The study of topography and structural details of the discharge vessels

A study of the topography and structural details of the discharge vessels from various lobes of the lungs by injection showed that to the right of the upper lobe are two paths that are most constant: the anterior-medial (internal) through the intrapulmonary interlobar, root, right tracheobronchial, paratracheal and prevenous groups of lymph nodes; and posterior-lateral (external) —through the intrapulmonary superior interlobar to the posterior-lower root group and further to the right tracheobronchial or bifurcation lymph nodes.

From the middle lobe, the lymphatic paths are traced in the direction from the upper interlobar or, passing them, through the anterior root to the right tracheobronchial and bifurcation groups of nodes.

From the lower lobe of the right lung, two possible pathways of lymph outflow are established: 1) the upper — through the root nodes to the right tracheobronchial and 2) the lower — to the bifurcation group of lymph nodes.

For the left lung, its upper lobe, there are two possible ways of lymph outflow: the upper and lower. The lymphatic paths that form the upper pathway are located on the upper surface of the main bronchus and then follow to the preaortocarotid group of nodes and to the left tracheobronchial. The lower outflow path from the upper lobe, in addition to the indicated groups of nodes along oblique transverse lymph connections, reaches the bifurcation nodes.

For the lower lobe of the left lung, there are three ways of lymph outflow. The upper and middle pass through the preaortocarotid, left tracheobronchial, paratracheal and partly bifurcation lymph nodes. The lower one follows in the direction through the root nodes and further mainly to the bifurcation ones.

It should be noted that a significant number of lymphatic vessels from both the right and left lungs are sent to the nodes of the prepericardial group of the same side and to the pretracheal lymph nodes.

The most complex relationships and relationships between groups of lymph nodes located within the mediastinum. So, the bifurcation group of nodes is associated with the lymphatic collectors of both its sides. Often there are numerous anastomoses between the bifurcation and right tracheobronchial lymph nodes. For the left tracheobronchial lymph nodes, such connections are less pronounced and less constant. Numerous lymphatic vessels have also been established, heading from bifurcation lymph nodes to pretracheal, prevenous, pre-aortocarotid and even higher located lymph nodes of the deep jugular group on the neck. A certain part of the lymphatic vessels from the bifurcation group of nodes follows in the ascending direction along the membranous part of the tracheal wall, anastomosing here with the vessels of the lymph nodes of the retrotracheal group, and then reaches the deep lymphatic collectors of the neck.

The connections between the bifurcation and lower-lying lymph nodes of the peresophageal group and pulmonary ligaments are very numerous. The dye injected into these sections of the mediastinal lymphatic collector of the lungs by injection in the experiment, even with a small positive pressure, easily reaches the retroperitoneal lymph nodes, most often located near the base of the celiac arterial trunk .

local_offerevent_note September 18, 2019

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