THE LYMPH NODES OF THE UPPER EXTREMITY 



785 



anterior portion of the forearm and the middle of the palm. The vessels from 

 them pass upward along the front and inner aspect of the arm. 



One or two superficial nodes lie above the internal condyle. This is the 

 supratrochlear or epitrochlear group of nodes. There is usually but one node, but 

 there may be two or more. It receives vessels from the three inner ringers, the 

 inner portion of the hand, and the inner portion of the forearm, but, because 

 [>f free anastomoses, also may receive lymph from any portion of the hand and fore- 

 irm. Lymph vessels from the supra trochlear node pass up along the basilic- 

 rein to the axillary nodes. 



There are sometimes several small nodes along the cephalic vein in the groove 

 between the Deltoid and the great Pectoral muscle. These are called infra- 

 slavicular nodes, the efferents of which drain into the subclavian nodes. 



WITH CEPHALIC VEIN EXTERNAL GROUP 



PECTORAL . 

 GROUP 



CUTANEOUS COLLECTING 



TRUNK FROM THE 



THORACIC WALL 



MAMMARY LYMPHATIC 

 ENDING IN SUB- 

 CLAVIAN NODES 



PECTORAL 



GROUP 



MAMMARY COL- 

 LECTING TRUNKS 



SUBAREOLAR 

 PLEXUS 



CUTANEOUS COL- 

 LECTING TRUNKS 



COLLECTING TRUNKS 

 PASSING TO INTERNAL 

 MAMMARY NODES 



FIG. 562. Axillary nodes and lymphatics of the breast. (Poirier and Charpy.) 



The Deep Lymph Nodes of the Upper Extremity or the Axillary Nodes 



(lymphoylandulae axillares) (Figs. 562 and 563). The chief deep nodes are situ- 

 ated adjacent to the axillary vessels. There are also a few small nodes along 

 the radial, ulnar, and brachial arteries which receive deep lymphatics from bones, 

 muscles, and ligaments, and send lymphatics to the axillary nodes. The axillary 

 nodes number from fifteen to thirty-five in each axilla. They are embedded 

 in the axillary fat and receive the lymphatic vessels from the upper extremity, 

 from the skin of the upper portion of the thorax, from the Pectoral muscles, and 

 from the mammary gland. They may be arranged in the following groups: 



(1) An external group, the humeral chain, lying on the inner surface of the vessels 

 and nerves, particularly the axillary vein, to the sheath of which they are adherent. 

 ( Jccasionally one or several of these nodes are found beneath the vein. Some 

 of the vessels from these nodes pass into the central group of lymph nodes; others 

 enter the subclavian nodes; others pass above the clavicle and terminate in nodes 

 situated in that region. (2) An anterior or pectoral group (lymphoylaitdulae 

 pectoralcx), situated along the lower border of the Pectoralis minor and in relation 



50 



