Part 66

2. The =anterior mediastinal lymph glands= (Lg. mediastinales craniales) (Fig. 428) are numerous. Some are situated on the course of the brachial arteries and their branches; on the right side they are related deeply to the trachea, on the left to the œsophagus also. They are variable in size and disposition and are continuous in front with the prepectoral glands. Other glands lie along the ventral face of the trachea on the anterior vena cava and the right atrium of the heart; these are continuous behind with the bronchial glands. A few glands usually occur along the dorsal surface of the trachea, and there is often one at the angle of divergence of the brachiocephalic trunk. The afferent vessels come chiefly from the pleura, the pericardium, the heart, the thymus or its remains, the trachea, and the œsophagus. Their efferent vessels pass to the prepectoral glands and the thoracic duct.

The glands along the ventral face of the trachea are frequently enlarged and usually pigmented in dissecting-room subjects. The left recurrent nerve lies above them on the ventral face of the trachea.

3. The =bronchial lymph glands= (Lg. bronchiales) are grouped around the terminal part of the trachea and the bronchi. One group lies on the upper surface of the bifurcation of the trachea and is continued a short distance backward under the œsophagus (Fig. 428). Others lie below the trachea and bronchi and also occupy the angle between the aortic arch and the pulmonary artery, concealing the left recurrent nerve and often covering the vagus in this part of its course. Small glands occur along the chief bronchi in the substance of the lungs (Lg. pulmonales). They receive the deep and most of the superficial lymph vessels of the lungs, and the efferents from the posterior mediastinal glands. Their efferent vessels go to the thoracic duct and the anterior mediastinal glands. The deep lymph vessels of the lung arise in plexuses which surround the terminal bronchi and accompany the bronchi to the root of the lung. The superficial vessels form a rich network under the pleura; most of them pass to the bronchial glands.

The bronchial glands are commonly pigmented except in young subjects and are often enlarged and indurated.

4. The =posterior mediastinal lymph glands= (Lg. mediastinales caudales) are usually small and are scattered along the posterior mediastinum above the œsophagus. They receive afferent vessels from the œsophagus, mediastinum, diaphragm, and liver. The efferents go to the bronchial and anterior mediastinal lymph glands, partly to the thoracic duct directly.

Sometimes one or two small glands are situated in the acute angle between the posterior vena cava and the diaphragm.

THE LYMPH GLANDS AND VESSELS OF THE ABDOMEN AND PELVIS

The =lymph glands of the abdomen= consist of two main groups, parietal and visceral. The =parietal glands= lie in the subperitoneal or subcutaneous tissue; they receive the lymph vessels from the abdominal and pelvic walls, from parts of the viscera, and from the proximal lymph glands of the pelvic limbs. The =visceral glands= lie on the walls of the viscera or in the peritoneal folds which connect the organs with the wall or with adjacent viscera. They receive all or most of the lymph vessels from the organs with which they are connected.

The =parietal glands= comprise the following:

1. The =lumbar lymph glands= (Lg. lumbales) lie along the course of the abdominal aorta and posterior vena cava (Fig. 450). Some are placed along the lower surface and sides of the vessels, others above. A few small glands may be found above the sublumbar muscles. The small nodes which are situated at the hilus of the kidneys are often termed the renal lymph glands. They receive afferent vessels from the lumbar wall of the abdomen and the paired viscera (kidneys, adrenals, genital organs), also the inguinal vessels and the efferents of the iliac glands. Their efferents go to the thoracic duct, constituting the lumbar trunks of origin of that vessel.

2. The =internal iliac lymph glands= (Lg. iliacæ internæ) are grouped about the terminal part of the aorta and the origins of the iliac arteries (Fig. 450). Their afferent vessels come chiefly from the pelvis, pelvic viscera, and tail, and they receive efferent vessels of the external iliac and deep inguinal glands.

3. The =external iliac lymph glands= (Lg. iliacæ externæ) form a group on either side on the iliac fascia at the bifurcation of the circumflex iliac artery (Fig. 450). Their afferent vessels come from the flank and abdominal floor, the outer surface of the thigh, and the precrural glands. The efferent vessels go to the lumbar and internal iliac glands.

