THE WITHERS 36 



the spinal accessory — the eleventh cranial — 

 nerve. 



The spinal nerves are seldom exposed to 

 view in surgery of the withers and as they have 

 a promiscuous distribution, loss of motor 

 power is never observed from incision of the 

 trunks or their ramuli. 



The spinal accessory being the chief motor 

 supply of the trapezius and lying in a super- 

 ficial position may be incised in making reck- 

 less vertical incision over the lateral surface 

 of the scapula below the scapular cartilage. 

 Its division while not attended with any pro- 

 nounced harm is inadvisable on the general 

 grounds that large muscular areas should not 

 be unnerved. 



The Lymphatic Systein of the Withers 



This may be said to include the intercostal 

 nodes of this region and the prescapular nodes, 

 together with their afferent vessels. 



The intercostal nodes are located at the 

 intercostal spaces at each side of the vertebrae, 

 and they receive vessels arising chiefly in and 

 among the dorsal muscles. They are small in 

 the normal state but in fistula of the withers 

 they become larger and may even suppurate or 

 become the initial seat of a secondary pleuritis, 



