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A MANUAL OF ANATOMY 



(3) Carpal. — The carpal lymphatics form two groups — palmar and dorsal, 

 which derive their vessels from the palmar and dorsal networks of the hand. 



{4) Antibrachial. — The superficial lymphatics of the front of the forearm 



are arranged in three groups — radial, median, 

 and ulnar, which accompany the corresponding 

 veins. As the radial and ulnar lymphatics 

 ascend they are joined at intervals by efferent 

 vessels from the dorsal plexus of the hand, 

 which wind round the radial and ulnar borders 

 of the forearm from its dorsal aspect. The 

 radial lymphatics in part ascend into the arm 

 and accompany the cephalic vein, and in part 

 join the median lymphatics. The median 

 lymphatics may terminate in the anticubital 

 glands, if these are present. When these are 

 absent, they join the ulnar lymphatics, which 

 terminate in the supra-trochlear gland or 

 glands. 



(5) Brachial. — The superficial lymphatics of 

 the brachial region form two groups — -inner 

 and outer. The inner lymphatics, which are 

 very numerous, lie along the inner border of 

 the biceps brachii. They largely represent the 

 efferent vessels of the supra-trochlear gland or 

 glands, and anticubital glands, if present, and 

 they lie at first superficial to the deep fascia. 

 Subsequently, however, they pierce that fascia 

 and pass to the external or humeral axillary 

 glands, in association with the deep brachial 

 lymphatics. The outer lymphatics, which are 

 reinforced by some of the radial lymphatics, 

 lie on the outer side of the biceps brachii, 

 along the course of the cephalic vein. They 

 then ascend in the groove between the deltoid 

 and pectoralis major muscles, where they may 

 traverse on© or two very minute deep lym- 

 phatic glands. Ultimately they pass to the 

 infra-clavicular glands, but one or two of them 

 may ascend over the clavicle, and terminate 

 in one of the supra-clavicular glands. 



Deep Lymphatics. — ^These, as stated, accom- 

 pany the deep bloodvessels, and they form five 

 groups — radial, ulnar, anterior interosseous, 

 posterior interosseous, and brachial. In con- 

 nection with each artery there are usually two 

 lymphatic vessels, and those accompanying 

 the radial, ulnar, anterior interosseous, and 

 brachial arteries occasionally traverse one or 

 two deep lymphatic glands, which are some- 

 times met with along the course of each of 

 these arteries. The brachial lymphatics are 

 formed by the union of the radial, ulnar, an- 

 terior interosseous, and posterior interosseous 

 lymphatic vessels. About the centre of the 

 Fig. 212. — The Superficial arm they are reinforced by the efferent vessels 



Lymphatics of the Upper of the supra-trochlear gland or glands, and 



Limb (Anterior View). they terminate in the external or humeral 

 axillary glands. 



Summary of the Lymphatic Glands of the Upper Limb. — ^The lymphatic 

 gHnds of the upi er limb form two groups — superficial and deep. 



The superflcial glands embrace the internal epicondylar or supra-trochlear; 



