Introduction

1)Anatomical positions

Anatomical erect Supine Prone Lat. decubitus Lithotomy

(used to describe body
anatomy)
*Body standing erect. Body lies on Body lies on Body lies on its Body lies on its back,
*Eyes looking forwards. its back its face side (Rt. or Lt.) with flexion of hip &
*Upper limbs hanging by sides. knee & abduction of
*Palms facing forwards. hip joints.
*Thumbs directed lat.
2)Anatomical planes

Median (sagittal) Paramedian Coronal (frontal) Horizontal

Vertical plane passing in Parallel to Plane cutting body Transverse plane running
middle body, dividing it & nearby vertically, into anterior horizontally, cutting body
longitudinally into equal right median part towards front & into upper (superior) &
& left halves. plane. posterior part towards lower (inferior) parts.
back of body.
3)terms of position

Anterior (ventral): Infront (near to front). Posterior (dorsal) (retro): Behind (near to back).
Superior (upper)(cranial): Near upper end. Inferior (lower) (caudal): Near to lower end .
Median: In middle line or median plane. Medial: Near to median plane.
Lateral: Away from median plane.
Proximal: Near to root of limb Distal: Away from root of limb.
Superficial: Towards skin or surface body. Deep: Away from skin or surface body.
Internal (inner): Inside organ or body. External (outer): On surface organ or body.
Peri: Around
4)terms of Number

Uni / Mono One

Bi / Di Two
Tri Three
Quadri Four
Multi / Poly Many
Oligo Little
 Fascia
*Definition: Collection of connective tissue under skin, divided into superficial,
deep & internal fasciae.

Superficial fascia Deep fascia

Nature Loose connective tissue Inelastic membrane of compact & regular
immediately deep to skin allowing collagen fibers.
skin to move freely on underlying
structures.
Distribution Contains variable quantity of fat Well defined in limbs, very strong in palm & sole,
more in females. Fat is abundant absent in face and anterior abdominal wall
in breast, ant. abdominal wall &
gluteal region, less in limbs &
absent in eyelid, penis & scrotum.
Functions 1-Softens and smoothens 1-Formation of broad sheets:Surround
body surface. different groups of muscles, so fix underlying
2-Facitilates skin structures in position, give attachment to some
movement on underlying muscles & help venous return.
structures. 2-Formation of intermuscular septa &
3-Prevents heat loss interosseous membranes:Separate different
(thermal insulator). groups of muscles with different actions & nerve
4-Conducting medium for supply. Also increase surface area for muscle
nerves, blood vessels and attachment.
lymphatics supplying the skin. 3-Formation of retinacula:Thickened
5-Contains muscles;in face localized transverse bands at wrist & ankle to
(expression muscles). keep tendons in position.
6-Contains glands;mammary 4-Formation of palmar & planter
gland. aponeurosis:Thick strong layers to protect
vessels, nerves & tendons.
5-Formation of fibrous sheaths around
big vessels:Carotid sheath around carotid
arteries, internal jugular vein & vagus nerve (in
neck).

*Clinical importance: -Knowledge of deep fascia arrangement help to explain

infection path when spreading from primary site (infection can spread from
mouth floor to larynx).

-Fluid accumulation in superficial fascia leads to edema.

-Skin mobilization after its incision occurs at superficial fascia plane & skin
incision along skin crease heals with minimal scar.
 Skeletal system

a)Bones
*Definition : Hard type of connective tissue forming skeleton.

*Functions :

1-Give specific shape & provides central axis.

2-Protect vital organs; skull protects brain, thoracic cage protects heart
& lungs.

3-Surface area for muscle attachment & form joints (important part of
locomotor system).

4-Support & transmit body weight; vertebral column to bony pelvis,

lower limbs, feet & ground.

5-Form blood elements in bone marrow & store calcium.

*Classification:

A)According to position in body;

*Axial skeleton: Skull, mandible, hyoid, sternum, ribs & vertebral column.

*Appendicular (peripheral )skeleton: Bones of upper & lower limbs.

B)According to ossification process (process of bone formation);

*Intra-membranous ossification: Bones develop directly from

connective tissue membrane (mesenchyme). Examples: Skull cap &
clavicle. It occurs at one or more ossification sites.

*Intra-cartilaginous ossification: Connective tissue membrane

(mesenchyme) is changed into cartilage which dissolves & disappears to
be replaced by bones. Examples: Skull base, long bones, ribs & vertebrae.

