THE VISCERAL GLANDS OF THE PELVIS. 1015 



The deep lymph vessels of the inferior extremity accompany the deep blood-vessels. 

 Many of the vessel from the leg and foot end in the popliteal glands, but some pass directly to 

 the deep subinguinal glands. ' The deep vessels of the more proximal parts of the inferior 

 extremity end in the deep subinguinal glands and in the hypogastric glands. 



THE LYMPH GLANDS OF THE ANTEKIOR ABDOMINAL WALL. 



Some lymph glands are regularly, and others are occasionally present in the anterior wall 

 of the abdomen. Those fairly regularly present are : 



The inferior epigastric lymph glands, 3-6, which lie along the course of the inferior epigastric 

 artery. Their afferents are from the deep part of the umbilicus and their efferents pass to the 

 inferior external iliac glands. 



The Pubic Gland or Glands. One or more small glands which lie anterior to the suspensory 

 ligament of the penis or clitoris. Their afferents are vessels from the superficial parts of the 

 penis or clitoris, and their efferents end in the proximal superficial subinguinal glands. 



The occasional glands are : 



(1) A superior epigastric gland which sometimes lies in the superficial fascia of the median 

 part of the epigastric region. Its afferents are from the adjacent parts and its efferents pass 

 to the sternal glands. It is probably very rare. 



(2) Circumflex iliac glands, 2-4, which lie along the course of the deep circumflex iliac artery. 



(3) An umbilical gland which lies in the extra-peritoneal tissue below the umbilicus. When 

 it is present it receives vessels from the umbilicus and its efferents go to the external iliac glands. 



(4) Supra-umbilical glands, 1-2, small glands which lie in the extra-peritoneal tissue above 

 the umbilicus. Its afferents are from the region of the umbilicus. The efferents probably pass to 

 the inferior anterior mediastinal glands. 



THE LYMPH VESSELS OF THE ANTERIOR WALL OF THE ABDOMEN. 



The superficial lymph vessels of the upper part of the anterior wall of the abdomen go, for 

 the most part, to the anterior or pectoral group of axillary glands ; but some pierce the wall of 

 the lower part of the thorax and end in the sternal glands. 



The superficial lymph vessels of the lower part of the anterior wall of the abdomen terminate 

 either in the inguinal glands or in the proximal group of superficial subinguinal glands. 



The deep lymph vessels of the upper part of the anterior abdominal wall accompany the 

 superior epigastric vessels and terminate in the sternal glands ; but some may be connected with 

 the supra-umbilical glands if they are present. 



The deep lymph vessels of the lower part of the anterior wall of the abdomen accompany the 

 inferior epigastric vessels, and end in the inferior external iliac glands or the inferior epigastric 

 glands. 



THE LYMPH VESSELS OF THE EXTERNAL GENITALS. 



The lymph vessels of the scrotum in the male and of the labia majora in the female pass 

 to the proximal superficial subinguinal glands, and mostly to the medial group. 



The superficial lymph vessels of the penis go to the medial glands of the proximal subinguinal 

 group. 



The deep lymph vessels of the penis, including those of the penile portion of the urethra, end 

 either in 'the medial glands of the proximal subinguinal group or in the deep subinguinal 

 glands. 



The termination of the lymph vessels of the clitoris is similar to that of the lymph vessels 

 of the penis. 



LYMPH GLANDS OF THE PELVIS AND ABDOMEN. 



The lymph glands of the pelvis are separable into visceral and parietal groups. 



The Visceral Glands of the Pelvis. 



Lymphoglandulae Vesicales. The lymph glands of the urinary bladder form an 

 anterior and two lateral groups. 



(a) The anterior lymph glands of the bladder are variable in number. They 

 lie in the retro-pubic fat and receive afferents from the anterior and antero-lateral 

 parts of the bladder wall. Their efferents go to the external iliac glands. 



(6) The lateral lymph glands of the bladder lie along the course of the umbilical 

 artery on each side. Their afferents are derived from the upper and lateral parts 

 of the bladder and their efferents end in the external iliac glands. 



Lymphoglandulae Anorectales. The ano-rectal lymph glands (2-8) lie in the 

 lower part of the pelvis minor, in relation with the ampullary part of the rectum, 



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