Manual of Surgery Volume First: General Surgery. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume First: General Surgery. Sixth Edition.
Thomson, Alexis
Surgery
tubercle and also by epithelioma secondary to disease in the tongue or
throat. _The inferior deep cervical (supra-clavicular) glands_ lie in
the posterior triangle, above the clavicle. They receive lymph from the
lowest cervical glands, from the upper part of the chest wall, and from
the highest axillary glands. They are frequently infected in cancer of
the breast; those on the left side also in cancer of the stomach. The
removal of diseased supra-clavicular glands is not to be lightly
undertaken, as difficulties are liable to ensue in connection with the
thoracic duct, the pleura, or the junction of the subclavian and
internal jugular veins. _The retro-pharyngeal glands_ lie on each side
of the median line upon the rectus capitis anticus major muscle and in
front of the pre-vertebral layer of the cervical fascia. They receive
part of the lymph from the posterior wall of the pharynx, the interior
of the nose and its accessory cavities, the auditory (Eustachian) tube,
and the tympanum. When they are infected with pyogenic organisms or
with tubercle bacilli, they may lead to the formation of one form of
retro-pharyngeal abscess.
#Upper Extremity.#--_The epi-trochlear and cubital glands_ vary in
number, that most commonly present lying about an inch and a half above
the medial epi-condyle, and other and smaller glands may lie along the
medial (internal) bicipital groove or at the bend of the elbow. They
drain the ulnar side of the hand and forearm, and pour their lymph into
the axillary group. The epi-trochlear gland is sometimes enlarged in
syphilis. _The axillary glands_ are arranged in groups: a central group
lies embedded in the axillary fascia and fat, and is often related to an
opening in it; a posterior or subscapular group lies along the line of
the subscapular vessels; anterior or pectoral groups lie behind the
pectoralis minor, along the medial side of the axillary vein, and an
inter-pectoral group, between the two pectoral muscles. The axillary
glands receive lymph from the arm, mamma, and side of the chest, and
pass it on into the lowest cervical glands and the main lymph trunk.
They are frequently the seat of pyogenic, tuberculous, and cancerous
infection, and their complete removal is an essential part of the
operation for cancer of the breast.
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