C)According to shape;
 Bones Long bones Short bones Irregular Flat bones Pneumatic bones Sesamoid bones
bones
Site Upper & lower limbs. Carpal bones in Bones with Scapula, ribs & Skull bones around nose Patella; largest
hand & tarsal projecting skull cap (roof) (frontal & maxillary), sesamoid bone,
bones in foot. processes bones. containing air cavities embedded in
as vertebrae. (paranasal air sinuses). quadriceps femoris
tendon infront knee.
Structure 2 ends (epiphysis) & a shaft (diaphysis). Spongy (cancellous) Similar in 2 plates of Contains one air Small bone nodules
*Epiphysis; bone covered by structure to compact bone cavity (maxillary embedded in some
- Expanded upper & lower ends of long bone. compact bone. short bones. with middle layer sinus) or multiple muscle tendons.
-It has smooth articular surface covered by of spongy bone. small cells (mastoid
articular hyaline cartilage. N.B.: In skull air cells).
*Diaphysis; bones 2 layers of
-Compact bone tube, with central medullary compact are
cavity filled with bone marrow (soft called outer &
vascular tissue). inner tables while
-Separated from epiphysis by epiphyseal spongy layer is
plate of hyaline cartilage, responsible for called diploe.
bone growth in length.
-Surrounded by periosteum (fibrous sheath),
responsible for bone growth in width.
N.B. Metaphysis; Upper & lower parts of
diaphysis just below epiphyseal cartilage
(most active part of long bone).
Function Protection & Decrease skull weight, Diminish friction
muscle resonance of voice & between tendons&
attachment. warming of inspired bones.
air by vascular mucosa.
 Growth of long bones
Growth in width (Periosteum) Growth in length (Epiphyseal plate of cartilage)

*Def.: Fibrous sheath around shaft of long bone. *Def.: Plate of cartilage between epiphysis & diaphysis of long bone.
*Structure: -Outer layer: White fibrous tissue. *Structure: Hyaline cartilage.
-Inner layer: Contains osteoblasts & highly vascular. *Function: Bone growth in length by proliferation of its cells. When
*Function:-Bone growth in width by osteoblasts. bone becomes mature, it stops division & ossifies resulting in fusion
-Periosteal blood vessels supply outer 1/3 of shaft. between epiphysis & diaphysis under hormonal control & 2 years
earlier in females. It ossifies at one end 2-3 years earlier than the other
end which is called the growing end.
Arterial supply of long bones
Nutrient artery Metaphyseal arteries Epiphyseal arteries Periosteal arteries
*Enters shaft at its middle through oblique *Enter through minute *Many arteries *Arise from deep layer of
nutrient foramen & runs away from growing end. foramina to supply metaphysis. supplying epiphysis. periosteum & anastomose
*Reaches medullary cavity dividing into *Anastomose with nutrient A. *Anastomose with with other arteries.
ascending & descending branches directed & with epiphyseal arteries after metaphyseal arteries *Supply outer 1/3 shaft.
towards upper & lower metaphysis. ossification of epiphyseal cartilage. after ossification of
*Supplies inner 2/3 of bone thickness & bone marrow. epiphyseal cartilage.
 B)Cartilage
*Properties:

*Rubbery type of connective tissue (tough & resilient), resisting friction

& compression forces.

*It consists of mature cartilage cells (chondrocytes), fibers and matrix. It

has no blood vessels (nutrition is by diffusion from blood vessels of
perichondrium), nerves or lymphatics.

*Great growth capacity by multiplication of chondroblasts (immature

cartilage cells).

*Types:
Hyaline (glass like) White Yellow elastic
(most widespread in human body) fibrocartilage fibrocartilage
Cartilage Numerous small rounded cells. Few. Abundant.
cells
(Chondroctes)
Matrix Translucent. Opaque, rich in Yellow, rich in
collagen bundles. yellow elastic fibers.
Sites -Developing bones in fetus. -Intervertebral discs. -Tip of nose.
-Epiphyseal plates of long bones. -Auricle of ear.
-Articular cartilage in joints. -Epiglottis of larynx.
-Cartilages of larynx (except
epiglottis) & tracheal rings.
-Xiphoid process (sternum) &
costal cartilages.
Ossification In certain sites; epiphyseal Does not occur. Does not occur.
cartilages & larynx.
 Articular system (Joints)
*Definition: Contact of 2 or more bones.

