胸导管
Ductus thoracicus
定义
胸导管是人体最大的淋巴管,负责将大部分身体的淋巴液输送至静脉系统。
胸导管通常起自乳糜池,乳糜池是位于第二腰椎(L2)水平的一个扩张囊状结构。紧接乳糜池之后,胸导管腹部经膈的主动脉裂孔上行进入胸腔。
在胸腔内,胸导管胸部通常位于右侧奇静脉与左侧主动脉之间,从膈的水平延伸至颈根部。它行于食管后方、脊柱前方,在第五胸椎(T5)水平从身体右侧跨越至左侧。
在胸廓上口处,胸导管颈部形成一个弓,终止于左静脉角,即左颈内静脉与左锁骨下静脉的汇合处。然而,其终止部位存在明显的解剖变异。最常见的终止部位为左静脉角,但也可终止于颈内静脉或锁骨下静脉。胸导管在多数情况下以单一管道终止,但也可在终止前分为多支。
胸导管的输入淋巴管如下:
參考資料
1.The Anatomy of the Thoracic Duct and Cisterna Chyli: A Meta-Analysis With Surgical Implications.Plutecki D, Bonczar M, Wilk J, et al.journal of Clinical Medicine. 2024;13(15):4285. doi:10.3390/jcm13154285.New Research
2.The Cisterna Chyli: A Systematic Review of Definition, Prevalence, and Anatomy.Moazzam S, O'Hagan LA, Clarke AR, et al.American Journal of Physiology. Heart and Circulatory Physiology. 2022;323(5):H1010-H1018. doi:10.1152/ajpheart.00375.2022.
3.Anatomical Study of the Thoracic Duct and Its Clinical Implications in Thoracic and Pediatric Surgery, a 70 Cases Cadaveric Study.Rabattu PY, Sole Cruz E, El Housseini N, et al.Surgical and Radiologic Anatomy : SRA. 2021;43(9):1481-1489. doi:10.1007/s00276-021-02764-z.
4.Review of Thoracic Duct Anatomical Variations and Clinical Implications.Phang K, Bowman M, Phillips A, Windsor J.Clinical Anatomy (New York, N.Y.). 2014;27(4):637-44. doi:10.1002/ca.22337.
5.Anatomical Variations in Distal Portion of the Thoracic Duct-a Systematic Review.Bellier A, Pardo Vargas JS, Cassiba J, et al.Clinical Anatomy (New York, N.Y.). 2020;33(1):99-107. doi:10.1002/ca.23476.
6.The Anatomy and Physiology of the Terminal Thoracic Duct and Ostial Valve in Health and Disease: Potential Implications for Intervention.Ratnayake CBB, Escott ABJ, Phillips ARJ, Windsor JA.Journal of Anatomy. 2018;233(1):1-14. doi:10.1111/joa.12811.