常见的纵隔淋巴结最全图示.ppt

* 胸内淋巴结的分组 介绍一下胸内淋巴结的分组第1组淋巴结群：在上纵隔胸腔内上1/3气管的周围，其双侧以锁骨下动脉的上缘作水平线以上，中间与左无名静脉上缘以上为界。第2组淋巴结群：气管旁淋巴结，位于第一组淋巴结与第四组淋巴结之间的气管旁两侧。第3组淋巴结群: 分为气管前和气管后淋巴结两组。在气管后面的淋巴结又称为3p组，气管与上腔静脉与无名静脉之间的淋巴结为3a组。第4组淋巴结群：位于气管与左右主气管分杈后周围的淋巴结，右侧通常在奇静脉下方，而左侧的常在纵隔内主动脉之下。第5组淋巴结群：位于主动脉之下的主肺动脉韧带的周围。第6组淋巴结群：位于升主动脉，主动脉弓的前面和两侧，迷走神经前面。第7组淋巴结群：位于气管与左右主气管分杈下的淋巴结。第8组淋巴结群：位于气管与左右主气管分杈下，食管周围的淋巴结。第9组淋巴结群：紧贴下肺静脉之下缘，下肺韧带之内的淋巴结。第10组淋巴结群：从双侧主支气管开口第一个软骨环开始至其刚开始分杈为上下肺叶支气管的最后一个软骨环外的淋巴结。第11组淋巴结群：位于肺内各肺叶支气管之间的淋巴结，在右侧，上肺叶与中肺叶支气管之间为11s群；中肺叶与下肺叶支气管之间为11i群。第12组淋巴结群：位于肺叶支气管周围的淋巴结。第13组淋巴结群：位于肺段支气管周围的淋巴结。第14组淋巴结群：位于亚段支气管起远端周围的淋巴结。 * Highest MediastinalNodes located above a horizontal line running along the upper rim of the left brachiocephalic vein, where it crosses in front of the trachea. On the left a station 1 node. The brachiocephalic vein is still to the left of the midline. Therefore this node is above the line where the left brachiocephalic crosses in front of the trachea. * 3. Prevascular and Prevertabral nodesStation 3 nodes are not adjacent to the trachea like station 2 nodes. They are either anterior to the vessels (3A) or behind the esophagus, which lies prevertebrally (3P). Station 3 nodes are not accessible with mediastinoscopy, however 3P nodes are accessible with endoscopic ultrasound (EUS). On the left a 3A node in the prevascular space.Notice also lower paratracheal nodes on the right, i.e. 4R nodes. * 4. Lower ParatrachealThe lower paratracheal nodes lie below a horizontal line drawn tangentially to the upper margin of the aortic arch. 4R nodes are lower paratracheal nodes that are located to the right of the midline of the trachea.They extend down to a horizontal line that runs across the right main bronchus at the upper margin of the upper lobe bronchus. On the left we see 4R paratracheal nodes.In addition there is an aortic node lateral to the aortic arch, i.e. station 6 node. * 4L nodes are lower paratracheal nodes that are located to the left of the tracheal midline, between