Human Anatomy Vol 1

CUTANEOUS NERVES, SUPERFICIAL VEINS AND LYMPHATIC DRAINAGE

i. A few vessels from the medial side of the forearm
which drain into the superficial cubital nodes.
ii. A few vessels from the lateral side of the forearm
which drain into the deltopectoral or infraclavicular
nodes.
The dense palmar plexus drains mostly into the
lymphvessels onto the dorsum of thehand, where these
continue with the vessels of the forearm. Lymph vessels
of the back of forearm and arm curve round ttreir medial
and lateral surfaces and ascend up to reach the floor of
the axilla. Thus, there is a vertical area of lymph shed in
the middle of back of forearm and arm (Fig. 7.10).

S?ep f,,r s*$res

Deep lymphatics are much less numerous than the
superficial lymphatics. They drain structures lying deep
to the deep fascia. They run along the main blood
vessels of the limb, and end in the axillary nodes.
Some of the lymph may pass through the deep lymph
nodes present along the axillary vein as mentioned
above (Fig. 7.10).

InJlammation of lymph nodes is called lyrnphndenitis.

It may be acute or chronic. The nodes enlarge and

become palpable and painful (Fi1.7.12).

Obstruction to lymph vessels can result in accumu-

lation of tissue fluid in areas of drainage.

This is called lymphoedema. This may be caused by

carcinoma (Figs 7.13a and b). InJection with some

parasites like filaria, or because of surgical removal

of lymph nodes.

Pain along the medial side of upper arm is due to

pressure on the intercostobrachial nerve by

enlarged cenfral group of axillary lymph nodes.

o Inflammation of lymph vessels is known as

lymphangitis, In acute lymphangitis, the vessels

may be seen through the skin as red, tender

(painful to touch) streaks (Fig. 7.11).

Ventral axial line ends close to wrist joint, while

dorsal axial line ends close to elbow joint.

Dermatome is an area of skin supplied by single

spinal segment through a pair of right and left

spinal nerves with both its dorsal and ventral rami.

There is no overlapping of the nerve supply across

the axial lines.

Cephalic vein at its beginning in the 'anatomical

snuff box' and median cubital vein near the elbow

are the veins of choice for intravenous infusions.

Median cubital vein is protected from the brachial

artery by the bicipital aponeurosis

Axillary lymph nodes

Lymph shed on the back

Vessels passing to the front

Anterior view

Fig.7.10: The

palmar plexus

Posterior view

superficial lymphatics of the upper limb

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