ANTERIOR REGION. 



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ribs. Entering these glands are the emerging lymphatic branches 

 of the prescapular and brachial glands, those from the guttural 

 ^lands which descend the trachea with the carotid artery, as well 



O 



as most of those which accompany the internal thoracic vessels. 

 They afford numerous short and voluminous branches, those of 

 the right side forming the lymphatic vein ; those of the left 

 join the thoracic duct, at times reaching the anterior cava by a 

 separate trunk. 



The guttural glands are numerous, and attached slightly to 

 each other. They are disposed in an elongated mass which 

 occupies the lateral wall of the pharynx, below the guttural 

 pouch, reaching almost to the thyroid gland. They receive all 

 the lymphatics of the head, some directly from the base of the 

 tongue, soft palate, walls, of the larynx and pharynx ; others are 

 efferents from the submaxillary glands, and from a lobe lodged in 

 the substance of the parotid gland. The efferents form four or 

 five large branches, which descend the trachea singly, or united 

 into a bundle which follows the carotid ; numerous elongated 

 glands receive the radical lymphatics from the cervical portion of 

 the trachea and oesophagus. On arriving at the entrance of the 

 thorax, the efferents enter the prepectoral glands ; branches 

 sometimes pass directly to the thoracic duct on the left, or the 

 lymphatic vein on the right side. 



The submaxillary glands are a fusiform mass situated at the 

 base of the tongue, between the digastric and mylo-hyoid muscles, 

 and a little above the glosso-fascial artery ; they receive the 

 lymphatic vessels from the tongue, cheeks, lips, nose, and nasal 

 cavities, the efferent vessels going to the guttural glands. 



The prescapular glands form by their union a chain running 

 in the course of the ascending branch of the inferior cervical artery, 

 under the internal face of the levator humeri, and descending 

 almost to the attachment of the sterno-maxillaris. The cervical 

 lymphatics, superficial and deep, mostly enter this glandular 

 chain, as well as those from the breast, and a part of those from 

 the shoulder ; their efferents, short and voluminous, pass to the 

 prepectoral glands. 



The 'brachial glands, situated under the shoulder, consist of 

 two groups ; one is situated near the elbow to the inside of the 

 inferior extremity of the humerus, receiving the lymphatic vessels 

 of the foot and fore-arm, which accompany the superficial veins, 

 or pass up the interstices of the muscles with the deep vessels ; 



