Anatomy
Abdomen
The pre-aortic lymph nodes receive lymph from all of the following structures EXCEPT for the:
Answer:
The kidneys drain to the lumbar (para-aortic) lymph nodes.Pre-aortic and Para-aortic Lymph Nodes
Anatomy / Abdomen / Posterior Abdominal Wall
Last Updated: 11th April 2019
Table: Lymphatic Drainage of the Abdomen and Pelvis
| Lymph Nodes | Structures |
|---|---|
| Coeliac | Abdominal oesophagus, stomach, pancreas, liver, gallbladder, spleen, duodenum proximal to major duodenal papilla |
| Superior mesenteric | Distal duodenum, jejunum, ileum, caecum, appendix, ascending colon, proximal two-thirds of transverse colon |
| Inferior mesenteric | Distal transverse colon, descending colon, sigmoid colon, proximal rectum |
| Lumbar (para-aortic) | Body wall, kidneys, adrenal glands, testes/ovaries, efferents of common iliac lymph nodes |
Pre-aortic Lymph Nodes
Lymphatic drainage of the abdominal part of the gastrointestinal tract, as low as the inferior part of the rectum, as well as the spleen, pancreas, gallbladder and liver is through vessels and nodes that eventually end in large collections of pre-aortic lymph nodes located at the origins of the three anterior branches of the abdominal aorta.
- The coeliac group of pre-aortic nodes receives lymph from structures of the foregut (abdominal oesophagus, stomach, pancreas, liver, gallbladder, spleen and duodenum proximal to the major duodenal papilla). The coeliac lymph nodes drain into the cisterna chyli of the thoracic duct.
- The superior mesenteric group receives lymph from structures of the midgut (distal duodenum, jejunum, ileum, caecum, appendix, ascending colon, and proximal two-thirds of transverse colon). The superior mesenteric nodes drain into the coeliac nodes.
- The inferior mesenteric group receives lymph from structures of the hindgut (distal one-third of transverse colon, descending colon, sigmoid colon, and proximal rectum). The inferior mesenteric nodes drain into the coeliac nodes.
Para-aortic Lymph Nodes
Lumbar nodes (para-aortic nodes) are positioned on either side of the abdominal aorta and receive lymphatics from:
- the body wall
- the kidneys
- the adrenal glands
- the efferents of the common iliac lymph nodes
- the testes or ovaries.
The para-aortic lymph nodes form the right and left lumbar trunks, and the pre-aortic lymph nodes form the intestinal trunk. These trunks come together to form the cisterna chyli, posterior to the right side of the abdominal aorta and anterior to the bodies of vertebrae L1 and L2, which marks the beginning of the thoracic duct.
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
