoracic vertebral bodies posteriorly formed by the union of the lumbar lymph trunks, sometimes dilated to form a cisterna chyli junction of the left subclavian v. and the left internal jugular v. all of the body and limbs below the respiratory diaphragm; the left side of the chest, left upper limb and the left side of the head and neck above the diaphragm thoracic duct is the largest lymphatic vessel; it passes through the aortic hiatus on the right side of aorta; it swings to the left side of the esophagus at the T4-T5 intervertebral disc (at the level of the sternal angle)
thymus root of the neck and superior mediastinum posterior to sternum none parasternal nodes essential for normal development of the immune system maturation thymus involutes at puberty and is mostly replaced by a mass of fat
tracheobronchial nodes along the trachea, around the tracheal bifurcation and primary bronchi lymphatic vessels from the lung bronchomediastinal lymph trunk lungs, visceral pleura, bronchi, thoracic part of trachea, left side of heart, esophagus, posterior mediastinum tracheobronchial nodes may be divided into five groups: paratracheal (tracheal), superior tracheobronchial, inferior tracheobronchial, bronchopulmonary (hilar), pulmonary
tracheobronchial nodes, inferior inferior to tracheal bifurcation bronchopulmonary nodes, left side inferior tracheobronchial nodes drain into right inferior tracheobronchial nodes right superior tracheobronchial nodes lower lobes of the lungs; middle mediastinum; posterior mediastinum left inferior tracheobronchial nodes drain to the right side
tracheobronchial nodes, superior superolateral to the tracheal bifurcation bronchopulmonary (hilar) nodes paratracheal (tracheal) nodes lungs, middle mediastinum, posterior mediastinum inferior tracheobronchial nodes drain lymph from the lower lobe of the left lung to the right superior tracheobronchial nodes


Some of the material presented in these tables is contained in the book:
MedCharts Anatomy by Thomas R. Gest and Jaye Schlesinger
Published by ILOC, Inc., New York. Copyright 1995.

The content of these tables has been edited for use in this course by Patrick W. Tank, Ph.D.
Copyright 2009, Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences.
Unauthorized use is prohibited.




Return to the Anatomy Tables contents page...

Return to the Gross Anatomy home page...