4. The =sacral lymph glands= (Lg. sacrales) are small nodes situated along the borders of the sacrum and on its pelvic surface. They receive afferents from the roof of the pelvis and from the tail, and their efferent vessels pass to the internal iliac glands.

5. The =superficial inguinal lymph glands= (Lg. inguinales superficiales) lie on the abdominal tunic in front of the external inguinal ring (Fig. 457). They form an elongated group along the course of the subcutaneous abdominal artery, on either side of the penis in the male, above the mammary glands in the female; in the latter they are often termed =mammary=. Their afferents come from the inner surface of the thigh, the abdominal floor, the sheath and scrotum in the male, and the mammary glands in the female. The efferent vessels ascend through the inguinal canal and go to the deep inguinal and lumbar glands.

6. The =ischiatic lymph gland= (Lg. ischiadica) is a small node which may be found at the lesser sciatic notch. It receives lymph from the adjacent parts and from the popliteal glands, and sends efferents to the sacral and internal iliac glands.

The =visceral glands= include the following:

1. The =gastric lymph glands= (Lg. gastricæ) are situated along the course of the gastric arteries. Several occur along the attachment of the gastro-phrenic ligament. A group lies at the lesser curvature a short distance below the cardia. There is another small group on the visceral surface where the posterior gastric artery divides into its primary branches. Two or three small nodes are usually found on the ventral aspect of the pylorus. Other small glands are scattered along the course of the gastro-epiploic and short gastric arteries in the great and gastro-splenic omenta. The efferent vessels pass largely to the cœliac radicle of the thoracic duct, but along the left part of the great curvature they go to the splenic glands.

2. The =hepatic lymph glands= (Lg. hepaticæ) lie along the portal vein and hepatic artery and in the lesser omentum. Their efferent vessels go to the cœliac radicle of the cisterna chyli.

Many of the lymph vessels from the parietal surface of the liver pass in the falciform and lateral ligaments to the diaphragm and anastomose with its lymphatics. Some pass through the diaphragm with the vena cava and go to the mediastinal glands.

The =pancreatic lymph vessels= follow the course of the blood-vessels which supply the gland; most of them go to the splenic and hepatic glands.

3. The =splenic lymph glands= (Lg. lienales) lie along the course of the splenic blood-vessels. Their afferent vessels come from the subscapular network of the spleen, from the greater curvature of the stomach, and from the left part of the pancreas. The efferents pass to the cœliac radicle of the thoracic duct.

4. The =mesenteric lymph glands= (Lg. mesentericæ) are situated in the great mesentery near its root. They are numerous and hence lie close together. They receive a very large number of afferent vessels (400 to 500) from the small intestine. They have several considerable efferents which concur in the formation of the intestinal radicles of the cisterna chyli.

The lymph vessels of the intestine form three sets of capillary plexuses, viz., in the subserosa, submucosa, and mucosa. The lymph follicles, solitary and aggregate, lie in the zone of the plexus of the mucosa. The collecting vessels arise from the subserous plexus.

5. The =lymph glands of the cæcum= are numerous and are distributed along the course of the cæcal blood-vessels. Their efferents enter into the formation of an intestinal radicle of the cisterna chyli.

6. The =lymph glands of the great colon= are extremely numerous and are placed close together along the colic blood-vessels. Their efferent vessels are large and numerous. They converge to two large trunks which concur with those of the cæcum and small intestine to form an intestinal radicle of the cisterna chyli.

The intestinal radicles of the cisterna chyli are formed by the confluence of efferents from the intestinal lymph glands. The anterior trunk lies on the left side of the anterior mesenteric artery, passes between that vessel and the cœliac artery, turns sharply backward across the right renal vessels and opens into the cisterna. It is formed by the union of the cœliac trunk with efferents from the glands of the small intestine, cæcum and colon. It is about four inches (ca. 10 cm.) in length and is ampullate. The posterior trunk receives vessels from the small intestine and small colon. It usually opens into a trunk formed by the union of the right and left lumbar ducts. It is usually ampullate at its termination (Franck). The arrangement of these collecting trunks is, however, very variable.

