874 THE VASCULAR SYSTEM. 
elands, and it will be sufficient to say that, speaking generally, they accompany the 
hlood-vessels of the viscera and of the deep portions of the parietes. 
THE LYMPHATIC GLANDS AND LYMPHATIC VESSELS OF THE THORAX. 
Most of the superficial lymphatic vessels of the thoracic wall are tributaries 
of the axillary glands, and they have already been described; the rest will be 
included with the afferents of the deep thoracic glands. 
Deep Lymphatics of the Thorax.—The glands are arranged in two sets, (1) 
parietal and (2) visceral. 
1. Parietal glands include the following :— 
The intercostal glands (lymphoglandule intercostales) which lie in the posterior 
parts of the intercostal spaces near the heads of the ribs, or a little farther 
out, between the intercostal muscles. They receive the lymphatic vessels from 
the deep parts of the posterior portions of the thoracic walls, including the 
parietal pleura, and their efferent vessels are divided into ascending and descend- 
ine trunks. The efferent vessels from the intercostal glands of the upper five 
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or six spaces open either separately, or, after uniting into a common trunk 
on each side, into the right lymphatic duct on the right side, and into the 
upper part of the thoracic duct on the left side. The efferent vessels from the 
intercostal glands of the lower four or five spaces unite to form a common trunk 
on each side, which descends through the aortic opening of the diaphragm and 
terminates in the receptaculum chyl. Some of them also communicate with the 
thoracic duct. 
The internal mammary or sternal glands (lymphoglandule sternales), which he 
along the side of the internal mammary artery, one or two, as a rule, being placed 
opposite the anterior end of each intercostal space. Their afferents are derived from 
the deeper parts of the anterior portion of the thoracic wall, from the deep part of the 
front of the abdominal wall, by vessels which ascend along the superior epigastric 
artery, from the inner portion of the mammary gland, and from the anterior part 
of the diaphragm. The majority of their efferents pass to the anterior mediastinal 
glands, but some of the efferents from the upper sternal glands ascend to the root 
of the neck, where they join the efferents of the lower deep cervical glands. 
The diaphragmatic glands lie upon the upper surface of the diaphragm. They 
are very irregular both in number and size. Their afferent vessels are received 
from the diaphragm and the upper surface of the liver, and they give off efferents, 
some of which pass upwards to the anterior mediastinal glands, and others which 
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descend to the pancreatic glands through the aortic orifice of the diaphragm. 
2. Visceral Thoracic Glands.—Of these there are :— 
The anterior mediastinal glands (lymphoglandule mediastinales anteriores) are 
embedded in the loose tissue of the anterior mediastinal region. They receive 
afferents from the middle part of the upper portion of the liver which ascend 
through the falciform ligament, from the anterior part of the diaphragm, and from 
the lower sternal glands. Their efferents pass upwards to the superior mediastinum, 
where some of them enter the superior mediastinal glands, whilst others, continuing 
upwards, terminate on the right side in the right lymphatic duct, and on the left 
side in the thoracic duct. 
The superior mediastinal glands (lymphoglandulz mediastinales superiores) are 
grouped round the innominate veins, along the upper part of the aortic arch, and 
in front of the thoracic portion of the trachea. They receive afferents from the 
heart, the pericardium, the thymus, and the anterior mediastinal glands. Their 
efferents terminate at the root of the neck in the right lymphatic, and thoracic 
ducts. 
The posterior mediastinal glands (lymphoglandule mediastinales posteriores) le 
along the aorta and the cesophagus in the posterior mediastinum. They receive 
afferents from the posterior part of the pericardium, the posterior part of the 
diaphragm, the cesophagus, and from the upper and posterior portion of the liver, 
the latter vessels accompany the inferior vena cava, and they include the super- 
ficial lymphatic vessels of the posterior surface of the liver and the deep lymphatic 
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