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Irina Münstermann

Lymphatics of the mediastinum (English)

Lymphatics of the mediastinum (English)

Several groups of mediastinal (i.e. visceral) lymph nodes are visible. The brachiocephalic/anterior mediastinal lymph nodes are located in the superior mediastinum anterior to the great vessels. The tracheobronchial/intermediate mediastinal lymph nodes surround the bifurcation of the trachea, as well as the superior and inferior aspects of the main bronchi. The juxtaesophageal, interaorticoesophageal and juxtaaortic lymph nodes are commonly grouped as posterior mediastinal lymph nodes. They drain adjacent organs, vessels and tissues of the posterior mediastinum and send efferents to the paratracheal lymph nodes and right lymphatic/thoracic ducts. Parietal thoracic lymph nodes visible in this illustration include the intercostal, juxtavertebral and superior diaphragmatic lymph nodes. They collect the lymph from the deep back and intercostal muscles, parietal pleura and vertebral column. Lymph drained from the upper intercostal nodes (approx. levels 1-7) drains into a common intercostal trunk destined for the supraclavicular nodes while the lower intercostal nodes often drain below the diaphragm to the gastric or celiac lymph nodes/cisterna chyli before ultimately reaching the thoracic duct. Efferent vessels of the juxtavertebral nodes may follow a similar drainage pattern and/or alternatively pass via the posterior mediastinal lymph nodes. The superior diaphragmatic lymph nodes drain the diaphragm, diaphragmatic portion of the pericardium and diaphragmatic pleura. They usually drain to the parasternal (not shown) or posterior mediastinal lymph nodes.
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