Left venous angle

Venous return · IJV + subclavian

The junction of the left internal jugular and left subclavian veins is where the thoracic duct empties and lymph rejoins the blood; low venous pressure and a terminal bicuspid valve keep blood from refluxing into the duct.

Traced from the start

  1. Testis and ovary
  2. Lower limb, scrotum and perineal skin
  3. Para-aortic (lumbar) nodesSuperficial and deep inguinal nodes
  4. Gut and abdominal viscera
  5. Preaortic nodes (coeliac, superior and inferior mesenteric)
  6. Head and neck
  7. Deep cervical nodesLeft supraclavicular (Virchow's) node
  8. Upper limbBreast
  9. Axillary nodes
  10. Lungs and thoracic viscera
  11. Tracheobronchial and mediastinal nodesParasternal (internal mammary) nodes
  12. Right and left lumbar trunksIntestinal trunkJugular lymph trunksSubclavian lymph trunksBronchomediastinal trunks
  13. Thoracic duct
  14. Left venous angle

Detail

Formed by
Left internal jugular and left subclavian veins, forming the left brachiocephalic vein
Receives
Thoracic duct, carrying three-quarters of body lymph
Returned daily
2-4 L of fluid with the escaped plasma protein
Also delivers
Chylomicrons and recirculating lymphocytes into the systemic circulation

When it goes wrong

Raised central venous pressure in right heart failure or tricuspid regurgitation

Impaired lymph drainage that compounds peripheral oedema and ascites

Central venous thrombosis at the angle

Obstructed lymph return with chylous ascites or effusion

Practise this structure

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