THE LYMPHATICS OF THE ABDOMEN. 



975 



The hepatic nodes (lymphoglandulae hepaticae) are more or less clearly arranged 

 in two series. One series accompanies the main stem of the hepatic artery along the 

 upper border of the head of the pancreas and throughout the vertical portion of its 

 course in the free margin of the gastro-hepatic omentum, and the other accompanies 

 the superior pancreatico-duodenal branch and ascends along the bile-duct to the 

 portal fissure. The afferents of the nodes come from the liver, the head of the 

 pancreas, and the first and second portions of the duodenum, and their efferents pass 

 to the cceliac nodes. 



The pancreatico-splenic nodes (lymphoglandulae pancreaticolienales) accom- 

 pany the splenic artery throughout the greater portion of its course, and are 

 consequently situated along and partly behind the upper border of the pancreas 

 (Fig. SiS). They vary in number from four to ten, and their afferents come from 

 the organs supplied by the splenic artery, — namely, the stomach, pancreas, and 

 spleen, — while their efferents pass to the cceliac nodes. 



The mesenteric nodes (lymphoglandulae mesentericae) are from one hundred to 

 two hundred in number, and are arranged along the superior mesenteric artery and 

 its branches to the small intestine. They form three more or less distinct series, 

 especially towards the upper portion of the mesentery. One series, in which the 



Fig. 8i8. 



Hepatic node 



Retropyloric node 



Mesocolic nodes 



Pancrealico-splenic nodes 



Transverse mesocolon 



Transverse colon 



Paiicre.ilico-splenic, retropyloric, and mesocolic nodes, new-born child ; liver drawn upward, stomach and 



duodenum laterally. (Cmieo and Delamare.*) 



nodes are more numerous and smaller than the others, lies close to the intestine, 

 among the terminal branches of the artery ; a second consists of larger scattered 

 nodes situated along the primary branches of the artery ; while the third series 

 includes the closely aggregated nodes which surround its main stem. Towards the 

 lower portion of the ileum the distinction of the first and second series becomes 

 less and less apparent, and at the junction of the ileum and caecum the nodes form a 

 single group, situated a short distance from the intestine between the two layers of 

 the mesentery. These nodes are sometimes termed the ileo-csecal nodes, and 

 associated with them by means of its efferents is a variable group of small nodes, 

 the appendicular nodes, situated partly in the base of the mesenteriole of the 

 appendix and partly in the immediate vicinity of the junction of the ileum and 

 caecum (Fig. 820). 



The various series of nodes are connected with one another by vessels, which in 

 this region are known as lacteals, and the nodes of the first series receive their 

 afferents from the walls of the small intestine, and, in the case of the ileo-caecal nodes, 

 from the caecum and vermiform appendix. The efferents of the nodes of the third 

 series pass to those nodes of the cceliac group which are situated around the origin 

 of the superior mesenteric artery. 



* Jour, de I'anat. et de la physiol., Tome .xxxvi., 1900. 



