PARIETAL LYMPHATICS OF THORAX 



657 



terior mediastinal glands. The lymphatics from the vertebral jjortion of the dia- 

 phragm end in the lumhar glands (see Lymphatics of Abdomen, page 661). Some 

 of tlie lymphatics from the right side join the hepatic lymphatics. 



2. The parietal lymphatic glands are also divided into the superficial and the 

 dee) ». 



The superficial parietal glands. — The three or four glands along the lower 

 border of the ptctoralis major, described here as the pectoral set of the axillary 

 glands, are by some authors classed as superficial thoracic glands. They receive 

 the lymphatics from the front of the chest, and some of the lymphatics of the 

 mammary gland. There is also occasionally a superficial gland a little ])elo\v the 

 ensiform cartilage called the epigastric gland. It receives, ■when present, some of 

 tlie lymjihatics from the lower anterior ciu-st walls and upper part of the abdomen. 



The deep parietal glands are: — (1) The internal mammary, sternal, or anterior 

 intercostal; and ( 2 i tlie intercostal or posterior intercostal. 



(1) The internal mammary, sternal, or anterior intercostal glands lie along 

 the course of the internal mammary artery behind the costal cartilages of the true 



Fig. 399a. — Diagram of the Superficial and Deep Lymphatic Vessels and Glands of 

 THE Upper Extremity including the Superficial Lymphatic Vessels of the Back 

 AND Chest. (After Drawing by Dr. Francis R. Sherwood.) 



Communication with deep cervical Lymphatics 



Efferent vessels to R. or L. Lymphatic Dutt 



> Lymphatics of front of Chest and Mamma 



Superficial Lymphatics of back as low as Ilium 



Superficial Lymphatics 



rilts. There is usually one gland corresponding to each intercostal space. These 

 glands receive the lymjthatics from the anterior ])art of the intercostal spaces, the 

 lymphatics ascending with the superior epigastric artery from the abdominal walls, 

 the lymphatics accompanying the musculo-phrenic artery from the diaphragm and 

 lower intercostal spaces, and the lymphatics from the inner portion of the mammary 

 gland. The efferent vessels from the uppermost glands join the thoracic and right 

 lym])hatic ducts respectively, Init some of the efferent vessels of the lower glands 

 join the anterior media.stinal glands. 



(2 ) The intercostal or posterior intercostal lymphatic glands lie in the pos- 

 terior end of each intercostal s])ace alxiut the level of tiie beads of tlie ribs. They 

 receive the lymphatics accompanying the intercostal vessels from the posterior juirts 

 of the intercostal spaces, and the lymphatics from tlie deep muscles of the back, and 

 from the spinal canal. The lowermost also receive some of the lymphatics from 

 the diaphragm. On the left side their efferent vessels open into the thoracic duct. 

 On the right side the efferent vessels from the lower glands also join the thoracic 

 duct, but the vessels from the upper glands may join the efferent vessels from the 

 bronchial glands (the bronchio-mediastinal trunk • and open into the right lym- 

 phatic duct. 

 42 



