368 THE VASCULAR SYSTEM. 
from the ee digital plexuses in each digit converge to four trunks, which lie 
two on each side in the subcutaneous tissue on the lateral margins of the dorsal 
aspects of the digits. They accompany the dorsal, digital veins, and, at the 
roots of the digits, they pass to the dorsum of the hand, where they anastomose 
together. The plexus i in the palm of the hand is ex tremely fine, and efferents pass 
from it not only upwards, but also downwards and laterally. The upper efferents, 
three or four in number, accompany the median vein, and terminate either in the 
superficial glands at the bend of the elbow or in the supra-trochlear glands. The 
lower efferents pass to the interdigital spaces, and turn backwards to the dorsum 
to join the digital trunks. The lateral efferents turn round the borders of the 
hand, those on the inner side join the efferents from the little finger, and those on 
the outer side the efferents from the thumb. Occasionally some of the efferents 
which pass towards the outer side fuse to form a fairly large trunk, the so-called 
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Fic. 595.—SUpPERFICIAL LYMPHATICS OF THE DIGITS AND OF THE DORSAL ASPECT OF THE HAND. 
central lymphatic which turns round the outer side of the second metacarpal bone 
and unites with the lymphatic vessels of the thumb and index-finger. 
The superficial lymphatic vessels of the forearm, including those which ascend 
from the dorsum and the palm of the hand, are erouped, for the main part, along 
the radial, median, and ulnar veins, the lateral vessels being joined at intervals by 
tributaries from the dorsum of the limb. 
The lymphatic trunks which accompany the ulnar veins terminate in the supra- 
trochlear glands, and those which accompany the median vein in the glands at the 
bend of the elbow, the ante-cubital glands, or, if these are not present, in the 
supra-trochlear olands. 
The efferent vessels of the ante-cubital and supra-trochlear glands have already 
been described (p. 867). 
A tew of the lymphatics of the outer side of the forearm and some of those of 
the upper arm accompany the cephalic vein and terminate in the infra-clavicular 
glands. 
All the remaining superficial vessels of the upper arm and forearm pass towards 
the axilla. They pierce the deep FABCIey, and terminate in the external set of 
axillary glands. 
The ‘deep lymphatics of the upper extremity commence in the bones, 
periosteum, ligaments, muscles, and intermuscular connective tissue; they 
accompany the main vessels, and some of them terminate in the deep glands 
of the forearm and arm, but the majority ascend to the external set of axillary 
olands. 
THE LYMPHATIC GLANDS AND VESSELS OF THE LOWER, EXTREMITY. 
Lymphatic Glands of the Lower Extremity.—Like those of the upper 
extremity, these are arranged in two sets, (1) superficial and (2) deep. 
(1) Superficial Glands.—The superficial glands all he in the region of the 
groin, and form three groups—the superior, the inferior, and the internal. 
(a) The superior or inguinal group includes from four to seven flattened ovoid 
