798 



THE VASCULAR SYSTEMS 



set, five or six in number, pass through the caval opening in the Diaphragm 

 and end in one or two nodes which are situated around the terminal part of 

 the inferior vena cava; a few vessels from the left side pass backward toward 

 the oesophageal opening, and terminate in the paracardial nodes of the gastric 

 chain; the vessels from the right side, one or two in number, run on the abdominal 

 surface of the Diaphragm, and, after crossing its right cms, terminate in the 

 preaortic nodes which surround the origin of the cceliac axis (lymphoc/landulae 

 coeliacae). From the portions of the right and left lobes adjacent to the falci- 

 form ligament, the lymphatic vessels converge to form two trunks, one of which 

 accompanies the vena cava through the Diaphragm, and ends in the nodes 

 around the terminal part of this vessel; the other runs downward and forward, 

 and, turning around the anterior sharp margin of the liver, accompanies the upper 

 part of the ligamentum teres, and ends in the upper hepatic nodes. From the 

 anterior surface a few additional vessels turn around the anterior sharp margin 

 to reach the upper hepatic nodes. 



LEFT LATERAL 

 LIGAMENT 



IMPERVIOUS 

 UMBILICAL VEIN 



FIG. 574. Lymphatics of the inferior surface of the liver. (Sappey.) 



Some of the lymph of the upper part of the liver traverses the Diaphragm along 

 several lymphatic vessels which drain into some nodes on the superior surface 

 of the Diaphragm, just behind the ensiform cartilage and also near the termination 

 of the inferior vena cava; the efferents from the former pass to the internal mam- 

 mary chain, a fact which may explain the involvement of the supraclavicular 

 nodes, particularly of the left side, 1 secondary to an abdominal carcinoma. 



(b) On the inferior surface. The vessels from this surface mostly converge to 

 the transverse fissure, and accompany the deep lymphatics emerging from this 

 fissure to the hepatic nodes; one or two from the posterior parts of the right 

 and Spigelian lobes accompany the inferior vena cava through the Diaphragm, 

 and end in the nodes around the terminal part of this vein. 



The deep lymphatics of the liver converge to ascending and descending trunks. 

 The ascending trunks accompany the hepatic veins and pass through the Dia- 



1 Osier, Principles and Practice of Medicine, 7th edition, 1909, page 485. 



