THE LYMPHATICS OF THE THORAX. 



967 



eight 



the nodes of the upper spaces are directed more or less medially to open into the 

 thoracic duct. 



The visceral nodes of the thorax may be arranged in three main groups, one 

 consisting of the nodes situated in the anterior mediastinum, a second of those 

 situated in the posterior mediastinum, and a third of those which occur in the 

 neighborhood of the bifurcation of the trachea and along the bronchi. 



The anterior mediastinal nodes (lymphoglandulae mediastinales anteriores) 

 are arranged in two groups, one of which occurs in the lower and the other in the 

 upper part of the mediastinum. The nodes of the lower group, termed the diaphrag- 

 matic nodes, are from three to four in number, and are situated upon the anterior 

 part of the upper surface of the diaphragm, immediately behind the xiphoid process  

 of the sternum ; their afferents come from the diaphragm and from the upper surface . 

 of the liver, and their efferents pass to the lower deep cervical nodes, following the 

 course of the internal mammary vessels. 



The upper group, that of the cardiac nodes, is composed of from eight to ten nodes 

 situated upon the anterior surfaces of the arch of the aorta and the left innominate vein. 

 They receive afferents from the anterior surface of the pericardium and thymus gland 

 and from the sternal and bronchial nodes. Their efferents pass upward and unite with 

 those from the bronchial nodes to form the broncho-mediastinal trunk (page 968). 



The posterior mediastinal nodes (lymphoglandulae mediastinales posteriores), . 

 to twelve in number, are situated along the thoracic aorta in the posterior 

 mediastinum. Their afferents come from the oesophagus, the posterior surface of 

 the pericardium, and the upper surface of the liver, while their efferents open mainly 

 into the thoracic duct, a few passing to the bronchial nodes. 



Two or three small nodes which may be regarded as belonging to this group 

 occur upon the convex surface of the diaphragm in the neighborhood of the opening 

 for the inferior vena cava. They receive afferents from the diaphragmatic net- work 

 and also from the superficial net-work of the upper surface of the liver. 



The bronchial nodes (lymphoglandulae bronchiales) on account of their number 

 and size are the most im- 

 portant of the thoracic 

 nodes, and for the con- 

 venience of description 

 they may be regarded as 

 forming three subgroups 

 (Fig. 813). One of these 

 is formed by the tracheal 

 nodes ( lymphoglandulae 

 tracheales), seven to ten 

 in number and situated 

 on either side of the 

 lower part of the trachea. 

 Those upon the right 

 side are as a rule more 

 numerous and larger than 

 those on the left side, 

 varying from the size of 

 a pea to that of a bean 

 in the normal condition. 

 A second subgroup is 

 that of the bronchial nodes 

 proper, from ten to twelve 

 in number and situated in 

 the angle formed by the 

 two bronchi. They are 

 for the most part large 

 those beneath the right 



Qisophagus 



Recurrent 

 laryngeal ner\'e 



Left vagus ner\e 



Left bronchus 



Pulmonary nodes 



Trachea 



Tr.iLheal nodes 



Right vagus 



nerve 



Bronchial node 



Aorta 



Tracheal and bronchial lymph-nodes, viewed from behind. (Halle.*) 



bronchus being usually larger and more numerous than 



* Clinique medicale. Tome iv. 



