THE LYMPH VESSELS OF THE PELVIC VISCEEA. 1017 



Lymphoglandulae Subaorticae. The subaortic lymph glands (1-3) lie on the 

 anterior aspect of the fifth lumbar vertebra. Their afferents are from the sacral 

 glands, the hypogastric glands, and the external iliac glands. Their efferents go 

 to the aortic glands (Fig. 817). 



Lymphoglandulae Hypogastricae. The hypogastric lymph glands form right 

 and left groups, which are associated with the corresponding hypogastric vessels. 

 As a rule they he near the origins of the main branches of the hypogastric artery, 

 or in the angles between the branches, and they, therefore, are separable into a 

 number of groups. 



The Gluteal Lymph Glands lie in relation to the superior gluteal artery and receive 

 afferents from the gluteal region. Their efferents pass to the common iliac glands. 



The Pubo-gluteal Lymph Glands (1-2) he in relation to the origins of the inferior 

 gluteal and internal pudendal arteries. They receive afferents from the thigh 

 and perineum and their efferents end in the common iliac glands. 



The Middle Hsemorrhoidal Gland lies more medially than the other glands of 

 the group, close to the lateral wall of the rectum at the point where the middle 

 hsemorrhoidal artery breaks up into its terminal branches. It receives afferents 

 from the rectum and gives efferents to the other hypogastric and to the external 

 iliac glands. 



The Inter-iliac Glands lie in the angle between the external iliac and the 

 hypogastric arteries, and cannot be clearly disassociated from the medial external 

 iliac glands. They receive afferents from the lower parts of the pelvic portions 

 of the genito-urinary organs. Their efferents pass to the common iliac glands. 



The Obturator Gland lies at the inner end of the obturator canal, above the 

 obturator vessels. It receives afferents from the upper and medial parts of the 

 thigh and its efferents join the inter-iliac and common iliac glands. 



Lymphoglandulae Iliacae. The iliac lymph glands are separable into a lower 

 group, associated with the external iliac artery, lymphoglandulse iliacae externae, 

 and an upper group, the lymphoglandulae iliacse communes. 



The External Iliac Glands. According to Poirier and Cuneo, the external iliac 

 lymph glands form three chains, lateral, intermediate, and medial, which lie, 

 respectively, at the lateral side, anterior to, and at the medial side of the external 

 iliac vessels. The three lowest members of the group, that is the lowest member 

 of each chain, lie in close relation to the abdominal aperture of the femoral ring, 

 and are frequently spoken of as supra-femoral glands. They receive afferents 

 from the superficial subinguinal and the deep subinguinal glands, from the 

 urethra and the deeper parts of the penis, and from the portions of the abdominal 

 wall supplied by the deep circumflex iliac and inferior epigastric arteries. Their 

 efferents end in the upper glands of the external iliac group. 



The higher members of the external iliac lymph glands receive afferents from 

 the membranous part of the urethra, the prostate, the bladder, the vagina, and 

 the neck of the uterus. They are connected by anastomoses with the hypo- 

 gastric glands, particularly the middle hsemorrhoidal gland, and their efferents pass 

 to the common iliac glands. 



The Common Iliac Lymph Glands. The glands of the common iliac group are 

 sometimes separated into a lateral and intermediate and a medial series. The 

 lateral and intermediate groups are quite distinct, the former lying along the 

 lateral margin of the artery and the latter posterior to it, but the medial group 

 is not clearly defined from the sub-aortic group already mentioned. Indeed 

 the sub-aortic group may be looked upon as constituted by the medial common 

 iliac glands of opposite sides. 



The common iliac glands receive afferents from the external iliac and the 

 hypogastric glands, and consequently from practically the whole of the pelvic 

 contents, except the ovaries of the female. 



THE LYMPH VESSELS OF THE PELVIC VISCERA. 



The Lymph Vessels of the Urethra of the Male. It has been pointed put that the 

 lymph vessels of the greater part of the penile portion of the urethra are said to pass to 

 the deep subinguinal glands. The lymph vessels of the bulbar and membranous parts of the 



