THE LYMPHATIC

DRAINAGE OF THE
UPPER LIMB
Makbruri
Fakultas Kedokteran Universitas Indonesia

The Lymph Nodes

1.Superficial lymph Nodes
1.a. Infraclavicular nodes
1.b. Deltopectoral nodes
1.c. Superficial cubital (Supratrochlear)
2. Deep lymph nodes
2. a. Axillary lymph nodes
2. b. Along the medial side of the brachial
artery
2. c. At the bifurcation of the brachial
artery (deep cubital lymph node)
2. d. Ocassionally along the arteries of the arm

The Lymphatics Vessels

The lymphatics vessels :

1. The Superficial Lymphatics

2. The Deep Lymphatics

1.Superficial lymph nodes

1a. Infraclavicular nodes
Lie in or on the clavipectoral fascia
along the cephalic vein.
They drain in the :
1. The Upper Part of the breast
2. The thumb with its web

1. Superficial lymph nodes

1.b. Deltopocteral node
Lies in the deltopectoral groove
along the cephalic vein. It is a
displaced node of the
infraclavicular set, drains similar
structur

1.Superficial lymph nodes

1.c. Superficial cubital
(Supratrochlear)
lie just above the medial
epicondyle along the basilic vein.
They drain the ulnar side of the
hand and forearm.
Afferent drain the middle, ring,
and little finger, the medial
portion of the hand, and the
medial side of the fore arm
Efferent enter the lateral
axillary limph nodes
Enlarged in secondary syphilis

2. Deep lymph nodes

2.a. Axillary lymph nodes
The main lymph nodes of the
upper limb. Divided into five
group
1. Anterior (Pectoral)
2. Posterior (Scapular)
3. Lateral
4. Central
5. Apical (infraclavicular)

2.a. Axillary Lymph nodes

Anterior (Pectoral)
Lies along the thoracacic
vessels, at the lower border
of pectoralis minor. Related
to the axillary tail of the
breast.
Receive :
2. Upper half of the trunk
anterior
3. The major part of the
breast
1.

2.a. Axillary Lymph Nodes

2. Posterior (Scapullar)
Lies along the subscapullar
vessels, in the posterior fold
of axilla. They receive :
1. Lymph from the upper half
of the trunk posteriorly
2. The axillary tail of the
breast

2. a. Axillary lymph Nodes

3. Lateral Group
Lies along the upper part of
the humerus, medial to the
axilllary vein. Receive lymph
from the upper limb.

2. a. Axillary lymph Nodes

4. Central Group
Lies in the fat of the upper
axilla. Intercostobranchial
nerve passes amongst these
nodes. They drain the floor of
axilla

2. a. Axillary lymph Nodes

5. Apical (Infraclavicullar)
Lies beneath the clavipectoral
fascia, along the axillary vesels.
Receive lymph from :
1. Upper Part of the breast
2. The breast and from the
thumb and its web
(Accompany the cephalic
vein)

2.b Along the medial side of the brachial artery

2.c At the bifurcation of the brachial artery

node)
Receive lymph

vessels from forearm

(deep cubital lymph

2.d. Ocassionally along the arteries of the arm

The Lymphatics Vessels

The Superficial Lymphatics
. More Numerous than deep
lymphatics
. Collect lymph from the skin and
subcutaneous
. Most drain axillary node
. Medial side forearm
superficial cubital nodes
A.

The Lymphatic Vessels

The Superficial lymphatics
(cont)
. The lateral sides forearm
deltopectoral or infraclavicular
nodes
. The Lymphatics of the palm
and fingers dorsum of the
hand upward along
superficial veins
A.

The Lymphatic Vessels

B. The deep Lymphatics
Much less numerous than
superficial lymphatics
Lying deep to the deep fascia
Run along the main blood vessels
of the limb
End into axillary nodes

Applied Anatomy
1. Common Route for the spread of Cancer

Applied Anatomy
2. Lymphangitis
Inflamation in lymphatics, acute lymphangitis caused by
infection : Red, tender, and Indurated streaks ascending to
the regional lymph nodes from the point of Infection.

Applied Anatomy
3. Lymphoedema
Result of Lymph Statis
produced by lymphatic
obstruction from various
causes
1. Filariasis
2. Carcinamatous
infiltration

Applied Anatomy
4. Common causes of enlarged lymph nodes are :
A. Local Causes
1. Acute Infection
2. Chronic Infection, like filariasis
3. Malignancy of breast or any other part of the
upper limb
B. General Causes
1. Tuberculosis and secondary siphilis
2. Hodgkins disease
3. Lymphatic Leukaemia