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A chylothorax is an abnormal accumulation of chyle, a type of lipid-rich lymph, in the pleural space surrounding the lung.The lymphatic vessels of the digestive system normally return lipids absorbed from the small bowel via the thoracic duct, which ascends behind the esophagus to drain into the left brachiocephalic vein.
Chyle (from Greek χυλός (chylos) 'juice' [1]) is a milky bodily fluid consisting of lymph and emulsified fats, or free fatty acids (FFAs). It is formed in the small intestine during digestion of fatty foods, and taken up by lymph vessels specifically known as lacteals. The lipids in the chyle are colloidally suspended in chylomicrons.
A bifid inferior portion of the thoracic duct (due to a failure of fusion during embryonic development) is not uncommonly observed; a plexus of lymphatic vessels replacing the thoracic duct inferiorly and only coalescing into a single duct in the mediastinum may also occur. Rarely, the thoracic duct may be entirely bilaterally paired. [3 ...
In humans, the cisterna chyli is located posterior to the abdominal aorta on the anterior aspect of the bodies of the first and second lumbar vertebrae (L1 and L2). There it forms the beginning of the primary lymph vessel, the thoracic duct, which transports lymph and chyle from the abdomen via the aortic opening of the diaphragm up to the junction of left subclavian vein and internal jugular ...
Modes of origin of thoracic duct. a. Thoracic duct. a’. Cisterna chyli. b, c’ Efferent trunks from lateral aortic glands. d. An efferent vessel which pierces the left crus of the diaphragm. e. f. Lateral aortic glands. h. Retroaortic glands. i. Intestinal trunk. j. Descending branch from intercostal lymphatics.
[6] Chylothorax results as a rare complication in which chyle leaks into the thoracic space following direct incidental damage and can also lead to increased thoracic duct pressure. [6] Chylothorax leakage commonly occurs in patients with additional complex congenital heart lesions, increasing the risk of underlying vascular anomalies.
Human lymph, obtained after a thoracic duct injury. Lymph has a composition similar but not identical to that of blood plasma. Lymph that leaves a lymph node is richer in lymphocytes than blood plasma is. The lymph formed in the human digestive system called chyle is rich in triglycerides (fat), and looks milky white because of its lipid content.
The right lymphatic duct drains the right side of the region and the much larger left lymphatic duct, known as the thoracic duct, drains the left side of the body. The ducts empty into the subclavian veins to return to the blood circulation. Lymph is moved through the system by muscle contractions. [9]