*Classification:

1-Fibrous joints

Bones are connected by fibrous tissue, fixed (immobile) joints

Sutures Gomphosis Syndesmosis

-In skull. -In teeth. -In inf. tibio-fibular joint.
-Bones are connected by -Roots of teeth are connected to -Lower ends of tibia & fibula
fibrous tissue (sutural ligament). sockets in mandible & maxilla by are connected by fibrous
-Obliterated in old age. fibrous tissue (periodontal ligament). tissue (interosseous ligament).

2-Cartilagenous joints

Bones are connected by cartilaginous tissue

Primary Secondary
Example : Epiphyseal plate. Intervertebral discs.

Site: At ends of growing long Midline.

bones between epiphysis
& diaphysis.
Type: Hyaline. White fibrocartilage disc (articulating surfaces are
covered by thin hyaline cartilage).It is strengthened by
ligaments which do not fuse to form complete capsule.

Ossification: Temporary, disappears by Permanent.

ossification.

Mobility: Immobile. Limited mobility (facilitated by white fibrocartilage elasticity).

 3-Synovial joints

Freely mobile, present mostly in limbs

*Structure (characters) :

Fibrous capsule Articular cartilage Joint cavity SynoviaL Synovial fluid Ligaments Structures inside cavity
membrane of some synovial joints
*Joint is *Articular surfaces are Potential *Thin, moist & Pale yellow Capsular, -Articular fibrocartilagenous
surrounded by covered by hyaline cartilage, cavity, glistening, covers viscus similar extra & intra disc: Example;
strong fibrous which is smooth & lubricated containing all structures to egg albumin capsular Temporomandibular joint
capsule, which is by synovial fluid. thin film of inside joint except (containing ligaments, (divides joint cavity into
lined by synovial *It has no blood vessels or synovial articular surfaces synovial cells, support & upper & lower compartments).
membrane & nerves (nutrition is from fluid. It & lines capsule. macrophages & strengthen -Menisci: Example;
supported by synovial fluid). becomes *It secretes, absorbs lymphocytes). the joint. Knee joint (semilunar plates
strong ligaments. *In old age it shows manifest synovial fluid. *It lubricates, of fibrocartilage).
irregularities due to erosion if fluid, helps in nutrition & -Ligaments: Example;
(eroded areas donot repair). blood or pus reduces erosion of Cruciate ligaments in knee joint.
collect in it. articular cartilage. -Tendon: Example;
Tendon long head biceps in
shoulder joint.
*Factors affecting stability of synovial joints:
1-Shape & fitting of articulating surfaces 2-Thickness & elasticity of capsule.
3-Position & strength of ligaments 4-Strength of surrounding muscles.
*Factors affecting range of movements of synovial joints:
1-Tension of surrounding ligaments 2-Contraction of antagonistic muscles.

3-Approximation & contact of soft tissues around joint.

*Nerve supply of synovial joints:
Hiltons law: N. supply to a muscle acting on specific joint, gives branch to joint
& another branch to skin covering joint.
N.B.: Nerves supplying joint (articular nerves) end in fibrous capsule & related
ligaments. They are sensitive to pain, position & movement of joint.
*Movements of synovial joints:
-Flexion: Bending (approximation of 2 ventral aspects).

-Extension: Straightening (2 ventral aspects move away from each other).

-Abduction: Movement of limb away from midline (middle finger in hand,

second toe in foot).

-Adduction: Movement of limb towards midline (middle finger in hand,

second toe in foot).

-Circumduction: Combination of all above movements.

-Rotation: Medially or laterally around a vertical axis.

-Supination: Lateral rotation forearm -Pronation: Medial rotation forearm.

-Inversion: Sole directed inwards. -Eversion: Sole directed outwards.

-Opposition: Thumb comes in contact with other 4 fingers.

-Gliding: Non axial movement.

*Clinical importance: 1-Cavity is swollen due to fluid, pus or blood collection.
2-Articular surfaces are eroded & rough in osteoarthritis or overweight (painful).
3-Separation of articular surfaces is called dislocation.
 Muscular system
*Definition: Muscle tissue has property of contraction, which is capacity
of muscle fibers to become short.

*Classification: According to structure & function, 3 types;

Muscle Skeletal Smooth Cardiac

Site Attached to skeleton. In walls of blood In myocardium of heart.
vessels & viscera.
Contraction Voluntary Involuntary Involuntary
Nerve supply Somatic Autonomic Autonomic
Striations Present Absent Present but less than
skeletal muscle.
Muscle cell (fiber) Multinucleated, with Spindle shaped, Branch & fuse together, with
peripheral nuclei. with single nucleus. single nucleus.
*Skeletal muscles attachment:

-Each muscle has 2 attachments:

*Origin; most fixed attachment *Insertion; most mobile attachment.

