LYMPHATIC VESSELS OF ABDOMINAL AXD PELVIC VISCERA 799 



phragm to end in the nodes around the terminal part of the inferior vena cava. 

 The descending trunks emerge from the transverse fissure, and end in the hepatic 

 nodes. 



The lymphatic vessels of the gall-bladder pass to the hepatic nodes in the 

 transverse fissure of the liver; those of the common bile duct to the hepatic nodes 

 along the duct and into the upper pancreaticoduodenal nodes. 



The lymphatic vessels of the pancreas arise from a network about the pan- 

 creatic lobules. The collecting trunks anastomose freely among themselves and 

 with the lymphatics of the duodenum, spleen, and in the mesentery and meso- 

 colon; 1 some end in the pancreaticoduodenal nodes, and others in the preaortic 

 nodes, near the origin of the superior mesenteric artery. 



2. The lymphatics of the spleen and suprarenal glands. 



The lymphatic vessels of the spleen, both superficial and deep, pass to the 

 splenic nodes in the lienorenal ligament and along the superior border of the 

 pancreas. 



The lymphatic vessels of the suprarenal glands usually accompany the supra- 

 renal veins, and end in the lateral aortic nodes; occasionally some of them pierce 

 the crura of the Diaphragm and terminate in the nodes of the posterior medi- 

 astinum. 



3. The lymphatic vessels of the urinary organs. 



The lymphatic vessels of the kidney form three plexuses one in the substance 

 of the kidney, a second beneath its fibrous capsule, and a third in the perinephric 

 fat; the second and third communicate freely with each other. 



The vessels from the plexus in the kidney substance converge to form four or 

 five trunks which issue at the hilum. Here they are joined by vessels from the 

 plexus under the capsule, and, following the course of the renal vein, end in the 

 lateral aortic nodes. The perinephric plexus is drained directly into the upper 

 lateral aortic nodes. 



The lymphatic vessels of the ureter run in different directions. Those from 

 its upper portion end partly in the efferent vessels of the kidney and partly in the 

 lateral aortic nodes; those from the portion immediately above the pelvic brim 

 are drained into the common iliac nodes; while the vessels from the intrapelvic 

 portion of the tube join the eft'erents from the bladder, or terminate in the internal 

 iliac nodes. 



The lymphatic vessels of the bladder (Fig. 575) originate in two plexuses, an 

 intramuscular and an extra muscular, it being generally admitted that the mucous 

 membrane is devoid of lymphatics. 2 The efferent vessels are arranged in two 

 groups, one from the anterior and another from the posterior surface of the 

 bladder. The vessels from the anterior surface pass to the external iliac nodes, 

 but in their course minute nodes are situated. These minute nodes are arranged 

 in two groups, an anterior vesical group, in front of the bladder, and a lateral 

 vesical, in relation to the hypogastric artery. The vessels from the posterior 

 surface pass to the internal, external, and common iliac nodes; those draining 

 the upper part of this surface traverse the lateral vesical nodes. 



The lymphatic vessels of the prostate (Fig. 575) terminate chiefly in the internal 

 iliac and sacral nodes, but one trunk from the posterior surface ends in the 

 external iliac nodes, and another from the anterior surface joins the vessels which 

 drain the membranous part of the urethra. 



Lymphatic Vessels of the Urethra. The lymphatics of the penile portion of 

 the urethra accompany those of the glans penis, and terminate with them in 

 the deep inguinal and external iliac nodes. Those of the membranous and 



1 P. Bartels, Ueber die Lymphgefusse des Pankreas, Archiv f. Anat. u. Physio!., 1907. 



- Some authorities maintain that a plexus of lymphatic vessels does exist in the mucous membrane of the 

 bladder (consult M^decine operatoire des Voies urinaires, par J. Albarran, Paris, 1909). 



