Anatomy of the Vessels and Nerves of the Trunk (Angioneurology) - Chornokulskyi S. T. 2011

Lymphatic vessels and lymph nodes of the trunk
Thoracic duct

The thoracic duct (ductus thoracicus), Fig. 40, 41, is a vessel 30-40 cm long and up to 6 mm in diameter, comprising abdominal, thoracic, and cervical parts. It originates in the retroperitoneal space (tissue) at the level of the ThXII-LII vertebrae by the merger of the right and left lumbar trunks, as well as the intestinal trunk (in 25% of cases). As mentioned above, this confluence forms its dilated segment known as the cisterna chyli. From here, the thoracic duct passes through the aortic hiatus of the Diaphragm into the thoracic cavity, ascending between the Thoracic Aorta and the azygos vein up to the level of the VI–VII thoracic vertebrae.

Afterward, it arches to the left and anteriorly, forming the arch of the thoracic duct (arcus ductus thoracici) at the level of the V–VII cervical vertebrae. The arch curves over the cupula of the Pleura and empties into the left venous angle, returning approximately 75% of the total Lymph volume. The orifice of the thoracic duct contains paired Valves that prevent venous Blood from flowing backward into it. The active factors promoting the centripetal flow of lymph within the thoracic duct include:    

- the muscular crus of the diaphragm and its movements during pulmonary excursion (the "lymphatic Heart");

- the pulsation of the thoracic aorta;

- the negative pressure in the thoracic cavity at the height of inspiration;

- the suction effect of the right atrium.

The presence of 7–9 valves (a passive factor) in the thoracic duct prevents the retrograde flow of lymph despite the Influence of the aforementioned active factors.

Class="center">

Fig. 44. Superficial Lymphatic vessels of the anterior trunk and their regional Lymph Nodes:

1 - superficial inguinal lymph nodes (nodi lymphoidei inguinales superficiales);

2 - axillary lymph nodes (nodi lymphoidei axillares);

3 - medial lymphatic Vessels of the upper limb;

4 - superficial lymphatic vessels (of the Skin) of the anterior and lateral walls of the thoracic cavity;

5 - superficial lymphatic vessels (of the skin) of the anterior abdominal wall;

6 - superficial lymphatic vessels of the lower limb



Last update: 11/08/2026

Editorial and Educational Adaptation: This material has been compiled based on the primary/original source text. The project team performed an editorial review, corrected technical inaccuracies, structured sections, and adapted the content for an educational format.

What was processed:

  • elimination of formatting defects (OCR errors, structural breaks, corrupted characters);
  • editorial organization of content;
  • standardization of terminology in accordance with academic sources;
  • verification of factual statements against the original source text.

All mentions of the author, publication year, and origin of the primary text have been preserved in accordance with the source.