604 THE VEINS 



Sometimes one or two small glands are situated in the acute angle between the 

 posterior vena cava and the diaphragm. 



THE LYMPH GLANDS AND VESSELS OF THE ABDOMEN AND PELVIS 

 The lymph glands of the abdomen consist of two main groups, parietal and 

 visceral. The parietal glands lie in the suljperitoneal or subcutaneous tissue; 

 they receive the lymph vessels from the abdominal and pelvic walls, from parts of 

 the viscera, and from the proximal lymph glands of the pelvic limbs. The visceral 

 glands lie on the walls of the viscera or in the peritoneal folds which connect the 

 organs with the wall or with adjacent viscera. They receive all or most of the 

 lymph vessels from the organs with which they are connected. 

 The parietal glands comprise the following: 



1. The lumbar lymph glands (Lg. lumbales) lie along the course of the abdom- 

 inal aorta and posterior vena cava (Fig. 450). Some are placed along the lower 

 surface and sides of the vessels, others above. A few small glands may be found 

 above the sublumbar muscles. The small nodes which are situated at the hilus 

 of the kidneys are often termed the renal lymph glands. They receive afferent 

 vessels from the lumbar wall of the abdomen and the paired viscera (kidneys, 

 adrenals, genital organs), also the inguinal vessels and the efferents of the iliac 

 glands. Their efferents go to the thoracic duct, constituting the lumbar trunks 

 of origin of that vessel. 



2. The internal iliac lymph glands (Lg. iliacse interna^) are grouped about the 

 terminal part of the aorta and the origins of the iliac arteries (Fig. 450). Their 

 afferent vessels come chiefly from the pelvis, pelvic viscera, and tail, and they receive 

 efferent vessels of the external iliac and deep inguinal glands. 



3. The external iliac lymph glands (Lg. iliacae externse) form a group on either 

 side on the iliac fascia at the bifurcation of the circumflex iliac artery (Fig. 450). 

 Their afferent vessels come from the flank and abdominal floor, the outer surface 

 of the thigh, and the precrural glands. The efferent vessels go to the lumbar and 

 internal iliac glands. 



4. The sacral lymph glands (Lg. sacrales) are small nodes situated along the 

 borders of the sacrum and on its pelvic surface. They receive afferents from the 

 roof of the pelvis and from the tail, and their efferent vessels pass to the internal 

 iliac glands. 



5. The superficial inguinal lymph glands (Lg. inguinales superficiales) lie on 

 the abdominal tunic in front of the external inguinal ring (Fig. 457). They form 

 an elongated group along the course of the subcutaneous alxlominal artery, on 

 either side of the penis in the male, above the mammary glands in the female; 

 in the latter they are often termed mammary. Their afferents come from the inner 

 surface of the thigh, the abdominal floor, the sheath and scrotum in the male, and 

 the mammary glands in the female. The efferent vessels ascend through the 

 inguinal canal and go to the deep inguinal and lumbar glands. 



6. The ischiatic lymph gland (Lg. ischiadica) is a small node which may be 

 found at the lesser sciatic notch. It receives lymph from the adjacent parts 

 and from the popliteal glands, and sends efferents to the sacral and internal iliac 

 glands. 



The visceral glands include the following: 



1. The gastric lymph glands (Lg. gastricse) are situated along the course of 

 th(? gastric arteries. Several occur along the attachment of the gastro-phrenic 

 ligament. A group lies at the lesser curvature a short distance below the cardia. 

 There is another small group on the visceral surface where the posterior gastric 

 artery divides into its i^rimary branches. Two or three small nodes are usually 

 found on the ventral aspect of the pylorus. Other small glands are scattered 



