350 LYMPHATICS OF THE LOWER EXTREMITY. 



converge, to form two groups which accompany the basilic and 

 cephalic veins. The lymphatics of the basilic group communicate 

 with the glands situated immediately above the elbow, and ascend 

 to join the axillary gland. Those of the cephalic group for the 

 most part cross the upper part of the biceps muscle, and also enter 

 the axillary glands, while two or three are continued onwards along 

 the cephalic vein, in the interspace between the pectoralis major and 

 deltoid muscle, to communicate with the subclavian glands. 



The Deep lymphatics accompany the vessels of the upper extre- 

 mity, and communicate occasionally with the superficial lymphatics. 

 They enter the axillary and subclavian glands, and at the root of 

 the neck terminate on the left side in the thoracic duct, and on the 

 right side in the ductus lymphaticus dexter. 



LYMPHATICS OF THE LOWER EXTREMITY. 



The Superficial lymphatic glands of the lower extremity are those 

 of the groin, the inguinal, and one or two situated in the superficial 

 fascia of the posterior aspect of the thigh, just above the popliteal 

 region. 



The Inguinal glands are divisible into two groups, a superior 

 group of small size, situated along the course of Poupart's ligament, 

 and receiving the lymphatic vessels from the parietes of the abdo- 

 men and genital organs ; and an inferior group of larger glands 

 clustered around the internal saphenous vein near to its termination, 

 and receiving the superficial lymphatic vessels from the lower 

 extremity. 



The Deep lymphatic glands are the anterior tibial, popliteal, deep 

 inguinal, gluteal, and ischiatic.' 



The Anterior tibial is generally a single gland, placed on the inter- 

 osseous membrane, by the side of the anterior tibial artery in the 

 upper part of its course. 



The Popliteal glands, four or five in number, are embedded in the 

 loose cellular tissue and fat of the popliteal space. 



The Deep inguinal glands, less numerous and smaller than the 

 superficial, are situated near the femoral vessels in the groin, beneath 

 the fascia lata. 



The Gluteal and ischiatic glands are placed above and below the 

 pyriformis muscle at the great ischiatic foramen. 



The Superficial lymphatic vessels are divisible into two groups, 

 internal and external ; the internal and principal group commencing 

 on the dorsum and inner side of the foot, ascend the leg by the side 

 of the internal saphenous vein^ and passing behind the inner condyle 

 of the femur, follow the direction of that vein to the groin, where 

 they join the saphenous group of superficial inguinal glands. The 

 greater part of the efferent vessels from these glands pierce the 

 cribriform fascia of the saphenous opening and the sheath of the 

 femoral vessels, to join the lymphatic gland situated in the femoral 

 ring, which serves to establish a communication between the lym- 



