286 CLINICAL APPLIED ANATOMY. 



fairly with the superficial veins. Those accompanying the 

 ulnar vein terminate in the supratrochlear gland, those with 

 the median in the antecubital glands, if they are present, while 

 most of those following the radial vein ascend to the axillary 

 nodes, except a few which, running with the cephalic vein, terminate 

 in the deep infraclavicular glands. It will thus be evident that 

 infection of the inner side of hand is apt to lead to lymphadenitis 

 of the supratrochlear gland, and suppuration here frequently 

 calls for treatment. Lymphangitis of the median set of lymphatics 

 should involve the antecubital glands, but suppuration in front 

 of the elbow joint is uncommon. Infection of any portion of the 

 rest of the skin of the upper extremity may lead to adenitis of 

 the outer set of the axillary lymphatic nodes. The supratrochlear 

 gland cannot be felt normally, but when it is enlarged it may be 

 readily palpated, but should not be mistaken for the ulnar nerve, 

 in front of which it lies. It can be easily distinguished by its 

 oval shape, and by its mobility in all directions, the nerve on the 

 other hand being elongated as a cord, and only moving from side 

 to side. Symmetrical enlargement of the supratrochlear glands 

 is often confirmatory evidence of constitutional syphilis. 



The Lower Extremity. The same intricacy of the peripheral 

 lymphatic capillaries is seen in the lower extremity as in the 

 upper. 



The lymph is conveyed from the foot by vessels which corre- 

 spond fairly to the superficial veins. Thus the short saphenous 

 vein is accompanied by lymphatic vessels passing from the heel 

 and back of the leg, and entering a gland close beneath the deep 

 fascia at the termination of the vein in the popliteal space. 

 This node may be the seat of inflammation in cases of blistered 

 heel. There are also some four or five glands deeply placed 

 along the popliteal vessels which may become secondarily involved 

 in septic conditions. Infections occurring on the toes, the 

 dorsum of the foot, the front and inner side of the leg, and 

 the whole of the thigh are apt to lead to lymphadenitis in the 

 groin, where there are situated two sets of lymph nodes. One, 

 the vertical set, near the saphenous opening, lying above the deep 



