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LYMPHATIC AND LACTEAL SYSTEM. 



Fig. 54. 



Superficial lymphatics of the lower extremity . 

 (After Ulascagni.) 



a, Saphena major vein. 

 6, Inguinal glands. 

 c, Commencing branches. 



<i, e,f,g. The continuations of the vessels simi- 

 larly marked in the former wood-cut. 



At least two lymphatics, which are united 

 frequently by short branches crossing from one 

 to the other, accompany eacli of these arteries, 

 and all are ultimately conducted by the blood- 

 vessels to the popliteal glands, in which they 

 terminate. The vasa efferentia of these glands, 

 from two to six in number, entwine around the 



popliteal and femoral vessels, having frequent 

 communications with each other by short cross 

 brandies, until they reach the inguinal region, 

 where they terminate for the most part in the 

 deep-seated cluster of inguinal glands; one or 

 more, however, may reach the superficial glands 

 or even those accompanying the external iliac 

 artery above Poupart's ligament. The deep- 

 seated lymphatics in their course are joined by 

 branches which have accompanied the principal 

 ramifications of the bloodvessels ; they also at 

 various points form communications with the 

 superficial lymphatic vessels. 



The superficial lymphatics of the lower extre- 

 mities may be divided into two groups; one con- 

 sisting of numerous vessels which follow more or 

 less the course of the saphena major vein and 

 terminate in the inguinal glands; the other com- 

 posed of but few vessels, which, accompanying- 

 the saphena minor vein, join the popliteal glands. 

 The latter take origin from the dorsal surface 

 of the little toe and from the outer edge of the 

 dorsum and sole of the foot; they proceed with 

 the branches of the saphena minor vein in the 

 direction of the external malleolus, from thence 

 to the outer edge of the tendo Achillis, where 

 they glide with the vein under the fascia of the 

 leg to reach the centre of the gastrocnemms 

 muscle, between the heads of which they dip 

 to join the popliteal glands. The superficial 

 lymphatics which accompany the saphena ma- 

 jor vein commence on the dorsal surface of the 

 toes, where they communicate with the digital 

 lymphatics. On the dorsum of the foot they 

 ascend in from three to six branches ; the most 

 internal mount over the internal malleolus with 

 the branches of the saphena major vein to the 

 inside of the knee ; the most external pass over 

 the external malleolus and outer side of the leg, 

 at a higher or lower level however, they are 

 directed inwards and pass over the spine and 

 inner surface of the tibia to join the former, at 

 the inner side of the knee ; those from the 

 centre part of the dorsum of the foot ascend in 

 front of the tibia ; these also soon tend inwards 

 to be associated with the rest. 



Another set take origin from the sole of the 

 foot and proceed upwards on the back of the 

 leg superficial to the fascia, having communi- 

 cated freely with the lymphatics accompanying 

 the saphena minor vein. These also sooner or 

 later turn inwards to gain the inside of the 

 knee. Prom these sources some twelve or fif- 

 teen branches maybe enumerated, which con- 

 tinue to ascend on the inside of the thigh with 

 the saphena major vein. Some few pass under 

 the fascia lata to join the deep-seated vessels. 

 From the back of the leg and thigh they receive 

 an accession to their numbers of several vessels ; 

 the most of these reach them from the inside, but 

 some few from the outside of the limb. They 

 ultimately terminate in the superficial cluster 

 of glands in the groin. Some few, however, 

 may dip down to join the deep-seated glands 

 and to unite with the deep-seated lymphatics. 

 One may occasionally be seen to pass the in- 

 guinal glands to reach those accompanying the 

 external iliac artery. 



The inguinal glands also receive the super- 



