1012 



THE VASCULAK SYSTEM 



----Thyreoid cartilage 



Crico-thyreoid ligament 

 Inferior laryngeal lymph vessels 



*r~-/--Thyreoid gland 



Left common carotid artery 



Pretracheal lymph gland 

 IT--- Paratracheal lymph glands 

 Left subclavian artery 



Arch of aorta 



Left tracheo-bronchial glands 

 Left pulmonary artery 



(4) Lymphoglandulae Mediastinales Posteriores. The posterior mediastinal 

 lymph glands, 8-12, lie along the descending part of the thoracic aorta and the 

 thoracic part of the oesophagus. They receive afferents from the diaphragm, the 



pericardium, the oesophagus, 

 and other immediately adjacent 

 tissues. Some of their eferents 

 join the thoracic duct, others 

 the broncho-mediastinal trunk, 

 and some pass to the bronchial 

 glands. 



(5) Lymphoglandulae 

 Bronchiales. Under the term 

 bronchial lymph glands are in- 

 cluded all the lymph glands 

 which are closely associated 

 with the walls of the intra- 

 thoracic part of the trachea and 

 with the main bronchi and 

 their intra - pulmonary 

 branches. The glands are ex- 

 tremely numerous, and they 

 are conveniently classified, by 

 Bartels, into four groups (1) 

 tracheo- bronchial right and 

 left; (2) the glands of the 

 bifurcation, also called inter- 

 tracheo-bronchial; (3) broncho- 

 pulmonary ; (4) pulmonary. 

 At birth and for some years 

 afterwards they are pink in 

 colour, but later they become 

 blackened by the deposit of 

 carbonaceous particles derived 

 from the atmosphere. 



(1) The Tracheo-Bronchial 

 Lymph Glands are those which 

 are situated in the lateral angle between the trachea and the bronchus, on each 

 side. On the right side they vary in number from 5 to 9, on the left from 3 to 6. 

 Those on the left are in close relation with the left recurrent nerve. Their 

 afferents are derived from the other groups of bronchial glands and from the 

 adjacent parts of the trachea and bronchi. They are connected with the anterior 

 and posterior mediastinal glands. Their efferents pass to the broncho-mediastinal 

 trunk and also to the inferior deep cervical glands. They are associated, also, by 

 interglandular vessels, with the paratracheal glands. 



(2) The Lymph Glands of the Bifurcation (intertracheo-bronchial) lie below the 

 trachea, in the angle between the two main bronchi. They are situated between the 

 roots of the great vessels anteriorly and the oesophagus and the aorta posteriorly. 

 Their afferents are derived from the broncho-pulmonary glands and from adjacent 

 parts ; their efferents terminate in the tracheo-bronchial glands. They are 

 connected with the posterior mediastinal glands. 



(3) The Broncho-Pulmonary Lymph Glands. Each group of broncho-pulmonary 

 glands, right and left, lies in the hilum of the corresponding lung, in the angles 

 between the branches of the bronchial tube. The glands vary considerably in number, 

 and they receive afferents, either directly or through the pulmonary glands, from 

 the lung substance. They also receive afferents from the pleura ; and their efferents 

 pass to the tracheo-bronchial glands and to the glands of the bifurcation. 



(4) The Pulmonary Lymph Glands lie in the lung substance and usually in the 

 angles between two bronchial tubes. Their afferents are derived from the lung 

 substance, and their efferents pass to the broncho-pulmonary glands. 



Right pulmonary 

 artery 



Broncho-pulmonary 

 glands. 



FIG. 810.- 



Glands of the bifurcation 

 (intertracheo-bronchial) 



THE GLANDS IN RELATION TO THE TRACHEA AND THE 

 MAIN BRONCHI. 



