hi let's talk about the thoracic duct in this video we'll discuss the major sources of lymph
to the thoracic duct and the course that the duct takes through the posterior mediastinum
the thoracic duct is the major lymphatic vessel of the body it's going to receive lymph from the
cisterna kylie which is the point at which nearly all of the lymph from inferior to the diaphragm
gathers it will then also receive lymph from various intercostal trunks
throughout the thorax the left jugular trunk that is going to drain the left head and neck of lymph
the left subclavian trunk which will drain largely the left upper limb of lymph but also
somewhat of the the neck and the left thorax also and also the left bronchomediastinal trunk
which is going to drain the tracheobronchial tree as well as portions of the mediastinum
of lymph this lymph will be delivered into the vicinity of the left venous angle recall that the
venous angle is where the internal jugular vein meets the subclavian vein thus the thoracic duct
is going to drain lymph from the entirety of the body with the exception of the right upper limb
the right thorax and the right head and neck that lymph will be drained by the right lymphatic duct
so the cisterna chyli uh is quite variable in size and origin typically it's in association with the
second lumbar vertebra and it's going to receive the lumbar trunks and various visceral trunks from
the abdominal organs it's a dilation of lymphoid tissue that is going to mark the origin of the
thoracic duct the thoracic duct is going to ascend the
retroperitoneal space of the abdominal cavity traveling through the aortic hiatus at
the t12 level with the descending aorta as it moves in the posterior mediastinum
it's typically going to be sandwiched between the esophagus which will be
left lateral to the thoracic duct and the azygos vein so look for the duct intermediate between
the esophagus and the azagus it's generally in its course throughout the posterior mediastinum
about one to two millimeters in diameter it has a very thin walled venous appearance to it
somewhere about the thoracic plane so at about that intervertebral disc between t4 and t5 the
thoracic duct is going to move from right lateral to left lateral so it's going to cross
the esophagus into that left lateral plane
it's going to move posteriorly behind the arteries and it's going to wrap around the
left subclavian artery as it makes its transition into the vicinity of the left venous angle
now along the way it's going to garner various intercostal trunks
and these can be quite variable with respect to how they empty into the thoracic duct
in the vicinity of the venous angle is typically where it may pick up the jugular subclavian and
left bronchomediastinal trunks although those trunks all may independently
enter into venous circulation in the vicinity of the venous angle it's uh it's quite variable
and keep in mind um on the right side we have all of these trunks as well so in association
with the subclavian vein we'll have a subclavian trunk with the internal jugular vein we'll have
that jugular trunk and on the right side of the trachea from the root of the lung ascending up the
right bronchomediastinal trunk and again these can either drain into the right lymphatic duct
or independently into the vicinity of the right venous angle so we've discussed the the origin and
various tributaries of the thoracic duct as well as its course through the posterior mediastinum
the superior mediastinum and the root of the neck this is your summary slide thank you for your time