-In limbs origin is usually proximal to insertion & during contraction

insertion moves towards origin producing movement in related joints.

-Sometimes insertion is fixed while origin is mobile. A muscle may have

more than one point of origin or insertion.

*Types of keletal muscles attachment:

-Attachment to bone; commonest, by flesh or by tendon.

-Attachment to skin; muscles of face, by its contraction can move skin.

-Attachment to fibrous raphe; mylohyoid muscles, fuse together in a

band or septum of fibrous tissue.

-Attachment to cartilage; muscles of larynx (cricothyroid).

*Form (shape) of skeletal muscles:

It depends on muscle fibers arrangement in relation to line of pull (line

extending between origin & insertion), fibers are parallel or oblique to it.
 Muscles with Muscles with oblique fibers Muscles having
parallel fibers more than
one fleshy belly or
head
Strap-like: Pennate (feather-like); oblique to Non pennate
Sartorius. tendons 2heads: Biceps.
Strape- like Unipennate: Fibers lie on one side Triangular:
with tendinous of tendon; flexor pollicis longus. Temporalis. 3 heads: Triceps.
intersections; Bipennate: Fibers lie on both sides Spiral: Supinator.
Rectus abdominis. of tendon; rectus femoris. Cruciate: 4 heads:
Quadrilateral: Multipennate: Series of bipennate Masseter. Quadriceps.
Thyrohyoid. lying beside each other; deltoid. Circular:
Fusiform: Circumpennate: Fibers converge Orbicularis oris. 2 bellies:
Lumbrical. from periphery towards a central Digastric.
tendon; tibialis ant.
*Action of skeletal muscles: A purposeful movement is done by action of
group of muscles acting together, 4 types of muscle actions;

1-Prime movement: It initiates & maintains a movement (brachialis is

prime mover of flexion while triceps is prime mover of extension of elbow.

2-Antagonist: It opposes action of prime mover (triceps can oppose

action of brachialis during elbow flexion).

3-Fixator (stabilizer): It fixes origin of prime mover or stabilize

joint acted upon (short muscles around shoulder stabilize it during prime
mover contraction).

4-Synergist: Sometimes prime mover muscle crosses many joints

before reaching insertion. Synergistic muscles contract to eliminate
unwanted movement at crossed joints, so action of prime mover at
desired joint become maximal.

*Clinical importance: Muscle atrophy occurs in;

*Immobilization after fracture. *Muscle disease. *Injury of muscle motor N.
*Spinal cord injury *Affection of higher centers (brain) as in hemiplegia.
 Nervous system
Classification: 1-Central nervous system (brain & spinal cord).

2-Peripheral nervous system (nerves; spinal & cranial, autonomic nervous

system; sympathetic & parasympathetic).

A)central nervous system

Brain Spinal cord

Site: Inside skull. Site: Inside vertebral column, 45 cm long & its end is tapering (conus medullaris).
Parts: *Cerebrum (2 cerebral Segments: 31 (8 cervical, 12 thoracic, 5 lumbar, 5 sacral & 1 coccygeal).
hemispheres): 4 lobes; (frontal, 2 enlargements; Cervical & lumbar, where N. plexuses arise.
parietal, occipital & temporal).
Structure:
*Cerebellum.
*Outer white matter; nerve fibers forming tracts.
*Brainstem;
*Inner gray matter; nerve cells. H-shaped;
Midbrain, pons & medulla oblongata.
*Diencephalon; -2ventral horns (motor nuclei).
Thalamus, hypothalamus, sub- -2 dorsal horns (sensory nuclei).
thalamus, metathalamus & epi- -2 lat. horns (contain sympathetic nuclei in thoracic & upper 2 lumbar segments
thalamus. while contain parasympathetic nuclei in 2nd, 3rd & 4th sacral segments).
*Central canal.

