THE LYMPHATICS OF THE LOWER EXTREMITY. 



993 



Popliteal 

 artery 



Popliteal 

 node 



Popliteal 

 vein 



Popliteal 

 node 



Popliteal lymph-nodes. (Poirier and Ctineo.*) 



ones receive the vessels which accompany the branches of the popHteal vessels and 



also those accompanying the anterior and posterior tibial vessels. Their efferents for 



the most part accompany the 



femoral vessels to terminate in Fig. 832. 



the deep subinguinal nodes. 



The anterior tibial node 

 (lymphoglandula tibialis anterior) 

 is a small and probably inconstant 

 node situated in the upper part 

 of the course of the lymphatic 

 vessels which accompany the 

 anterior tibial artery. Its effcr-. 

 enfs pass upward along with 

 the anterior tibial and popliteal 

 blood-vessels to terminate in the 

 deeper popliteal nodes. 



The Lymphatic Vessels. 



The lymphatic vessels of the 

 lower extremity may be divided 

 into two groups, one of which 

 consists of the subcutaneous net- 

 work and its efferent stems and 

 the other of those vessels which 

 accompany the principal blood- 

 vessels. 



The superficial lymphat- 

 ics take their origin from a 

 net-work distributed throughout all portions of the subcutaneous tissue of the 

 extremity, but increasing in richness and complexity toward the distal part of the 

 limb, until in the foot, and especially in the plantar region, it forms a very close and 

 abundant net-work. This plantar net-work extends not only throughout the entire 

 plantar region, but curves dorsally upon both the outer and inner borders of the foot, 

 and also over the posterior surface of the heel, and from these lateral and posterior 

 portions of the net-work as well as from the subcutaneous net-work of the digits 

 numerous collecting stems arise. These anastomose abundantly, and those from the 

 digits, the whole of the inner border of the foot and the distal half of its outer border 

 form an open plexus upon the dorsum of the foot. The stems, several in number, 

 which arise from this plexus pass upward along the inner surface of the leg 

 (Fig. 833), following in general the course of the long saphenous vein and receiving 

 as they go commuitications from the superficial net-works of the regions they 

 traverse. In the neighborhood of the knee stems arising from the net-work over 

 the anterior tibial region become associated with them, and above the knee branches 

 which drain the net-work of the outer, inner, and posterior surfaces of the thigh also 

 curve upward and inward or forward, as the case may be, to accompany them. 

 The numerous stems so formed are all situated superficially to the fascia lata, and 

 terminate above in the superficial subinguinal nodes, the more anterior stems passing 

 to the outer and the more posterior to the inner members of the group. 



The stems which arise from the calcaneal portion of the plantar net-work and 

 from that portion of it which curves upward over the posterior half of the outer 

 border of the foot, pass upward upon the posterior surface of the crus in company 

 with the short saphenous vein. They receive communications from the superficial 

 net-work of the calf and, as they approach the bend of the knee, they perforate the 

 crural fascia and terminate in the more superficial popliteal nodes. 



Finally, from the net-work over the gluteal region a number of collecting stems 

 arise, the majority of which curve forward and converge to terminate in the outer 

 inguinal nodes, some from the more posterior portions of the net-work, however^ 



* Poirier et Charpy : Traits d'anatomie humaine. Tome ii., 1902- 



63 



