1. Thoracic
DucT
1
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2.  Introduction
 Formation
 Course
 Relations
 Tributaries
 Applied anatomy
Learning objectives
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3. Thoracic duct
- Is the largest lymphatic trunk which drains
chyle(product of fat digestion) & most lymph of
body.
- Extent- Upper abdomen at lower border of T12
to lower part of neck, crossing post & sup
mediastinum
- 45cms long & 0.5cms wide
- Appears Beaded due to presence of many valves
in its lumen 3

4. Drains lymph from whole of body except
• Rt side of head & neck
• Rt upper limb
• Rt lung & thoracic wall
• Rt side of heart and rt surface of liver
Area of drainage
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5. 5

6. Course of Thoracic Duct
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7. Course:
 Begins in abdomen at lower border of T12 as a continuation
of cisterna chyli
 Enters post mediastinum through aortic opening of
diaphragm(T12)
 At T5 shifts to left & runs in superior mediastinum
 At C7 (root of neck) arches laterally, then downwards
 Ends at angle formed by union of left int jugular vein
& lt subclavian vein, (regurge of blood prevented by
a pair of valves)
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8. 8

9. 9

10. Relations
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11. Scalenus ant
Termination
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12. Termination
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13. Azygos vein
TS at T4 V level
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14. Tributaries:
 Receives lymph from both halves below diaphragm
through Cisternae chyli & Lt half above diaphragm
1. From post IC lymph nodes of lower 6 spaces
2. From upper lumbar nodes(paraaortic LN)
3. From Post Mediastinal lymph nodes & post IC LNs of
upper 6 IC spaces
4. From axilla through Lt Subclavian trunk
5. From nodes in Lt ½ of H & N thru Lt Jugular trunk
6. From Lt half of thorax (Lt lung & Lt side of heart) through
Lt Bronchomediastinal trunk
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15. Applied anatomy
 Obstruction of Thoracic duct – Due to mature
filarial parasites lymph vessels get burst
chylothorax, chyloperitoneum, chyluria.
 Cervical part of thoracic duct is damaged in
block dissection of neck
 Thoracic duct is very thin walled and colourless
so more prone for injury during surgery in post
mediastinum. 15