Manual of Surgery Volume First: General Surgery. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume First: General Surgery. Sixth Edition.
Thomson, Alexis
Surgery
#Head and Neck.#--_The anterior auricular (parotid and pre-auricular)
glands_ lie beneath the parotid fascia in front of the ear, and some
are partly embedded in the substance of the parotid gland; they drain
the parts about the temple, cheek, eyelids, and auricle, and are
frequently the seat of tuberculous disease. _The occipital gland_,
situated over the origin of the trapezius from the superior curved line,
drains the top and back of the head; it is rarely infected. _The
posterior auricular (mastoid) glands_ lie over the mastoid process, and
drain the side of the head and auricle. These three groups pour their
lymph into the superficial cervical glands. _The submaxillary_--two to
six in number--lie along the lower order of the mandible from the
symphysis to the angle, the posterior ones (paramandibular) being
closely connected with the submaxillary salivary gland. They receive
lymph from the face, lips, floor of the mouth, gums, teeth, anterior
part of tongue, and the alæ nasi, and from the pre-auricular glands. The
lymph passes from them into the deeper cervical glands. They are
frequently infected with tubercle, with epithelioma which has spread to
them from the mouth, and also with pyogenic organisms. _The submental
glands_ lie in or close to the median line between the anterior bellies
of the digastric muscles, and receive lymph from the lips. It is rare
for them to be the seat of tubercle, but in epithelioma of the lower lip
and floor of the mouth they are infected at an early stage of the
disease. _The supra-hyoid gland_ lies a little farther back, immediately
above the hyoid bone, and receives lymph from the tongue. _The
superficial cervical (external jugular) glands_, when present, lie along
the external jugular vein, and receives lymph from the occipital and
auricular glands and from the auricle. _The sterno-mastoid
glands_--glandulæ concatinatæ--form a chain along the posterior edge of
the sterno-mastoid muscle, some of them lying beneath the muscle. They
are commonly enlarged in secondary syphilis. _The superior deep cervical
(internal jugular) glands_--from six to twenty in number--form a
continuous chain along the internal jugular vein, beneath the
sterno-mastoid muscle. They drain the various groups of glands which lie
nearer the surface, also the interior of the skull, the larynx, trachea,
thyreoid, and lower part of the pharynx, and pour their lymph into the
main trunks at the root of the neck. Belonging to this group is one
large gland (the tonsillar gland) which lies behind the posterior belly
of the digastric, and rests in the angle between the internal jugular
and common facial veins. It is commonly enlarged in affections of the
tonsil and posterior part of the tongue. In the same group are three or
four glands which lie entirely under cover of the upper end of the
sterno-mastoid muscle, and surround the accessory nerve before it
perforates the muscle. The deep cervical glands are commonly infected by
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