THE LYMPHATIC VESSELS OF THE LOWER EXTREMITY 789 



The deep inguinal nodes (lymphoglan- 

 dulae subinguinales profundae) (Fig. 565) 

 vary from one to three in number, and 

 are placed under the fascia lata, on the 

 inner side of the femoral vein. When 

 three are present, the lowest is situated 

 just below the junction of the internal 

 saphenous and femoral veins, the middle 

 in the femoral (crural) canal, and the 

 highest in the outer part of the femoral 

 ring. The middle is the most incon- 

 stant of the three, but the highest one, 

 the node of Cloquet, or Rosenmiiller, is 

 also frequently absent. They receive as 

 afferents the deep lymphatic trunks 

 which accompany the femoral vessels, 

 .the lymphatics from the glans penis or 

 glans clitoridis, and also some efferents 

 from the superficial inguinal nodes. 



Applied Anatomy. Inflammation and sup- 

 puration of the popliteal nodes are most com- 

 monly due to a sore on the outer side of the 

 heel. 



The inguinal nodes frequently become en- 

 larged in diseases implicating the parts from 

 which their lymphatics originate. Thus, in 

 malignant or syphilitic affections of the prepuce 

 and penis, or labia majora, in cancer scroti, in 

 abscess in the perineum, or in similar diseases 

 affecting the integument and superficial struc- 

 tures in those parts, or the subumbilical part 

 of the abdominal wall, or the gluteal region, 

 the upper chain of nodes is almost invariably 

 enlarged, the lower chain being implicated in 

 diseases affecting the lower limb. 



Superficial 



inguinal 



nodes. 



The Lymphatic Vessels of the Lower 

 Extremity. 



The lymphatic vessels of the lower 

 extremity consist of two sets, superficial 

 and deep, and in their distribution corre- 

 spond closely with the veins. 



The superficial lymphatic vessels of 

 the lower extremity are placed beneath 

 the integument in the superficial fascia, 

 and are divisible into three sets trunks 

 which follow the course of the internal 

 saphenous vein, trunks which accompany 

 the external saphenous, and trunks from 

 the gluteal region. (1) Trunks which fol- 

 low the course of the internal saphenous 

 vein arise from a plexus on the dorsum 

 of the foot, which plexus obtains lym- 

 phatics from all the toes, the sole, and both 



FIG. 566. The superficial lymphatics and nodes 

 of the lower extremity. 



