992 



HUMAN ANATOMY. 



Fig 



ring, 



separation of the nodes which lie respectively above and below a horizontal line 

 drawn through the point at which the long saphenous vein pierces the cribriform 

 fascia, and to those lying above this lihe the term inguinal nodes (lymphoglandulae 

 inguinales) is applied, while those below it are termed the subinguinal nodes 

 (lymphoglandulae subinguinales). This latter subgroup is again di\'ided into a super- 

 ficial (lymphoglandulae subinguinales superticiales) and a deep (lymphoglandulae sub- 

 inguinales profundae) set, according as they are situated on or beneath the fascia lata. 

 Finally, by means of a vertical line passing through the orifice in the cribriform fascia 

 through which the long saphenous vein passes, the inguinal and superficial subinguinal 

 groups are each subdivided into an inner and an outer set, a small central group of 

 nodes, surrounding the saphenous orifice, being also sometimes recognizable. It 

 may, however, again be emphasized that these subdivisions are purely conventional 

 and cannot always be clearly distinguished, nor do they represent, except in a very 



general way, the terminations of definite drainage 

 areas. Indeed, the numerous connections which 

 exist between the nodes of the various subgroups 

 cause their distinction to be of comparatively little 

 importance from the surgical stand-point. 



The inguinal nodes are arranged in a more 

 ( V or less distinct chain over the base of Scarpa's 



\ ,-^ ^ triangle, immediately below Poupart's ligament. 



They receive as afferents the superficial lymphatics 

 ii 1|l\ / of the abdominal walls and the gluteal region, the 



I' ''^> il superficial vessels of the scrotum and penis in the 



male and of the labia majora and minora in the 

 female, as well as those from the perineum and 

 the circumanal region. Their efferents perforate the 

 cribriform fascia, enter the abdomen by the femoral 

 and terminate in the lower iliac nodes. 

 The superficial subinguinal nodes receive 

 some afferents from the gluteal regions and also 

 some from the perineum and circumanal regions, but 

 the principal set is formed by the superficial vessels 

 of the leg. Their efferents have essentially the 

 same course as those of the inguinal nodes, piercing 

 the cribriform fascia to accompany the femora] 

 vessels to the abdomen, where they terminate in the 

 lower iliac nodes. In their course through the 

 femoral sheath some of them lie on the anterior 

 surface of the vessels, but the majority lie on their 

 inner side in the crural canal and some of them 

 terminate in the deep subinguinal nodes. 



The deep subinguinal nodes vary in number 

 from one to three. They are placed along the 

 course of the femoral vein, one occurring immediately beneath the point of junction 

 of the long saphenous vein with the femoral, a second a little higher up in the crural 

 canal, and the third, termed by French authors the node of Cloqnet and by the 

 Germans th^ node of RosenmuIIer, is situated at the entrance into the crural canal 

 from the abdomen. Their principal afferents are the deep lymphatics of the thigh 

 which accompany the femoral vessels and their branches, but in addition they receive 

 stems from the superficial subinguinal nodes and the deep vessels of the penis and 

 clitoris. Their efferents pass, like those of the superficial nodes, to the lower iliac 

 nodes. 



The popliteal nodes (lymphoglandulae popliteae) are some four or more in 

 number and are embedded in the adipose tissue of the popliteal space (Fig. 832). 

 One or two occur in the neighborhood of the short saphenous vein immediately 

 after it has entered the popliteal space, while the rest are situated more deeply upon 

 the popliteal vessels. The more superficial nodes receive as afferents the superficial 

 lymphatics of the leg which accompany the short saphenous vein, while the deeper 



Superficial inguinal lymph-nodes; 

 horizontal line subdivides nodes into 

 upper and lower groups; vertical line 

 into median and lateral groups. 



