LYMPHATICS OF THE LOWER EXTREMITY. 355 



elbow. The greater part reach their destination by passing along the dorsa* 

 surface of the fingers, wrist, and fore-arm, and then curving around the 

 borders of the latter ; but some few are met with in the palm of the hand, 

 which take the direction of the median vein. At the bend of the elbow 

 the lymphatics arrange themselves into two groups ; an internal and larger 

 group, which communicates with a gland situated just above the inner 

 condyle, and then accompanies the basilic vein upwards to the axilla to 

 enter the axillary glands ; and a small group which follows the course of 

 the cephalic vein. Several of the vessels of this group cross the biceps 

 muscle at its upper part to enter the axillary glands, while the remainder, 

 two or three in number, ascend with the cephalic vein in the interspace of 

 the deltoid and pectoralis major ; these latter usually join a small gland in 

 this space, and then cross the pectoralis minor muscle to become continu- 

 ous with the subciavian lymphatics. 



Besides the lymphatic vessels of the arm, the axillary glands receive 

 those from the integument of the chest, its anterior, posterior, and lateral 

 aspect, and the lymphatics of the mammary gland. 



The Deep lymphatics accompany the vessels of the upper extremity, and 

 communicate occasionally with the superficial lymphatics. They enter the 

 axillary and subciavian 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 lym- 

 phatic us 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 abdomen, gluteal region, peri- 

 neum, and genital organs ; and an inferior group of larger glands clustered 

 around the internal saphenous vein near its termination, and receiving the 

 superficial lymphatic vessels from the lower extremity. 



The Deep lymphatic glands are the anterior tibialj popliteal, deep ingui- 

 nal, gluteal , and ischiatic. 



The interior tibial is generally a single gland, placed on the interosse- 

 ous membrane, by the side of the anterior tibial artery in the upper part 

 of its course. 



The Popliteal glands , four or five in number and small, are embedded 

 in the loose areolar 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 near the vessels of that 

 name, 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 dorsuru 

 and inner side of the foot, ascend the leg by the side of the internal sa- 

 phenous 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 