7. The =lymph glands of the small colon= are situated in part on the wall of the bowel along the attachment of the mesentery, in part between the layers of the latter along the course of the blood-vessels. The efferent vessels go to the lumbar glands and to the posterior intestinal radicle of the thoracic duct.

The =lymph vessels of the rectum= pass chiefly to the lumbar and internal iliac glands.

8. The =anal lymph glands= (Lg. anales) form a small group on either side of the sphincter ani externus (Figs. 451, 453). They receive afferents from the anus, perineum, and tail. Their efferents go to the internal iliac glands.

THE LYMPH GLANDS AND VESSELS OF THE THORACIC LIMB

1. The =axillary lymph glands= (Lg. axillares), some ten to twelve in number, are grouped on the inner face of the distal part of the teres major and the tendon of the latissimus dorsi at the angle of junction of the external thoracic and subscapular veins with the brachial (Fig. 466). Their efferents include most of the lymph vessels of the limb, which come directly or as efferents from the cubital glands. They receive also lymph vessels from the thoracic wall. The efferents accompany the brachial blood-vessels and end in the prepectoral glands and the thoracic and right lymphatic ducts.

2. The =cubital lymph glands= (Lg. cubitales), usually eight to ten in number, form a discoid oval group at the inner side of the distal part of the shaft of the humerus (Figs. 441, 446). They lie behind the biceps muscle on the brachial vessels and median nerve and are covered by the deep fascia and the posterior superficial pectoral muscle. They receive as afferents most of the vessels from the limb below this point. Their efferents pass chiefly to the axillary glands, but in part to the prescapular glands also.

A number of superficial lymph vessels ascend with or near the subcutaneous veins (cephalic and accessory cephalic) and join the prescapular and prepectoral glands. Superficial vessels from the chest-wall and shoulder run across the latter to the prescapular glands. The superficial lymphatics of the pectoral region form a plexus which drains into the prepectoral and prescapular glands by a number of vessels which accompany the cephalic vein. The deep lymph vessels of the pectoral region run with the external thoracic vein to the axillary glands.

THE LYMPH GLANDS AND VESSELS OF THE PELVIC LIMB

1. The =precrural= or =subiliac lymph glands= (Lg. subiliacæ) are situated in the fold of the groin on the anterior border of the tensor fasciæ latæ, about midway between the point of the hip and the patella (Figs. 450, 451, 457). They lie on the course of the posterior branch of the circumflex iliac artery, and number usually about a dozen. They receive superficial lymph vessels from the hip, thigh, and flank. Their efferent vessels ascend with the posterior circumflex iliac vein, enter the abdomen near the external angle of the ilium, and join the external iliac lymph glands.

2. The =deep inguinal lymph glands= (Lg. inguinales profundæ) form a large group situated in the upper part of the femoral canal between the pectineus and sartorius muscles (Figs. 451, 457). They cover the femoral vessels and are related superficially to the inguinal ligament. They receive nearly all of the lymph vessels of the limb below them. Their efferent vessels ascend to the internal iliac glands.

3. The =popliteal lymph glands= (Lg. popliteæ), usually four to six in number, lie behind the origin of the gastrocnemius and between the biceps femoris and semitendinosus at the division of the posterior femoral artery into its primary branches (Fig. 455). They receive the deep lymph vessels of the distal part of the limb. Their efferent vessels chiefly follow the course of the femoral vessels to the deep inguinal glands, but one or two ascend in company with a vein along the great sciatic nerve and may enter a gland at the lesser sciatic notch. From this a vessel accompanies the internal pudic vein and joins the internal iliac glands.

Several superficial lymph vessels ascend with or near the internal metatarsal and saphenous veins, enter the femoral canal, and end in the deep inguinal glands.

THE FŒTAL CIRCULATION

The blood of the fœtus is oxygenated, receives nutrient matter, and gives off waste matter by close contiguity with the maternal blood in the placenta. The chief differences in the blood-vascular system as compared with that which obtains after birth are correlated with this interchange.