Meninges: -Coverings of C.N.S, arranged as pia, arachnoid & dura mater (from inside to outside).

b)Peripheral nervous system

Nerves Autonomic nervous

system
Spinal: Cranial: Sympathetic &
-From spinal cord. -From brain & leave skull parasympathetic
-31 pairs: through foramina. are concerned with
8 cervical, 12 thoracic, 5 lumbar, 5 sacral & 1 coccygeal. -12 pairs: involuntary activities.
-Arises by 2 roots; *Ant. (ventral): Contains motor fibers I-Olfactory II-Optic
*Post. (dorsal): Contains sensory fibers. III-Oculomotor IV-Trochlear
-Both roots unite forming mixed trunk which divides V-Trigeminal VI-Abducent
into mixed ant. & post. rami. VII-Facial VIII-Auditory
IX-Glossopharyngeal
X-Vagus XI-Accessory
XII-Hypoglossal.
 Cardiovascular system
A)Heart

*Site: Behind sternum & costal cartilages (from 2nd to 6th), 2/3 of heart
lies to Lt. & 1/3 of heart lies to Rt. of median plane.

*Chambers: Four (2 atria & 2 ventricles);

Rt. atrium Rt. ventricle Lt. atrium Lt. ventricle

Receives deoxygenated Pumps deoxygenated Receives oxygenated Pumps oxygenated
blood from all body blood through pulmonary blood from lungs blood to all parts
through 2 large veins valve to pulmonary trunk through 4 pulmonary of body through
(S.V.C & I.V.C), sends it which divides into 2 veins, sends it to Lt. aortic valve to aorta
to Rt. ventricle through branches (one for each ventricle through & its branches.
tricuspid valve. lung) to be oxygenated. mitral valve.
N.B.: *Rt. 1/2 contains deoxygenated (venous) blood, while Lt. 1/2 contains oxygenated (arterial) blood.
*Heart is covered by 2 pericardial sacs; fibrous & serous pericardium.
*Blood circulation: 3 types

Systemic Pulmonary Portal

-Begins in Lt. ventricle, where -Begins in Rt. ventricle, where -Venous blood collected from
oxygenated blood passes deoxygenated blood passes stomach, intestine, pancreas &
through aortic valve to aorta through pulmonary valve to spleen is collected by portal
& its branches to all body tissues pulmonary artery & its 2 vein, which enters porta hepatis
for exchange of gases & materials. branches to both lungs for of liver & divides into branches
-Deoxygenated blood is collected exchange of gases. ending in liver sinusoids.
by small then large veins & -Oxygenated blood returns -Blood leaves sinusoids by
finally by S.V.C & I.V.C into Rt. through 4 pulmonary veins to hepatic veins ending in I.V.C.
atrium, which sends it through Lt. atrium, which sends it through -It transmits venous blood from
tricuspid valve to Rt. ventricle mitral valve to Lt. ventricle GIT to liver, to metabolize
where this circulation ends. where this circulation ends & a undigested nutrients & to
new cycle starts. detoxify blood.
B)blood vessels

1-Arteries

*Def.: Blood vessel carrying oxygenated blood from heart to periphery,

except pulmonary & umbilical arteries which carry deoxygenated blood.
*Classification: According to size & structure into; large sized, medium
sized & small arteries.
 *Arterial anastmosis

-Def.; communication between arteries, mainly around joints.

-Function; *Increase blood supply to some organs as stomach.

*Equalize pressure in communicating arteries.

*Maintains blood flow to body area or part, if main artery is

obstructed by forming a collateral circulation.
-Types;

Type By end to end By terminal arterioles By convergence

Def. 2 ends of 2 arteries *Lie around joints, between 2 arteries converge
are connected branches of main A. above joint uniting together.
forming arch. & its branches below joint.
*In gradual obstruction of main
A., it will open to maintain blood
supply below obstruction.
Example In hand & foot, Anastomosis around elbow. Anastomosis
between gastric between the 2
arteries, between gut vertebral AA.
arteries, between ant.
& post. intercostal AA.
Clinical *Large AA. crossing over a joint are liable to be kinked during joint movement.
importance Distal blood flow is not interrupted because there is adequate anastomosis
between branches proximal & distal to joint.
*Sudden closure of main A. by faulty ligation, will lead to death of limb part
distal to closure because anastomosis is does not open in sudden closure.
*End arteries: Arteries which donot anastomose with adjacent arteries &
their obstruction lead to death (necrosis) of tissues supplied.
1-Central retinal A.: Supplies retina 2-Pulmonary AA.

3-Central branches of cerebral AA.

4-Renal A.: Supplies kidney 5-Splenic A.: Supplies spleen.

2-Veins
*Def.: Blood vessel carrying deoxygenated blood from periphery to heart,
except pulmonary & umbilical veins which carry oxygenated blood.
*Factors helping venous return:
1-From upper part body: Gravity.

