THE LYMPHATICS OF THE UPPER LIMB. 



557 



Fig. 422. SUPERFICIAL LYMPHATICS OF THE BREAST, 



SHOULDER, AND UPPER LIMB, FROM BEFORE (after 



Mascagni and Sappey). 4 



The lymphatics are represented as lying upon the 

 deep fascia. 



a, placed on the clavicle, points to the external 

 jugular vein ; b, cephalic vein ; c, basilic vein ; d, 

 radial ; e, median ; /, ulnar vein ; g, great pectoral 

 muscle, cut and turned outwards ; 1, superficial 

 lymphatic vessels and glands above the clavicle ; 

 2, infraclavicular glands ; 3, 3, pectoral glands ; 

 4, 4, axillary glands ; 5, two small glands placed 

 near the bend of the arm ; 6, radial lymphatic 

 vessels ; 7, ulnar lymphatic vessels ; 8, 8, palmar 

 lymphatics. 



sets being joined at intervals by tributaries 

 derived from the posterior surface of the 

 limb. The inner set, after being connected 

 with the glands above the internal con- 

 dyle, ascend in a straight direction along 

 the arm, following the basilic vein, while 

 the middle and the greater number of the 

 outer vessels incline gradually inwards 

 over the biceps muscle, and finally all enter 

 the axillary glands. One or two vessels 

 on the outer side accompany the cephalic 

 vein to the glands in the infraclavicular 

 fossa, and these are joined by others which 

 pass forwards from the shoulder. 



The deep lymphatics of the upper 

 limb correspond with the deep blood- 

 vessels. In the forearm they consist, there- 

 fore, of three sets, associated respectively 

 with the radial, ulnar, and interosseous 

 arteries and veins. In their progress up- 

 wards, they communicate near the wrist 

 with the superficial lymphatics, and some 

 of them enter the glands which lie by 

 the side of the brachial artery near the 

 bend of the elbow. They all terminate in 

 the glands of the axilla. 



The superficial lymphatics of the 

 chest include the vessels running under 

 cover of, and collecting lymph from, the 

 pectoral muscles, the cutaneous lymphatics 

 of this region, and the greater number of 

 the lymphatics of the mamma. They are 

 directed outwards and traverse the pectoral 

 glands on their way to join the principal 

 axillary glands. Associated with these 

 vessels are the superficial lymphatics of the 

 upper part of the abdominal wall, which 

 commence about the level of the umbilicus, 

 where they mingle with others passing downwards to the superficial inguinal 

 glands, and then ascend to the pectoral and axillary glands. Some of the inner- 



