Lymphatic Drainage of the Upper Extremity

The lymphatic drainage of the deep tissues of the upper limb follows the main neurovascular bundles ending in the lateral axillary lymph nodes. Lymphatic vessels draining the deep tissues are internal to the deep fascia (Fig. 17.1). The lymphatic vessels of the arm drain through the lateral group of lymph nodes, the lateral drainage of the subareolar plexus (from the breast), and the pectoral group of lymph nodes drain to the apical group of lymph nodes (Fig. 17.2), which drain through the subclavian lymphatic trunk, joined by the jugular trunk into the subclavian vein or into the thoracic duct (in the left side) (Fig. 17.3).

Lymphatics of the Deep Tissues
Lymphatics of the Superficial Tissues

The superficial lymphatic drainage begins at the lymphatic plexuses in the skin and converges in the direction of the superficial veins, following approximately the same direction toward the terminal group of axillary lymph nodes (Fig. 17.1).

At the Hand

The groups of lymphatic plexus are finer on the palmar than on the dorsal surface. The digital vessels run along the border of the fingers and join larger vessels at the palm, passing toward the dorsal aspect of the hand. The main palmar vessels pass toward the wrist, where they join vessels along the ulnar border of the hand and laterally join the draining vessels of the thumb.

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