The =umbilical arteries=, right and left, are large vessels which arise from the internal iliac arteries and pass downward and forward in the umbilical folds of peritoneum on either side of the bladder to the umbilicus. Here they are incorporated with the umbilical vein and the urachus in the umbilical cord, ramify in the allantois, and end as the capillaries of the fœtal placenta. They conduct the impure blood to the placenta. After birth these vessels retract with the bladder to the pelvic cavity; their lumen becomes greatly reduced and the wall thickened so that they are cord-like and are termed the round ligaments of the bladder.

The =umbilical vein= receives the oxygenated blood from the placenta. Its radicles converge to form in the horse a single large trunk which separates from the other constituents of the umbilical cord on entering the abdomen and passes forward along the abdominal floor in the free border of the falciform ligament of the liver. It enters the latter at the umbilical fissure and joins the portal vein, so that the blood conveyed by it passes through the capillaries of the liver before entering the posterior vena cava.

In the ox and dog some of the blood in the umbilical vein is conveyed directly to the vena cava by the =ductus venosus= (Arantii). This vessel is given off within the liver from a venous sinus formed by the confluence of the portal and umbilical veins and passes directly to the posterior vena cava.

The =foramen ovale= is an opening in the septum between the atria, by which the latter communicate with each other. It is guarded by a valve (Valvula foraminis ovalis) which prevents the blood from passing from the left atrium to the right. After birth the foramen soon closes, but this part of the septum remains membranous, and there is a deep =fossa ovalis= in the right atrium which indicates the position of the former opening. In some cases the foramen persists to a variable extent in the adult without apparent disturbance of the circulation.

The =pulmonary circulation= is very limited in the fœtus, and most of the blood which enters the pulmonary artery passes through the =ductus arteriosus= to the aorta. This vessel is larger than the divisions of the pulmonary which go to the lungs and joins the left side of the aortic arch. After birth the pulmonary circulation undergoes promptly an enormous increase and the ductus is rapidly transformed into a fibrous cord—the =ligamentum arteriosum=.

The only arterial blood in the fœtus is that carried by the umbilical vein. This blood is mixed in the liver with the venous blood of the portal vein, and after passing through the capillaries of the liver is carried by the hepatic veins to the posterior vena cava. The latter receives also the venous blood from the posterior part of the trunk and the pelvic limbs. It is generally believed that the blood carried into the right atrium by the posterior vena cava passes largely, if not entirely, through the foramen ovale into the left atrium, while the blood flowing into it through the anterior vena cava passes into the right ventricle. On this basis the blood received by the left atrium consists chiefly of mixed blood from the posterior vena cava, since the small amount of blood conveyed by the pulmonary veins is venous. This mixed blood passes into the left ventricle and is forced into the systemic arteries. The venous blood from the anterior part of the body and the thoracic limbs is conveyed by the anterior vena cava to the right atrium, passes into the right ventricle, and is forced into the pulmonary artery. A small amount is carried to the lungs, but the bulk of it passes by the ductus arteriosus into the aorta behind the point of origin of the brachiocephalic trunk (anterior aorta), and is carried to the posterior part of the body, a large part passing by the umbilical arteries to the placenta.

THE BLOOD-VASCULAR SYSTEM OF THE OX

THE PERICARDIUM AND HEART

The =pericardium= is attached by two fibrous bands (Ligamenta sternopericardiaca) to the sternum opposite the facets for the sixth costal cartilages; these ligaments, right and left, are embedded in the mass of fat which separates the apex of the pericardium from the floor of the thorax.

[Illustration:

FIG. 467.—HEART OF OX, LEFT VIEW. ]

The =heart= of the adult ox has an average weight of about 5½ to 6 pounds (ca. 2.5 to 2.7 kg.), or about 0.4 to 0.5 per cent. of the body-weight. Its length from base to apex is relatively longer than that of the horse and the base is smaller in both its diameters.

A shallow =intermediate groove= (Sulcus intermedius) extends from the coronary groove down the left side of the posterior border, but does not reach the apex. The amount of fat in and near the grooves is much greater than in the horse.