2-From lower part body: A)lower limb:

*Venous valves *Arterial pulsations.
*Muscle contraction (pump) *Deep fascia around muscle groups.
*Negative intra-thoracic pressure draws blood from abdomen, head &
neck into thorax.
B)Abdomen, pelvis & thorax: Venous return by suction mechanism of
-ve intrathoracic pressure.
3-Arterio-venous connections
Arteries & veins are connected by:
1-Capillaries; narrow uniform diameter.

2-Sinusoids; wide irregular diameter with dilatations & constrictions.

3-Arterio-venous shunt; between small AA. & accompanying VV.

Arterio-venous shunt
*Sites: *External ear, nail bed & palmar aspects of digits.
*Tongue *Thyroid gland *Penis *Alimentary tract.
*Characters: Straight or coiled, surrounded by thick muscular coat &
supplied by sympathetic fibers controlling its opening & closure.
*Functions: 1-Regulation of body temperature & local heat ; on
opening blood pass from A. to V. decreasing local heat.
2-Regulation of food absorption 3-Play role in erection.
N.B.: Clinical importance; Varicose veins & stagnation
A varicosed vein is one with larger diameter than normal, elongated &
tortuous. I t may be due to hereditary weakness of veins walls,
incompetent valves & elevated intra-abdominal pressure (due to
multiple pregnancies or abdominal tumors). Blood escapes from deep to
superficial VV. leading to varicosity which is common in lower limbs.
Blood stagnation in varicose veins leads to thrombosis (as deep venous
thrombosis in calf muscles).
 Lymphatic system
-System responsible for lymph (clear colorless fluid rich in proteins) circulation from tissue spaces (intercellular spaces) to blood stream.

-It consists of *Lymph vessels *Lymphoid tissue (lymph nodes, spleen, tonsils & thymus) *B & T Lymphocytes (free cells).

Lymph vessels Lymph nodes Spleen

-Fine vessels in tissue spaces, unite together forming *Def.: oval or kidney small bodies. *Site: Haemo-lymphatic organ, in upper
larger lymph vessels which join lymph nodes. left part of abdominal cavity below
1-Afferent vessels: Carry lymph to lymph nodes (open in *Site: Along lymph vessels course, in groups at fixed sites; left dome of diaphragm, behind stomach
periphery at convex border). *In neck; on sides & at junction with head. & protected by 9th, 10th & 11th ribs.
2-Efferent vessels: Carry lymph away from lymph nodes *In chest; Close to trachea & bronchi & in chest wall.
(emerge from hilum). *In abdomen; around abdominal aorta & close to *Size: Not palpable, unless enlarged
-Characters: *End blindly in tissue spaces, containing abdominal organs. at least 3 times.
wide pores for fat & protein passage. *In pelvis; around blood vessels & close to pelvic organs.
*Have many valves allowing lymph flow in one direction. *In root of upper limb; axillary lymph nodes. *Functions: -In fetus plays role in
Absent in brain, spinal cord, bone marrow & avascular *In root of lower limb; inguinal lymph nodes. blood cell formation.
structures (cartilage, cornea & hair). -In adult it stores & concentrates
-All lymph vessels are collected in 2 large lymph ducts *Functions: blood cells to be used in hemorrhage.
in root of neck; *Filtration of lymph from bacteria & foreign bodies. -Destroys old expired red cells.
*Thoracic duct: Drains Lt. side head & neck, Lt. *Formation & production of lymphocytes. -Filters blood from any harmful
upper limb, Lt. side thorax & body below diaphragm. *Site of interaction between micro-organisms (antigens) substances (spleen filters blood
*Rt. lymphatic duct: Drains Rt. side head & neck, & lymphocytes & phagocytes, playing important role while lymph nodes filter lymph).
Rt. upper limb & Rt. side thorax. in defense mechanism.
-Both ducts open in 2 large veins at root of neck.
-Factors helping lymph flow & movement:
*Arterial pulsation *Muscular contraction *Negative
intra-thoracic pressure *Peristaltic intestinal movement.
Thymus gland: Lymphatic organ with endocrine function (secretes thymosine hormone). It is formed of 2 lobes & lies behind sternum (its size increases
until puberty then it decreases with age advance).

Clinical importance: -Extensive destruction of lymph vessels (in surgery) or obstruction (in filariasis) leads to edema of part drained.
-Lymph nodes may swell in inflammation, metastases or by primary tumor (lymph drainage of all body organs including skin should be known).
-In lymph node enlargement, area drained should be examined & in any lesion draining lymph nodes should be examined.