hi. i elions Bel —— we we 
LYMPHATIC GLANDS AND VESSELS OF LOWER EXTREMITY. 869 
glands which lie parallel with and just below Poupart’s ligament. They receive 
afferent vessels from the back and outer part of the thigh and the buttock, and 
the superficial lymphatics from the body wall below the level of the umbilicus, 
except those from the lower and anterior part which pass to the internal group of 
glands. Their efferents pass through the deep fascia, and terminate either in the 
deep femoral or the external iliac glands. 
(b) The inferior or femoral group is formed by from three to six oval glands which 
are disposed vertically along the upper part of the internal or long saphenous 
vein. They receive all the superficial lymphatics of the foot and leg, except a few 
which accompany the external saphenous vein to the popliteal glands; all the 
superficial lymphatics of the thigh, except those from the upper ‘and outer part, 
which terminate in the superior set of glands, and a few from the upper and inner 
part which terminate in the inner group of elands. The efferent vessels of the 
femoral group pass through the saphenous opening, and terminate either in the 
deep femoral glands or in the external iliac elands. 
(ec) The internal or pubic group includes two, three, or four rounded glands 
which le internal to the saphenous opening and close to the spine of the “pubis. 
They receive afferent vessels from the lower and middle portion of the abdominal 
wall, from the upper and inner part of the thigh, from the external genitals, 
5 
including the lymphatics of the membranous and spongy portions of the urethra 
in the male, or the lower third of the vagina in the female, and from the perimeum, 
including the lymphatics of the lowest part of the rectum and of the anus, in 
both sexes. The vessels from the lower third of the vagina and the correspc mding 
part of the rectum communicate not only with the inguinal glands but also w ith 
the internal iliac glands. The efferent vessels of the pubic “elands communicate 
with the efferents of the superior and inferior groups, and, after passing through 
the saphenous opening, they terminate either in the deep femoral or the external 
iliac glands. 
(2) Deep Glands.—The deep lymphatic glands of the lower extremity are found 
on the upper part of the imterosseous membrane of the leg, in the popliteal space, 
and in Scarpa’s triangle. 
The anterior tibial gland (lymphoglandula tibialis anterior) is situated near the 
anterior tibial artery on the upper part of the front of the interosseous membrane. 
It receives afferent vessels from the deep parts of the sole and the dorsum of the 
foot, and from the deep parts of the front of the leg. It gives off two efferent 
vessels which pass backwards along the anterior tibial artery and terminate in the 
popliteal glands. 
The popliteal glands (lymphoglandule poplitez) are four or five in number; they 
lie in the popliteal space, generally round the popliteal artery, but occasionally 
there is one immediately beneath the deep fascia near the entrance of the external 
saphenous vein. They receive afferent vessels from the sole of the foot and the back 
of the leg, and from the anterior tibial gland; they also receive the superficial 
lymphatics which accompany the external saphenous vein. The efferent vessels 
join the deep femoral glands. 
The deep femoral glands, three or four in number, le on the inner side of 
the femoral vein, and the largest of the group is embedded in the crural canal. 
Their afferent vessels are the efferents of the popliteal glands, some of the 
efferents from the superficial glands of the groin, and the deep lymphatic vessels 
from the front and outer side of the thigh and knee. Their efferents pass to the 
external iliac glands. 
Lymphatic Vessels of the Lower Extremity.—There are two sets of these 
vessels, (1) the superficial and (2) the deep. 
(1) Superficial Vessels.—The superficial lymphatics he in the subcutaneous 
tissues. They commence in plexuses which are best marked on the plantar aspects 
of the toes and foot. The lymphatic vessels which emerge from the plantar plexus 
in each toe terminate in four digital vessels which are arranged i in pairs along the 
dorso-lateral border of the digit, and these end posteriorly in a plexus on the 
dorsum of the toot. 
Some of the vessels which drain the plexus in the sole of the foot turn round 
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