LYMPHATICS OP THE LOWER EXTREMITY. 391 



radial and ulnar vessels. In the upper arm there is a chain of small 

 glands, accompanying the brachial artery. 



The Axillary glands are numerous and of large size. Some are 

 closely adherent to the vessels, others are dispersed in the loose areolar 

 tissue of the axilla, and a small chain may be observed extending 

 along the lower border of the pectoralis major to the mammary gland. 

 Two or three subclavian glands are situated beneath the clavicle, and 

 serve as the medium of communication between the axillary and deep 

 cervical lymphatic glands. 



The Superficial lymphatic vessels of the upper extremity commence 

 upon the fingers and take their course along the fore-arm to the bend 

 of the elbow. The greater part reach their destination by passing 

 along the dorsal surface of the fingers, wrist, and fore-arm, and then 

 curving around the borders of the latter ; but some few are met with 

 in the palm of the hand, which take the direction of the median vein. 

 At the bend of the elbow the lymphatics arrange themselves into two 

 groups ; an internal and larger group, which communicates with a gland 

 situated just above the inner condyle, and then accompanies the basilic 

 vein upwards to the axilla to enter the axillary glands ; and a small 

 group which follows the course of the cephalic vein. Several of the 

 vessels of this group cross the biceps muscle at its upper part to enter 

 the axillary glands, while the remainder, two or three in number, 

 ascend with the cephalic vein in the interspace of the deltoid and pec- 

 toralis major ; they usually join a small gland in this space, and then 

 cross the pectoralis minor muscle to become continuous with the sub- 

 clavian lymphatics. 



Besides the lymphatic vessels of the arm, the axillary glands receive 

 those from the integument of the chest, its anterior, posterior, and 

 lateral aspect, and the lymphatics of the mammary gland. 



The Deep lymphatics accompany the vessels of the upper extremity, 

 and communicate occasionally with the superficial lymphatics. They 

 enter the axillary and subclavian glands, and at the root of the neck 

 terminate on the left side in the thoracic duct, and on the right side 

 in the ductus lymphaticus dexter. 



LYMPHATICS OF THE LOWER EXTREMITY. 



The Superficial lymphatic glands of the lower extremity are those 

 of the groin, the inguinal ; and one or two situated in the superficial 

 fascia of the posterior aspect of the thigh, just above the popliteal 

 region. 



The Inguinal glands are divisible into two groups ; a superior group 

 of small size, situated along the course of Poupart's ligament, and re- 

 ceiving the lymphatic vessels from the parietes of the abdomen, 

 gluteal region, perineum, and genital organs ; and an inferior group of 

 larger glands clustered around the internal saphenous vein near its 



