184 SURGICAL APPLIED ANATOMY. [Chap. xi. 



The artery is, however, very inconstant, is small, and 

 is not far below the surface. It is usually met with 

 in female subjects. 



Lymphatic glands. The axillary glands are 

 numerous, and of much surgical importance. They 

 may be arranged in three sets. (1) The greater 

 number are placed along the axillary vessels, and 

 reach up into the neck along those vessels so as 

 to form a chain continuous with the cervical 

 glands. They receive mainly the lymphatics of the 

 upper limb, and are enlarged in inflammatory and 

 other affections of that part. (2) Other glands lie 

 upon the serratus magnus muscle on the thoracic side 

 of the axilla, and just behind the lower border of the 

 pectoral muscles. They receive the lymphatics from 

 the front of the chest, the principal lymph vessels 

 of the breast, and the superficial lymphatics of the 

 abdomen as low down as the umbilicus. Their 

 efferent vessels for the most part pass on to join the 

 chief axillary glands. These glands will be the 

 first to be enlarged in certain breast affections, and 

 after blistering and other superficial inflammations, 

 etc., of the chest and upper abdomen. Paulet has 

 seen them affected in inflammation of the hand. 

 (3) The remaining glands are situated at the back of 

 the axilla, along the subscapular vessels. They are 

 joined by the lymphatics from the back. 



It may here be convenient to note that one or 

 two glands are commonly found in the groove between 

 the deltoid and pectoralis major muscles. They 

 receive some vessels from the outer side of the 

 arm and a part of the shoulder. The superficial 

 lymphatics over the upper part of the deltoid go 

 to the cervical glands (Tillaux), over the lower half 

 to the axilla. The lymphatics from the supraspinous 

 fossa follow the suprascapular artery, and join the 

 lowest cervical glands. The superficial lymphatics of 



