Answer to Take Me Home, Country Roads
Correct answer is C, the pylorus. As described in Grant’s Atlas, lymphatic drainage follows the arterial supply, but in a retrograde fashion. Hence, structures of the foregut will ultimately drain to the celiac nodes, and structures from the midgut will drain to the superior mesenteric nodes. This was the basic concept taught years ago. As imaging technology improved, it is now clear that numerous intermediate nodes are present in the abdomen that will drain specific regions of the viscera prior to delivering their content to the main nodes located at the celiac, superior and inferior mesenteric nodes. In the structures labeled in the image, the following intermediate nodes are the initial sites for lymphatic drainage: small intestines to mesenteric; inferior part of duodenum to pancreaticoduodenal; spleen to pancreaticosplenic; tail of pancreas to pancreaticospelnic. This level of detail, however, is best left for the abdominal surgeons.
= Small intestines
= Duodenum, inferior part
= Pylorus
= Spleen
= Tail of pancreas
Answer to this question is based on material presented in lectures 9 of the Abdomen Lecture Series.
