1014 



THE VASCULAR SYSTEM. 



Lymph vessels which pass 



to the proximal superficial 



subinguinal glands 



Lymph vessels which 

 pass to the medial 

 group of proximal 

 superficial sub- 

 inguinal glands 



Lymph vess 

 which pass to distal 

 group of superficial 

 subinguinal glands 



Popliteal glands ir~Hr 



Lymph vessels which 

 accompany the small- 

 saphenous vein 



The more medial members of the proximal group receive afferents from the 

 anal canal, the perineum, the scrotum, the penis, and the pubic region in the male, 



and from the corresponding parts, including the 

 lower part of the vagina, in the female. 



The distal group of superficial subinguinal 

 glands lies along the line of the proximal part 

 of the great saphenous vein some on its lateral 

 and some on its medial side. They receive 

 afferents bearing lymph from the superficies of 

 the greater part of the inferior extremity, with 

 the exception of the lateral part of the foot, the 

 heel, and a part of the posterior aspect of the leg. 



The efferents of both proximal and distal groups 

 of subinguinal glands pass to the deep subinguinal 

 glands. 



The Deep Lymph Glands of the inferior 

 extremity are the popliteal and the deep sub- 

 inguinal glands. Occasionally a deep gland is 

 met with in the leg in relation with the proximal 

 third of the anterior tibial artery. 



Lymphoglandulae Poplitese. The popliteal 

 lymph glands (Fig. 812) lie in the popliteal fossa. 

 One is usually situated, comparatively super- 

 ficially, at the point where the small saphenous 

 vein pierces the deep fascia and enters the fossa. 

 It receives afferents, which .accompany the small 

 saphenous vein, from the lateral part of the foot, 

 the heel, and the posterior part of the calf. Its 

 efferents pass to the deeper glands. 



The deeper glands lie in the fat around the 

 popliteal vessels and are sometimes separated into 

 inter-condylar and supra-condylar groups. Their 

 afferents are derived from the more superficial 

 gland and from the deeper tissues of the leg and 

 foot. Their efferents pass to the deep subinguinal 

 glands. 



Lymphoglandulae Subinguinales Profundse. 

 The deep subinguinal glands (Figs. 807, 811, 817) 

 lie in the femoral trigone. They are small glands, 

 FIG. 812. DIAGRAM OF THE LYMPH three to seven in number, which are difficult to 

 VESSELS OF THE POSTERIOR PART OF demonstrate. Some of them lie in the femoral 

 THE LOWER EXTREMITY. -, ,, i i -j. *. j 



canal, the most proximal being situated in or 



close to the femoral ring. Their afferents are the efferents of the other glands 

 of the lower extremity, and, in addition, vessels from the deeper parts of the penis 

 or the clitoris. Their efferents pass to the external iliac glands. 



THE LYMPH VESSELS OF THE INFERIOR EXTREMITY. 



The arrangement of the superficial lymph vessels of the toes and the foot is very similar 

 to that met with in the fingers and the hand. From lymph plexuses on the plantar aspect 

 vessels pass to the dorsum of the foot and toes, where they unite into a number of vessels, the 

 majority of which accompany the great saphenous vein and terminate in the distal group of 

 superficial subinguinal glands. Some of the lymph from the lateral part of the plantar surface 

 and from the lateral border of the foot, and the lymph from the heel enters vessels which 

 accompany the small saphenous vein; they end either in the more superficial gland of the 

 popliteal fossa or in the deeper glands of that region (Fig. 812). 



With the exception of the lymph vessels from the lateral and posterior part of the leg, which 

 accompany the small saphenous vein to the popliteal glands, all the superficial lymph vessels o: 

 the leg, thigh, and buttock pass to the superficial subinguinal glands ; those from the leg ai 

 thigh mainly to the glands of the distal group ; those of the buttock chiefly to the latera 

 glands of the proximal group. 



