30 THE SUPERIOR EXTREMITY 



along the axillary vessels. They receive the lymph vessels 

 from the greater part of the upper extremity, and those at the 

 upper part of the chain also receive lymph from the deep 

 part of the mamma. (2) A pectoral group, or anterior group, 

 which lies in the angle between the anterior and medial walls 

 of the axilla. This is subdivisible into two parts : (a) an 

 upper group of two or three small glands which lie behind 

 the pectoralis major in the region of the second and third 

 intercostal spaces these receive lymph from the anterior wall 

 of the thorax and from the lateral two-thirds of the mamma ; 

 (l>) an inferior group which lies along the posterior border of 

 the lateral thoracic artery, and receives lymph from the lateral 

 wall of the thorax. (3) A posterior or subscapular group, 

 which lies along the subscapular artery on the posterior wall of 

 the axilla, and receives lymph vessels from the back. (4) The 

 delto-pectoral glands, a group of two or three small glands 

 which lie in the delto-pectoral triangle and receive lymph 

 from the proximal and lateral parts of the arm. 



In addition to the lymph glands which are usually seen in 

 an ordinary dissection, there are three other groups of glands. 

 (a) Inter-pectoral glands, from one to three or four, which lie 

 on the anterior surface of the pectoralis minor ; they receive 

 lymph from the deep part of the mamma by lymph vessels 

 which pierce the pectoralis major, (b) The central glands, 

 which are very variable ; they lie either on the surface of the 

 axillary fascia, in a pocket of its substance, or deep to it 

 in the fat of the middle part of the axilla ; they have no 

 afferents from any definite region, but are connected with 

 the other groups, (c) The infraclavicular glands, which lie 

 in the apex of the axilla behind the costo-coracoid membrane. 

 They receive efferents from all the lower groups, and their 

 efferents unite to form a subclavian lymph trunk which 

 terminates on the left side in the thoracic duct, and on the 

 right side in the right lymph duct (Fig. 14). 



Kami Laterales (O.T. Lateral Cutaneous Branches) of the 

 Anterior Branches of the Second and Third Thoracic Nerves. 

 As a rule, the first thoracic nerve does not give off a lateral 

 branch. That which springs from the second thoracic nerve 

 is the largest of the series, and differs from the others in not 

 dividing into an anterior and a posterior branch. It is termed 

 the intercosto-brachial nerve, on account of its being distributed 

 to the skin on the medial and dorsal aspects of the proximal 



