706 ANGIOLOGY 







below the cisterna chyli, on the bodies of the third and fourth lumbar vertebrae. 

 They receive lymphatic trunks from the lateral and preaortic glands, while their 

 efferents end in the cisterna chyli. 



The Lymphatic Vessels of the Abdomen and Pelvis. 



The lymphatic vessels of the walls of the abdomen ahd pelvis may be divided 

 into two sets, superficial and deep. 



The superficial vessels follow the course of the superficial bloodvessels and 

 converge to the superficial inguinal glands; those derived from the integument 

 of the front of the abdomen below the umbilicus follow the course of the superficial 

 epigastric vessels, and those from the sides of the lumbar part of the abdominal 

 wall pass along the crest of the ilium, with the superficial iliac circumflex vessels. 

 The superficial lymphatic vessels of the gluteal region turn horizontally around the 

 buttock, and join the superficial inguinal and subinguinal glands. 



The deep vessels run alongside the principal bloodvessels. Those of the parietes 

 of the pelvis, which accompany the superior and inferior gluteal, and obturator 

 vessels, follow the course of the hypogastric artery, and ultimately join the lateral 

 aortic glands. 



Lymphatic Vessels of the Perineum and External Genitals. The lymphatic vessels 

 of the perineum, of the integument of the penis, and of the scrotum (or vulva), 

 follow the course of the external pudendal vessels, and end in the superficial ingui- 

 nal and subinguinal glands. Those of the glans penis vel clitoridis terminate 

 partly in the deep subinguinal glands and partly in the external iliac glands. 



The visceral glands are associated with the branches of the celiac, superior 

 and inferior mesenteric arteries. Those related to the branches of the celiac 

 artery form three sets, gastric, hepatic, and pancreaticolienal. 



The Gastric Glands (Figs. 613, 614) consist of two sets, superior and inferior. 



The Superior Gastric Glands (lymphoglandulce gastricce superiores) accompany 

 the left gastric artery and are divisible into three groups, viz.: (a) upper, on the 

 stem of the artery; (6) lower, accompanying the descending branches of the artery 

 along the cardiac half of the lesser curvature of the stomach, between the two layers 

 of the lesser omentum; and (c) paracardial outlying members of the gastric glands, 

 disposed in a manner comparable to a chain of beads around the neck of the stomach 

 (Jamieson and Dobson 1 ). They receive their afferents from the stomach; their 

 efferents pass to the celiac group of preaortic glands. 



The Inferior Gastric Glands (lymphoglandulas gastricce inferiores; right gastro- 

 epiploic gland), four to seven in number, lie between the two layers of the greater 

 omentum along the pyloric half of the greater curvature of the stomach. 



The Hepatic Glands (lymphoglandulcehepaticce) (Fig. 613), consist of the follow- 

 ing groups: (a) hepatic, on the stem of the hepatic artery, and extending upward 

 along the common bile duct, between the two layers of the lesser omentum, as 

 far as the porta hepatis; the cystic gland, a member of this group, is placed near 

 the neck of the gall-bladder; (6) subpyloric, four or five in number, in close relation 

 to the bifurcation of the gastroduodenal artery, jn the angle between the superior 

 and descending parts of the duodenum; an outlying member of this group is some- 

 times found above the duodenum on the right gastric (pyloric) artery. The glands 

 of the hepatic chain receive afferents from the stomach, duodenum, liver, gall- 

 bladder, and pancreas; their efferents join the celiac group of preaortic glands. 



The Pancreaticolienal Glands (lymphoglandulas pancreaticolienales; splenic 

 glands) (Fig. 614) accompany the lienal (splenic) artery, and are situated in rela- 

 tion to the posterior surface and upper border of the pancreas; one or two members 



1 Lancet, April 20 and 27, 1907. 





