974 



HUMAN ANATOMY. 



corresponding position with relation to the right psoas, lying posterior to the vena 

 cava inferior, but a varying number of nodes which may be referred to this group 

 also occur upon the anterior surface of that vessel. 



Since all the nodes are united by communicating vessels, they form a plexus and 

 will receive afferents from and give efferents to one another. In addition, the median 

 row receives afferents from the descending colon and the mesocoUc nodes, while the 

 lateral rows receive them from the muscles of the posterior abdominal walls, from 

 the iliac nodes, from the testes in the male and the ovaries, Fallopian tubes, and 

 uterus in the female, and from the kidneys and suprarenal capsules. The efferents 

 of the upper nodes of the median row pass upward to terminate in the lower coeliac 

 nodes, while those of the lateral rows either pass to the nodes of the median row, 

 or unite together to form on either side a common trunk, the truncus lumbalis, 

 which unites with its fellow to form the receptaculum chyli (page 943), or else 

 they perforate the crus of the diaphragm and open independently into the 

 thoracic duct. 



The visceral abdominal nodes are arranged in groups or chains which follow 

 in general the principal visceral branches of the aorta, those following the branches of 

 the coeliac axis and the superior mesenteric artery communicating by their efferents 



Fig. 817. 



Superior 



gastric nodes 



Spleen 



Sjilenic nodes 



Inferior 



gastric nodes 



Lymphatic nodes and vessels of stomach. {Pulya and Navratil.*) 



mainly with the coeliac nodes, while those accompanying the inferior mesenteric 

 branches communicate with the median lumbar nodes. 



Corresponding with the branches of the coeliac axis are the gastric, hepatic, and 

 pancreatico-splenic nodes. The gastric nodes consist of two chains (lynipho* 

 jilandulae gastricae superiores et inferiores) situated respectively along the lesser and 

 greater curvatures of the stomach. The superior nodes, three to fifteen in number, 

 are situated along the course of the gastric artery, principally along the lesser 

 curvature of the stomach between the two layers of the gastro-hepatic omentum 

 (Fig. 817), although a few also occur along the course of the artery before it 

 reaches the stomach and others upon the left side of the cardiac orifice of the 

 viscus. The inferior nodes are situated in the vicinity of the pyloric end of the 

 stomach, pardy , along the right half of the greater curvature, accompanying 

 the right gastro-epiploic vessels, and partly on the posterior surface of the pylorus 

 along the course of the gastro-duodenal vessels. The gastric nodes receive affereyits 

 from the stomach and in the case of the retro-pyloric nodes also from the first 

 portion of the duodenum, and their effcrc7its pass to the coeliac nodes, those of 

 the superior group following the course of the gastric vessels, while those from the 

 inferior group accompany the gastro-duodenal and hepatic arteries. 



* Deutsche Zeitsclirift f. Chirurgie, Bd. l.xix. 