The heart is situated more to the left of the median plane than in the horse and is opposite to the third, fourth, and fifth ribs when it is contracted. It has extensive contact with the lateral wall of the thorax on the left side, but none on the right side, where a considerable thickness of lung covers the pericardium.[178]

Two bones, the =ossa cordis=, develop in the aortic fibrous ring. The right one is in apposition with the atrio-ventricular rings and is irregularly triangular in form. Its left face is concave and gives attachment to the right posterior cusp of the aortic valve. The right surface is convex from before backward. The base is superior. The posterior border bears two projections separated by a notch. It is usually a little more than an inch (ca. 4 cm.) in length. The left bone is smaller and is inconstant. Its concave right border gives attachment to the left posterior cusp of the aortic valve. There is a large fleshy moderator band in the right ventricle.

THE ARTERIES[179]

The great arterial trunks in the thorax resemble those of the horse in general disposition.

The =left coronary artery= is much larger than the right one; it gives off a branch which descends in the intermediate groove, and terminates by running downward in the right longitudinal groove. The =right artery=, after emerging from the interval between the right auricle and the pulmonary artery, divides into branches which are distributed to the wall of the right ventricle.

The =brachiocephalic trunk= (anterior aorta) is usually four or five inches (ca. 10 to 12 cm.) in length.

The =brachial arteries= give off in the thorax the following branches:

1. A common trunk for the subcostal, dorsal, superior or deep cervical, and vertebral arteries.

(1) The =subcostal artery= commonly arises separately, but may be given off as in the horse. It supplies the first three intercostal arteries.

(2) The =dorsal artery= is relatively small. It usually ascends in front of the first costo-vertebral joint and is distributed as in the horse.

(3) The =superior= or =deep cervical artery= may arise from a common stem (Truncus vertebro-cervicalis) with the vertebral, or may constitute a branch of that artery. It passes up between the first thoracic and last cervical vertebræ or between the sixth and seventh cervical and is distributed as in the horse.

(4) The =vertebral artery= passes along the neck as in the horse to the intervertebral foramen between the second and third cervical vertebræ, gives off a muscular branch, and enters the vertebral canal (Fig. 469). It runs forward on the floor of the canal—connected with its fellow by two or three transverse anastomoses—and divides in the atlas into two branches. The smaller internal division (cerebrospinal artery) passes forward to the floor of the cranium and concurs with the condyloid artery and branches of the internal maxillary in the formation of a large =rete mirabile=. The large external branch emerges through the intervertebral foramen of the atlas and ramifies in the muscles of the neck in that region, compensating for the smallness of the branches of the occipital artery. It also sends a branch to the rete mirabile. The collateral branches detached to the cervical muscles are large and compensate for the small size of the deep cervical artery. The collateral spinal branches of the vertebrals pass through the intervertebral foramina, divide into anterior and posterior branches, and form two longitudinal trunks which are connected by cross-branches so as to form irregular polygonal figures.

2. The =internal thoracic artery=.

3. The =inferior cervical artery= corresponds usually to the ascending branch of that vessel in the horse.

4. The =external thoracic artery= is large and usually gives off a branch which is equivalent to the descending branch of the inferior cervical artery of the horse.

THE COMMON CAROTID ARTERY

[Illustration:

FIG. 468.—SCHEMA OF CHIEF ARTERIES OF HEAD OF COW.

_1_, Common carotid artery; _2_, thyro-laryngeal; _3_, thyroid; _4_, laryngeal; _5_, pharyngeal; _6_, occipital; _7_, condyloid; _8_, middle meningeal; _9_, pharyngeal; _10_, external maxillary; _11_, lingual; _12_, sublingual; _13_, superior labial; _14_, internal maxillary; _15_, masseteric; _16_, inferior alveolar; _17_, buccinator; _18_, great palatine; _19_, sphenopalatine; _20_, posterior auricular; _21_, superficial temporal; _22_, posterior meningeal; _23_, anterior auricular; _24_, artery to matrix of horn; _25_, deep temporal; _26_, arteries to rete mirabile; _27_, frontal; _28_, malar; _28′_, dorsal nasal continuation of malar; _29_, infraorbital; _29′_, lateral nasal continuation of _29_. ]