97 



-;'■> 



HUMAN ANATOMY. 



the bronchial nodes are especially enlarged in influenza and that some of the anomalous 

 pulmonary symptoms of that disease — simulating congestion, pneumonia, etc. , are 

 thus accounted for. Marked enlargement of the bronchial nodes may be indicated 

 by an area of percussion dulness below the level of the fourth dorsal \ertebra (Yeo). 



In cancer of the oesophagus either the mediastinal nodes or those at the root of 

 the neck may be involved, as both sets receive lymphatics from that tube. Medias- 

 tinal growth (sarcoma) or abscess may originate in these nodes. Either condition 

 — but especially the neoplasm — will occasion marked symptoms of pressure on 

 the trachea, bronchi, oesophagus, and superior cava and innominate veins, — e.g., 

 dvspnoea, dysphagia, oedema of the face, neck, and upper limbs, dilatation of the 

 superficial veins of the abdomen and thorax. 



THE LYMPHATICS OF THE ABDOMEN. 

 The Lymph-Nodes. 



The principal nodes of the abdominal region are those associated with the 

 viscera and those situated upon the posterior wall in the vicinity of the aorta. 

 A few small and inconstant nodes also occur upon the anterior wall, and of these the 

 most important are the epigastric, the circumflex iliac, and the umbilical nodes. 



The epigastric nodes (lymphoglandulae epigastiicae) are three or four in 

 number and are interposed in the course of the lymphatic stems which accompany 



Fig. S15. 



Umbilical node 



Deep epigastric 



artery -4-^ 



Epigastric node 



Iliac node 



-Umbilical node 



Lymphatic vessels 

 accoiDpanying deep 



epigastric artery 



Iliac node 



Epigastric and umbilical lymph-nodes, seen from behind. (Cutieo and Marcille.*) 



the deep epigastric vessels (Fig. 815) ; they occur toward the lower part of the 

 vessels and their cffcrcnts pass to the lower iliac nodes. 



The circumflex iliac nodes are from two to four in number when present, 

 but are not unfrequently wanting. They are situated along the course of the deep 

 circumflex iliac vessels ; they receive afferents from the lower lateral portions of the 

 abdominal wall, and send effei-ents to the lower iliac nodes. 



The umbilical nodes are situated in the subserous areolar tissue in the 

 neighborhood of the umbilicus. They are three in number, one being situated a 

 little below and to one side of the umbilicus, and the other two above the umbilicus 



* Bull, et M^m. Soci^t^ anatom., 1901. 



