1006 



THE VASCULAR SYSTEM. 



!$&' Infra-clavicular 



3P^~" glands 



' . . .Delto-pectoral 



gland 

 .-=- Central axillary 



lower surface of the anterior free portion of the tongue. The main trunks pierce the mylo- 

 hyoid muscle and end in the submental glands. (2) The middle group of lymph vessels of the 

 tongue drain the anterior two-thirds, exclusive of the tip, and they terminate partly in the 

 submaxillary glands and partly in the medial superior deep cervical glands. Small lingual 

 glands are intercalated in the course of some of these vessels. (3) The posterior lymph vessels drain 

 the portion of the tongue which lies in the anterior wall of the pharynx posterior to the papillae 

 vallatae ; they pass to the medial superior deep cervical glands. (4) The lymph vessels from 

 the deeper central portions of the tongue go, mainly, to the upper deep cervical glands. 



The Lymph Vessels of the Salivary Glands. The lymph vessels of the parotid gland 

 terminate in the parotid and superior deep cervical lymph glands. The lymph vessels of the 

 submaxillary gland terminate, according to Most, not in the submaxillary lymph glands but 

 in the medial superior deep cervical glands. Practically nothing is known of the lymph vessels 

 of the sublingual gland. 



The Lymph Vessels of the Pharynx. From the upper part of the pharynx, and from the 

 posterior wall and lateral borders of the middle and lower parts, the lymph stream flows to the 

 median line posteriorly. There the larger vessels pierce the walls of the pharynx, then they 

 turn laterally and end in the lateral retro-pharyngeal glands. 



From the lower and anterior part of the pharynx, that is, from the region of the piriform 

 recesses and the adjacent part of the larynx, the lymph vessels pass along the course of the 

 laryngeal branch of the superior thyreoid' artery, pierce the hyo- thyreoid membrane and 



terminate in the medial superior deep cervical 

 glands ; they may be connected also with the 

 infra-hyoid, and with the prelaryngeal glands. 



The lymph vessels of the palatine tonsil and 

 the adjacent parts of the glosso - palatine and 

 pharyngo -palatine arches pierce the lateral wall 

 of the pharynx and end in a gland, or group 

 of glands, which lies on the lateral surface of 

 the internal jugular vein, immediately below 

 the posterior belly of the digastric at the level 

 of the angle of the mandible. 



The Lymph Vessels of the Thyreoid 

 Gland. The lymph vessels of the thyreoid 

 gland form a plexus common to both lobes and 

 the isthmus, therefore the lymph can pass from 

 the lobe of one side to the terminal glands of 

 the opposite side. The terminal vessels end in 

 the prelaryngeal, the pretracheal, the para- 

 tracheal, the superior and inferior deep cervical, 

 and the upper mediastinal glands. 



The Lymph Vessels of the Larynx. The 

 lymph plexus of the larynx is separable into 

 upper and lower portions ; they are connected 

 together on the posterior wall of the cavity, 

 but are separated, laterally and anteriorly, 

 by the plicae vocales which contain extremely 

 few lymph vessels. The efferent stems of the 

 upper part pass mainly along the laryngeal 

 branch of the superior thyreoid artery, and they 

 end in the superior deep cervical glands, but are 

 frequently connected also with the infra-hyoid 

 glands. The efferent vessels from the lower 

 part of the larynx form two subordinate groups. 

 Those from the anterior region pierce the median 

 crico- thyreoid ligament and end in the pre- 

 laryngeal, the pretracheal, and the deep cervical 

 glands. The efferents from the posterior region 

 pierce the crico-tracheal membrane and end in 

 the paratracheal glands (Fig. 800). 



The Lymph Vessels of the Cervical Part 

 of the Trachea and (Esophagus. The ter- 

 minal vessels of the cervical part of the trachea 

 and the adjacent portion of the cesophagus and 

 the paratracheal and the inferior deep cervical glands. From the upper part of the trachea 

 some vessels pass to the prelaryngeal glands also. 



-Lateral axillary glands 



s -Brachial glands 



-Superficial cubital glands 



Deep cubital glands and a 

 "deep gland of forearm 



FIG. 805. SCHEMA OF THE LYMPH VESSELS AND 

 GLANDS OF THE UPPER EXTREMITY. 



LYMPH GLANDS OF THE SUPEBIOB EXTEEMITY. 



The lymph glands of the superior extremity form two groups (1) superficial, 

 (2) deep. 



(1) Lymphoglandulae Cubitales Superficiales. The superficial cubital lymph 



