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USMLE - Chapter 2 - Immunology

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  1. Primary Lymphoid Organs to Lymph Node Structural Diagram
    7Topics
  2. Introduction to Lymphatic Drainage to Lymph Node Palpability and Right Lymphatic Duct
    6Topics
  3. Spleen Structure Overview to Thymus-Related Conditions
    6Topics
  4. Components and Mechanism of Immunity to Understanding Immune Privilege
    4Topics
  5. MHC I and II: Introduction and Loci to DQ8, DR3, DR4
    9Topics
  6. Functions of Natural Killer Cells to Major Functions of T Cells
    3Topics
  7. T Cell Development: Bone Marrow & Thymus to Regulatory T Cells and Autoimmunity
    6Topics
  8. T-cell Activation: Antigen Presentation to B-cell Activation: Co-stimulation, Class Switching, and Maturation
    4Topics
  9. Antibody Structure and Function to Antibody Diversity and Specificity
    4Topics
  10. Introduction to Immunoglobulin Isotypes to Thymus-Dependent Antigens
    7Topics
  11. Introduction to Complement System to Convergence and MAC Formation
    9Topics
  12. Early Complement Deficiencies to PNH: Hemolysis & Thrombosis
    4Topics
  13. Interleukin-1: Macrophage Secretion and Acute Response to IL-10 and IL-13: Immune Regulation and IgE Production
    7Topics
  14. Respiratory Burst Introduction to Interferons Clinical Use & Side Effects
    5Topics
  15. T Cell Surface Proteins to Examples of Passive and Active Immunity
    4Topics
  16. Live Attenuated Vaccines: Description to mRNA Vaccine
    8Topics
  17. Overview of Hypersensitivity Types to Type II: Cellular Dysfunction & Clinical Examples
    6Topics
  18. Type III Hypersensitivity: Mechanism & Examples to Type IV Hypersensitivity: Examples & Tests
    5Topics
  19. Allergic and Anaphylactic Transfusion Reactions to Delayed Hemolytic Transfusion Reaction
    5Topics
  20. Autoantibodies in Neuromuscular and Systemic Diseases to Autoantibodies in Metabolic, Hematologic, and Renal Disorders
    5Topics
  21. Bruton's Agammaglobulinemia to Chronic Mucocutaneous Candidiasis
    7Topics
  22. Severe Combined Immunodeficiency (SCID) to Chronic Granulomatous Disease
    7Topics
  23. Intro to Immunodeficiency & T-Cell Bacterial Infections to Parasitic Infections & Key Deficiency Note
    5Topics
  24. Hyperacute Transplant Rejection to Histology of Transplant Rejection
    5Topics
  25. Immunosuppressants: Definition and Risks to Sirolimus & Basiliximab: Clinical Aspects
    5Topics
  26. Azathioprine to Immunotherapy: Interleukin-2 and Interferons
    6Topics
  27. TNF-α Inhibitors: Adalimumab & Infliximab to Omalizumab & Palivizumab: Allergic & Viral
    7Topics
Lesson 2 of27
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Introduction to Lymphatic Drainage to Lymph Node Palpability and Right Lymphatic Duct

Content August 26, 2025

Lymphatic drainage associations

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This page provides a detailed overview of lymphatic drainage, illustrating key lymph node clusters, the areas of the body they drain, and associated pathologies. The diagram on the left visually maps these nodes, while the table on the right offers specific details.


Upper Body Lymph Nodes

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Submandibular, Submental Nodes

Drain: Oral cavity, anterior tongue, lower lip.

Pathology: Malignancy and metastasis to the oral cavity.

Deep Cervical Nodes

Drain: Head, neck, oropharynx.

Pathology: Upper respiratory tract infection, infectious mononucleosis, Kawasaki disease, malignancy of head, neck, oropharynx.

Supraclavicular Nodes

Drain: Right hemithorax; Left (Virchow node) left hemithorax, abdomen, pelvis.

Pathology: Malignancies of thorax, abdomen, pelvis.


Thoracic and Axillary Lymph Nodes

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Mediastinal Nodes

Drain: Trachea, esophagus.

Pathology: Pulmonary TB (unilateral hilar), Sarcoidosis (bilateral hilar), Lung cancer, Granulomatous disease.

Hilar Nodes

Drain: Lungs.

Pathology: Lung cancer, Granulomatous disease.

Axillary Nodes

Drain: Upper limb, breast, skin above umbilicus.

Pathology: Mastitis, Metastasis (especially breast cancer).


Abdominal and Upper Limb Lymph Nodes

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Epitrochlear Nodes

Drain: Hand, forearm.

Pathology: Secondary syphilis.

Celiac Nodes

Drain: Liver, stomach, spleen, pancreas, upper duodenum.

Superior Mesenteric Nodes

Drain: Lower duodenum, jejunum, ileum, colon to splenic flexure.

Pathology: Mesenteric lymphadenitis, Inflammatory bowel disease, Celiac disease.

Inferior Mesenteric Nodes

Drain: Colon from splenic flexure to upper rectum.

Periumbilical (Sister Mary Joseph node)

Drain: Abdomen, pelvis.

Pathology: Gastric cancer.


Pelvic and Lower Limb Lymph Nodes

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Para-aortic Nodes

Drain: Pair of testes, ovaries, kidneys, fallopian tubes (uterus).

Pathology: Metastasis.

External Iliac Nodes

Drain: Cervix, vagina (upper third), superior bladder, body of uterus.

Internal Iliac Nodes

Drain: Lower rectum to anal canal (above pectinate line), bladder, vagina (middle third), cervix, prostate.

Pathology: Sexually transmitted infections, Medial foot/leg cellulitis (superficial inguinal).

Superficial Inguinal Nodes

Drain: Anal canal (below pectinate line), skin below umbilicus (except popliteal area), scrotum, vulva, vagina (lower third).

Popliteal (“pop-lateral”) Nodes

Drain: Dorsolateral foot, posterior calf.

Pathology: Lateral foot/leg cellulitis.


Legend and Lymphatic Duct Note

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The diagram uses two symbols:

  • ● Palpable lymph node
  • ● Nonpalpable lymph node

Important note: The right lymphatic duct drains the right side of the body above the diaphragm into the junction of the right subclavian and internal jugular vein.

Topics Covered:

  • Introduction to Lymphatic Drainage
  • Head, Neck, and Shoulder Lymphatics
  • Chest and Armpit Lymphatics
  • Abdominal and Forearm Lymphatics
  • Pelvic and Lower Limb Lymphatics
  • Lymph Node Palpability and Right Lymphatic Duct