724 



THE LYMPHATIC SYSTEM 



2. THE DEEP LYMPHATIC NODES OF THE THORAX 



The lymphatic nodes of the thoracic cavity may be divided into the parietal 

 and the visceral. The parietal nodes are arranged in two sets, the internal 

 mammary chain and the intercostal nodes (fig. 570). Along the internal mam- 

 mary arterj^ are from four to six small nodes, [Igl. sternales] which receive ducts 

 from the anterior thoracic and the upper part of the abdominal walls, from the 

 anterior diaphragmatic nodes which drain the liver, and from the medial edge of 

 the mammary gland. The efferent vessels usually unite with the vessels of the 

 anterior mediastinal and bronchial nodes, to form the broncho-mediastinal trunk, 

 which may join the thoracic duct on the left and the jugular or subclavian trunk 

 on the right or mux empty separately- into the subclavian vein on both sides. 



Fig. 568. — Lymphatics of the Subareolar Plexus of the Breast. (After Sappey.) 



Vessels from network 



Lobule of gland, 

 uninjected 



Superficial W 5i 



network 



Subareolar 

 network 

 Vessel from 

 network 

 Subareolar |; 

 network 



Lobule of gland 

 uninjected 



Superficial 

 network \4 



Vessels from network 



The intercostal nodes [Igl. intercostalos] lie along the intercostal vessels, near 

 the heads of the ribs. There arc usually one or two in each space, and occasionally 

 a node is placed where the perforating lateral artery is given off. They receive 

 afferonts from the deeper part of the thoracic wall and costal pleura. Their 

 efferents enter the thoracic duct, those from the nodes of the lower four or five 

 interspaces uniting usually to form a common duct on each side, but more marked 

 on the left side, which descends to the rccei)taculum chyli. 



The efferent lymph-vessels from the upper intercostal nodes often unite into common 

 trunks which drain several interspaces, and which may pass through a large gland near the 

 thoracic duct before emptying into it. Occasionally such collecting vessels from the right side 

 cross the mid-line behind the aorta to reach a large gland to tlie left of the aorta. 



The visceral nodes of the thorax are arranged in three groups: — 

 1. The anterior mediastinal nodes flgl. modiastinales anteriores] are situated, 

 as their name; indicates, in i\\v. anterior mediastinum, and are arranged in an upper 

 and a lower set. . 'J'he uj)])er set is situated upon the anterior surface of the arch 

 of the aorta, and consists of eight or ten nodes, which receive afferents from the 

 pericardium and the remains of the thymus gland. Their efferent vessels pass 

 upward to join the Ijroncho-mediastinal trunk. The lower set consists of from 



