Human Anatomy Vol 1

THORAX

Right lymphatic duct

Right jugular lymph trunk

Right subclavian lymph trunk

Right bronchomediastinal lymph tiunk

lntercostal lymph vessels

Cisterna chyli

lnternal iliac lymph trunk

Left jugular lymph trunk

Left subclavian lymph trunk

Left bronchomediastinal lymph trunk

Thoracic duct

Descending thoracic lymph trunk

lntestinal lymph trunk

Left lumbar lymph trunk

External iliac lymph trunk

Fig. 20.11: The tributaries of the thoracic duct

Anteriorly

1 Left common carotid artery.

2 Leftvagus.

3 Left internal jugular vein.

Posteriorly

1 Vertebral artery and vein.

(^2) Sympathetic trunk.
3 Thyrocervical trunk and its branches.
4 Lefl phrenic nerve.
5 Medial border of the scalenus anterior.
5 Prevertebral fascia covering all the structures
mentioned.
7 The first part of the left subclavian artery.
Tilbutories
The thoracic duct receives ly-ph from, roughly, both
halves of the body below the diaphragm and the left
half above the diaphragm (Fig. 20.11).
In the thorax, the thoracic duct receives lymph
vessels from the posterior mediastinal nodes and from
small intercostal nodes. At the root of the neck, efferent
vessels of the nodes in the neck form tiire left jugular
trunk, and those from nodes in the axilla form tl,:re left
subclaoian trunk. These trunks end in the thoracic duct.
The left bronchomediastinal trunk drains lymph from the
left half of the thorax and ends in the thoracic duct.
Trachea contains C-shaped hyaline cartilaginous
rings which are deficient posteriorly, so that the
oesophagus situated behind the trachea is not
compressed by trachea.
Trachea begins at 6th cervical vertebra and ends
at thoracic 4 (in expiration) by dividing into two
principal bronchi. Trachea is always patent.
Oesophagus is 25 cm long, like duodenum and
ureter. Its maximum part about 20 cm/8" lie in
thoracic cavity.
There is no digestive activity in the oesophagus.
Lower part of oesophagus is a site of portocaval
anastomoses.
Thoracic duct drains lymph from both lower
limbs, abdominal cavity, left side of thorax, left
upper limb and left side of head and neck.
A young lady during her midpregnancy period
complained of rapid breathing and difficulty in
swallowing. She also gave a history of sore throat
with pains in her joints during childhood.
o What is the likely diagnosis?
o What is the explanation for her symptoms?