THE LYMPH GLANDS OF THE NECK 697 



The Lymph Glands of the Neck. 

 The lymph glands of the neck include the following groups: 



Submaxillary. Superficial Cervical. 



Submental. Anterior Cervical. 



Deep Cervical. 



The submaxfllary glands (lymphoglandulfB submaxillares) (Fig. 604), three to 

 six in number, are placed beneath the body of the mandible in the submaxillary 

 triangle, and rest on the superficial surface of the submaxillary salivary gland. 

 One gland, the middle gland of Stahr, which lies on the external maxillary artery 

 as it turns over the mandible, is the most constant of the series; small lymph glands 

 are sometimes found on the deep surface of the submaxillary salivary glands. The 

 afferents of the submaxillary glands drain the medial palpebral commissure, 

 the cheek, the side of the nose, the upper lip, the lateral part of the lower lip, 

 the gums, and the anterior part of the margin of the tongue; efferent vessels 

 from the facial and submental glands also enter the submaxillary glands. Their 

 efferent vessels pass to the superior deep cervical glands. 



The submental or suprahyoid glands are situated between the anterior bellies 

 of the Digastrici. Their afferents drain the central portions of the lower lip and 

 floor of the mouth and the apex of the tongue; their efferents pass partly to the 

 submaxillary glands and partly to a gland of the deep cervical group situated on 

 the internal jugular vein at the level of the cricoid cartilage. 



The superficial cervical glands (lymphoglandulae cervicales superficiales] lie in 

 close relationship with the external jugular vein as it emerges from the parotid 

 gland, and, therefore, superficial to the Sternocleidomastoideus. Their afferents 

 drain the lower parts of the auricula and parotid region, while their efferents pass 

 around the anterior margin of the Sternocleidomastoideus to join the superior deep 

 cervical glands. 



The anterior cervical glands form an irregular and inconstant group on the front 

 of the larynx and trachea. They may be divided into (a) a superficial set, placed 

 on the anterior jugular vein; (6) a deeper set, which is further subdivided into 

 prelaryngeal, on the middle cricothyroid ligament, and pretracheal, on the front 

 of the trachea. This deeper set drains the lower part of the larynx, the thyroid 

 gland, and the upper part of the trachea; its efferents pass to the lowest of the 

 superior deep cervical glands. 



The deep cervical glands (lymphoglanduloe cervicales pro/undo?) (Figs. 602, 

 605) are numerous and of large size: they form a chain along the carotid sheath, 

 lying by the side of the pharynx, esophagus, and trachea, and extending from the 

 base of the skull to the root of the neck. They are usually described in two groups : 

 (1) the superior deep cervical glands lying under the Sternocleidomastoideus in 

 close relation with the accessory nerve and the internal jugular vein, some of the 

 glands lying in front of and others behind the vessel ; (2) the inferior deep cervical 

 glands extending beyond the posterior margin of the Sternocleidomastoideus 

 into the supraclavicular triangle, where they are closely related to the brachial 

 plexus and subclavian vein. A few minute paratracheal glands are situated along- 

 side the recurrent nerves on the lateral aspects of the trachea and esophagus. 

 The superior deep cervical glands drain the occipital portion of the scalp, the 

 auricula, the back of the neck, a considerable part of the tongue, the larynx, thyroid 

 gland, trachea, nasal part of the pharynx, nasal cavities, palate, and esophagus. 

 They receive also the efferent vessels from all the other glands of the head and 

 neck, except those from the inferior deep cervical glands. The inferior deep cervical 

 glands drain the back of the scalp and neck, the superficial pectoral region, part 

 of the arm (see page 701), and, occasionally, part of the superior surface of the 



