LYMPHATIC GLANDS AND VESSELS OF THE ABDOMEN. 873 
The efferent vessels of the external ilac glands pass to the common iliac and 
to the lumbar glands. 
The obturator gland is frequently absent. When present it les at the 
posterior end of the obturator canal, and is usually small. It receives afferent 
vessels from the deep parts of the upper and inner portion of the thigh, and its 
efferents join the internal iliac glands. 
The sacral glands (lymphoglandul sacrales).—This term is apphed to several 
small glands which lie in the concavity of the sacrum, behind the rectum. They 
receive afferent vessels from the rectum and from the pelvic wall, and their 
efferents end in the subaortic and lumbar glands. 
The sub-aortic glands present many variations both in number and in size. 
They lie in front of the lower lumbar vertebrae, beneath the bifurcation of the 
aorta. Their afferent vessels come from the pelvic walls and from the sacral 
glands, and their efferents accompany the efferents of the internal and common 
iliac glands, to terminate like them in the lumbar and pre-aortic glands. 
The internal iliac glands are numerous but small. They ihe on the lateral 
wall of the pelvis, in front of the imternal ilac artery and the ureter, and in the 
angle between the internal and the external iliac vessels. 
Their afferents are (@) the lymphatics, which accompany the gluteal and sciatic 
vessels from the deep parts of the buttock and back of the thigh: (b) the lym- 
phatics from the deep parts of the upper and inner portion of the thigh and the 
efferents of the obturator gland; (c¢) visceral lymphatics from the lower two-thirds 
of the uterus, the upper two-thirds of the vagina, the bladder, the seminal vesicle 
and vas deferens, the prostate and the upper portion of the urethra, and from 
the root of the penis or clitoris. The efferents of the internal iliac glands 
terminate either in the common iliac glands, in the lumbar glands, or in the pre- 
aortic glands. 
The common iliac glands le along the sides of the common iliac arteries; they 
vary both in number and size; im some bodies there may be only two or three small 
glands, whilst in others there may be several large elands. Their afferent vessels 
are derived chiefly from the external and internal iliac glands, and their efferents 
terminate in the lumbar or the pre-aortic glands. 
Lumbar Glands.—There are two sets of lumbar glands, (@) the lateral and (0) 
the median. 
(a) The lateral lumbar glands, which are of small size, lie close to the transverse 
processes of the lumbar vertebrae under cover of the psoas muscle; they receive 
the afferent vessels, which pieameel the lumbar arteries, from the deeper portions 
of the posterior part of the abdominal wall. Their efferent vessels unite with the 
efferent vessels of the median lumbar glands, and terminate with them, forming 
a common lumbar lymphatic trunk on each side. 
(b) The median lumbar glands lie along the sides of the aorta and the inferior 
vena cava. They are numerous and of large size, and they receive afferent 
vessels (1) from ‘the lumbar portion of the “vertebral column and. the deeper 
portions of the posterior part of the abdominal wall in its immediate neighbour- 
hood ; (2) from the common iliac glands; (5) from the external iliac glands ; (4) 
from the internal iliac elands; (5) from the lateral lumbar glands ; (6) from the 
kidneys ; (7) from the suprarenal bodies ; (8) from the testicles or ov aries ; (9) from 
the upper part of the uterus; (10) from the subaortic glands; (11) from the crura 
of the diaphragm ; (12) from the ascending and descending portions of the colon. 
Their efferent vessels unite with some of the efferent vessels of the lateral lumbar 
glands, and they terminate in two common lumbar lymphatic trunks, one on each 
side, which open into the receptaculum chyh. 
The pre-aortic glands lie in the extra-peritoneal fat in front of the aorta and 
the inferior vena cava; they receive afferent vessels from the mesenteric glands 
and from the sub-aortic glands. Their efferents unite with those of the cceliac 
glands to form a common int@tinal lymphatic trunk which terminates in the 
receptaculum chyh. 
Deep Lymphatic Vessels of the Abdomen and Pelvis.—These require no 
special description. They have already been referred to in describing the deep 
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