Superior Mesenteric Lymph Nodes

Again with lymph nodes, think about organs are receiving blood from the artery that the lymph nodes are surrounding. So, in this case, what does the superior mesenteric artery supply?      (see drawing for answer)

So the superior mesenteric (SM) lymph nodes have 2 sets. The first set sits right around the pancreas. They’re called the cetnral superior group. Makes sense, right? They’re the closest to the SM artery. The second group is the juxtaintestinal group. Juxta- means combining, so combining with the intestines. This group is in the mesentery all up in the small intestines.

They also have colic lymph nodes drain into them. The thing to remember is what organs these are near. This will help you remember what the name most likely is.

Colic = colon, i.e., ascending and 2/3 of the transverse colon specifically.

There are (PP RAMI. These are right side specific for the most part. See Netter’s plate 296. Might help with following the logic):

paracolic nodes: para = next to, therefore next to colon. They make a ring on the inside of the colon.

prececal nodes: They look like paracolic nodes, but they’re right next to the cecum.

right colic nodes: They are right because they are right of the descending aorta. Following the branches of the superior mesenteric a.

appendicular nodes: The line of nodes that come from the appendix.

middle colic nodes: Because they’re more or less medial within in the mesocolon superior to where the superior mesenteric a. enters the mesentery.

ileocolic nodes: These are a set of diagonal nodes heading down toward the iliac crest from the superior mesenteric a., more of less.

PP  are right next to the colon, while RAMI is in the mesocolon.

If it doesn’t make sense why SM artery/lymph nodes take care of only 2/3 of the transverse colon, take a look at Netter’s plate 288. It’s because there is an anastomosis with the inferior mesenteric artery (IMA) in the mesocolon. This plate shows the branches of the SMA and IMA pretty well.

Netter Plates: 284, 286, 287, 288, 290, 291, 293-296

Published by goldilocksthedoc

I am an internal medicine physician living in a van with my husband and our furbaby, Rosco. He works remotely and we are starting a new chapter in the Navajo Nation in New Mexico where I will be working as a night doctor.

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