998 THE VASCULAE SYSTEM. 



the liver, the diaphragm, the wall of the thorax, and the mammary gland of the 

 left side, the thynius, the pericardium, the left lung, and the left part of the heart. 



At the root of the neck, just before its termination, it receives the efferents 

 from the glands of the left superior extremity, which frequently unite to form a 

 subclavian trunk, and the left jugular trunk, which conveys the lymph from the 

 left side of the head and neck ; but either of those vessels or both of them may 

 end separately in the innominate vein. 



Ductus Lymphaticus Dexter. The right lymph duct (Fig. 798) is not always 

 present. It is a short trunk, from 12 to 1*7 mm. (half to three-quarters of an 

 inch) in length, which lies at the right side of the root of the neck along the 

 medial border of the right scalenus anterior, and it is formed by the confluence of 

 (1) the right jugular trunk, (2) the right subclavian trunk, and (3) the right broncho- 

 mediastinal trunk, which carries lymph from the bronchial, the posterior, and the 

 anterior mediastinal and .tjie sternal glands. It thus receives lymph from the 

 right side of the head and neck, the right upper limb and the right side of the 

 trunk, including the upper part of the thoracic wall, the right lung and pleura, 

 the right half of the heart and pericardium, the right side of the diaphragm, and 

 the upper surface of the liver. As a rule, the right lymph duct is not present 

 as a definite stem, and the right jugular trunk carrying the lymph, from the head 

 and neck, the right subclavian trunk bearing lymph from the right upper ex- 

 tremity, and the right broncho-mediastinal trunk, end separately in the upper 

 part of the right innominate vein, but any two of the three main trunks of the 

 right side may unite together. The right broncho-mediastinal trunk frequently 

 communicates, below, with the thoracic duct. 



LYMPH GLANDS OF HEAD AND NECK. 

 THE LYMPH GLANDS OF THE HEAD. 



} All the lymph glands of the head are extracranial. 



Lymphoglandulae Occipitales. The occipital lymph glands, two or three in 

 number, lie, in or deep to the deep fascia, upon the upper part of the trapezius 

 muscle, or, if the trapezius is small, upon the upper part of the semispinalis capitis 

 or on the splenius muscle. They receive afferent vessels from the occipital region of 

 the scalp and from the superficial parts of the upper and back portion of the neck. 

 Their efferents terminate in the deep cervical glands. Some of the lymph vessels 

 of the occipital region pass directly to the deep cervical glands (Fig. 799). 



Lymphoglandulae Auriculares Posteriores. The posterior auricular lymph 

 glands (O.T. mastoid) lie on the upper part of the sterno-mastoid muscle and on 

 the mastoid portion of the temporal bone, and they are bound down by a sheathing 

 of deep cervical fascia. They receive afferent vessels from the posterior part of 

 the parietal region of the scalp, and from the medial surface of the auricle. 

 Their efferents join the superficial and the deep cervical glands (Fig. 799). 



Lymphoglandulae Auriculares Anteriores. The anterior auricular lymph 

 glands (O.T. parotid) lie both superficial and deep to the parotid fascia on the 

 lateral surface of the parotid gland. They receive afferents from the frontal and 

 the temporal regions of the scalp, from the eyebrow, the upper and lower eyelids, 

 the upper part of the cheek, the root of the nose, and the lateral surface of the 

 auricle. Their efferents pass to the superficial and the upper deep cervical glands, 

 and to the parotid lymph glands (Fig. 799). 



Lymphoglandulae Parotideae. The parotid lymph glands (O.T. deep parotid 

 glands) lie embedded in the deeper parts of the parotid gland. They receive afferents 

 from the external acoustic meatus, the tympanum, the soft palate, the posterior 

 part of the nose, and the deeper portions of the cheek. Their efferents open into 

 the upper deep cervical glands. 



The Superficial Facial Lymph Glands. Several lymph glands, or groups of 

 lymph glands, have been found in the region of the face but, apparently, they are 

 irregular, both in occurrence and in position. Those which appear to be most 



