Under normal conditions, despite the vastness and abundance of lymphatic connections between the individual links of the outlet collectors of the lungs, lymph from certain sections of the lungs goes to regional groups of lymph nodes for them. It was established that the movement of lymph within the lungs is naturally oriented in the direction: from the periphery to the center, to the root lymph nodes. At the same time, for each lobe of the lung, there are relatively independent, clearly traced paths of regional outflow of lymph. Having passed the group of root lymph nodes, the lymph then enters the mediastinal region of the regional collectors. Here its advancement is carried out mainly and mainly in the ascending direction — to the supraclavicular regions. Lymph movement within mediastinal lymph collectors in a downward direction – to the retroperitoneal lymph nodes, is regarded as an additional path celebrated less than 10% Observed eny .
Within the mediastinum, the movement of lymph from the right or left lung under normal conditions naturally occurs along the lymphatic collectors of the corresponding side of the same name.
Reaching the supraclavicular areas, the lymph passes through the vessels of the group of deep jugular lymph nodes located here as well as in the mediastinum – strictly oriented accordingly to the right or left lung, and then enters the venous channel.
Regional lymph flow from each of the lobes of the lung under normal conditions implies its passage from one group of lymph nodes to another. These nodes for the corresponding lung fraction are regional .
It should be noted that from the standpoint of the concept of regional outflow of lymph, individual segments of the lungs are not the main structural unit, as is customary in the anatomical structure of this organ. From several adjacent segments, the lobe of the lymph enters the general group of lymph nodes, and often even into one lymph node common to adjacent segments.
From the upper lobe of the right lung, lymph enters the nodes located at the base of the lobar bronchus and partly to the upper interlobar, grouped along the venous and arterial vessels. Having reached the area of the root of the lung, it passes here through the group of anteroposterior lymph nodes and then follows to the mediastinal section of the regional collector.
In the mediastinum, the lymph is drained by the right tracheobronchial, paratracheal, prevenous and partly prepericardial groups of lymph nodes, which are regional for the upper lobe of the right lung. Through the efferent vessels, the paratracheal and prevenous group of lymph nodes in the ascending direction reaches the right supraclavicular, mainly deep jugular lymph nodes and then enters the venous system along the right lymphatic trunk.
From the middle lobe of the lymph, it initially enters the nodes located on the posterolateral and anterior surface of the middle lobe bronchus, and partly in the lower interlobar. Then it follows through a group of nodes adjacent to the interlobar trunk of the pulmonary artery and the upper interlobar. In the area of the root of the lung lymph from the middle lobe passes through the nodes of the anterior group and are sent to the mediastinum. Here, the regional lymph nodes of the middle lobe of the right lung are the right tracheobronchial, paratracheal, prevenous and prepericardial, after which the bulk of the lymph enters the lymph nodes of the right supraclavicular region and into the venous system. It should be noted that a significant part of the lymph from the middle lobe is also directed to the bifurcation lymph nodes, passing through which it reaches in the ascending direction of the right tracheobronchial and right paratracheal forming a common collector.
At the beginning of the lower lobe of the right lung, the lymph enters the lower lobe lymph nodes located at the base of the lower lobe bronchus, and the lower interlobar lymph nodes are located under the pleura along the blood vessels. In the area of the root of the lung, lymph drainage is provided mainly by the lymph nodes of the lower and posterior groups, partly located in the pulmonary ligament. In the mediastinum, the lymph of the lower lobe of the right lung is drained by the bifurcation and peresophageal lymph nodes, as well as by the pericardial, located along the phrenic nerve closer to the diaphragm. Further, with an upward current, lymph through the vessels of the pretracheal chain connecting the bifurcation and right tracheobronchial nodes, through the paratracheal lymph nodes reaches the deep divisions of the collectors of the right supraclavicular region and venous system.
From the upper lobe of the left lung, the normal outflow of lymph initially occurs through a group of lymph nodes located at the base of the upper lobe bronchus. Moreover, from the reed segments, it is largely drained mainly by the interlobar group of lymph nodes, which are especially constantly pronounced near the base of the upper lobar artery. In the area of the root of the lung, lymph passes through the groups of front and especially upper lymph nodes. Further, in the mediastinum, the lymph goes to the prea-carotid, left tracheobronchial and paratracheal lymph nodes and reaches the nodes of the deep jugular chain in the left supraclavicular region and flows into the thoracic duct through their efferent vessels. Of the reed segments of the upper lobe, part of the lymph, passing through the interlobar and root nodes, can reach the bifurcation group, but then follow the anastomoses in the ascending direction to the left tracheobronchial and pre-aortocarotid and further to the left supraclavicular lymph nodes.