790 THE VASCULAR SVSTKM8 



borders of the foot. The internal trunks, three or four in number, pass to the 

 superficial inguinal nodes. The external trunks run upward and inward and 

 end in the internal trunks. (2) The trunks which follow the external saphenous 

 vein number two or three, and they take origin from the heel and from the posterior 

 half of the outer edge of the foot. They empty into the superficial inguinal 

 nodes. (3) The lymph trunks from the gluteal region join vessels from the anus 

 and enter the superficial inguinal nodes. 



The deep lymphatic vessels of the lower extremity are few in number, and 

 accompany the deep bloodvessels. In the leg they consist of three sets, the anterior 

 tibial, peroneal, and posterior tibial, which accompany the corresponding blood- 

 vessels, two or three to each artery; they ascend with the bloodvessels and enter 

 the lymph nodes in the popliteal space; the efferent vessels from these nodes 

 accompany the femoral vein and join the deep inguinal nodes; from these nodes 

 vessels pass beneath Poupart's ligament and communicate with the chain of nodes 

 surrounding the external iliac vessels. The deep lymphatic vessels of the gluteal 

 and sciatic regions follow the course of the bloodvessels, and join the gluteal and 

 sciatic nodes at the great sacrosciatic foramen. 



THE LYMPHATICS OF THE PELVIS AND ABDOMEN. 



The lymphatics of the pelvis and abdomen may be divided from their situation 

 into (a) parietal, lying retroperitoneally and in close association with the larger 

 bloodvessels; and (6) visceral, which are found in relation to the visceral arteries. 



The parietal nodes (Fig. 567) include the following groups: 



External iliac. ( Lateral aortic. 



Internal iliac. Lumbar < Preaortic. 



Common iliac. ( Retroaortic. 



The external iliac nodes form three chains around the external iliac vessels. 

 An external chain of three or four nodes lies between the artery and the Psoas 

 muscle. A middle chain of three nodes lies upon the front surface of the external 

 iliac vein. An internal chain of three or four nodes is placed to the inner side 

 of the external iliac vein. An obturator node belongs to the inner chain of external 

 iliac nodes. The external iliac nodes receive vessels from the superficial and 

 deep inguinal nodes, from the glans penis or glans clitoris, deep lymphatics from 

 the umbilicus and lower part of the belly wall, vessels from the superior portion 

 of the vagina, the uterine cervix, the prostate gland, the bladder, the membranous 

 portion of the urethra, and the internal iliac nodes, and the obturator node 

 receives deep lymph vessels from along the course of the obturator vessels. 

 The external iliac nodes send vessels direct to the common iliac nodes and also 

 lymphatics to join vessels from the internal iliac nodes on their way to the 

 common iliac group. The nodes along the epigastric artery and those along 

 the deep circumflex iliac artery are accessory chains to the main group of external 

 iliac nodes. 



The internal iliac or hypogastric nodes (lymphoglandulae hypogastricae) .sur- 

 round the internal iliac vessels, and receive the lymphatics corresponding to the 

 distribution of the branches of the internal iliac artery; /. e., lymphatics from 

 all the pelvic viscera, from the deeper parts of the perineum including the mem- 

 branous and penile portions of the urethra, from the deep tissues of the posterior 

 portion of the thigh, and from the buttocks. Their efferents pass to the common 

 iliac nodes and also to the external iliac nodes.- 



