Lymphatic drainage of the upper limb

Lymphatic drainage of the upper limb is via a series of deep and superficial channels that ultimately drain into the axillary lymph nodes.

Gross anatomy

Lymph from the hand and forearm drain from lymphatic plexuses via superficial channels that accompany the basilic and cephalic veins to a series of nodes around the elbow:

• superficial and deep cubital lymph nodes
• epi/supratrochlear lymph node(s) 
  • one-to-five nodes lying medial to the brachial vein, just superior to the medial epicondyle of the humerus

There are also deep channels that accompany the arteries and drain via the occasional deep lymph node accompanying arteries in the forearm to the axillary nodes.

Lymph then drains up the arm, passing through a few deep brachial lymph nodes and deltopectoral lymph node(s) with the cephalic vein at the deltopectoral groove, before draining into:

• infraclavicular lymph nodes: predominantly lateral upper limb and lateral two digits
• axillary lymph nodes: predominantly medial upper limb and medial three digits