634 THE LYMPHATIC SYSTEM 



In the female the lymphatic vessels of the mucous membrane of the labia, 

 nymphse, and clitoris terminate in the upper chain of the inguinal glands. 



The deep lymphatic vessels of the abdomen and pelvis take the course of the 

 principal blood-vessels. Those of the parietes of the pelvis, which accompany 

 the gluteal, ischiatic, and obturator vessels, follow the course of the internal iliac 

 artery, and ultimately join the lumbar lymphatics. 



The efferent vessels from the inguinal glands enter the pelvis beneath Poupart's 

 ligament, where they lie in close relation with the femoral vein ; they then pass 

 through the chain of glands surrounding the external iliac vessels, and finally ter- 

 minate in the lumbar glands. They receive the deep epigastric and circumflex 

 iliac lymphatics. 



The lymphatic vessels of the bladder arise from the entire surface of the 

 organ ; l the greater number run beneath the peritoneum on its posterior surface, 

 and, after passing through the lymphatic glands in that situation, join with the 

 lymphatics from the prostate and vesiculse seminales, and enter the internal iliac 

 glands. 



The lymphatic vessels of the rectum are of large size ; after passing through 

 some small glands that lie upon its outer wall and in the meso-rectum they pass to 

 the sacral glands. 



The lymphatic vessels of the uterus consist of two sets, superficial and deep, 

 the former being placed beneath the peritoneum, the latter in the substance of the 

 organ. The lymphatics of the cervix uteri, together with those from the greater 

 part of the vagina, enter the internal iliac and sacral glands ; those from the body 

 and fundus of the uterus pass outward in the broad ligaments, and, being joined 

 by the lymphatics from the ovaries, broad ligaments, and Fallopian tubes, 

 ascend with the ovarian vessels to open into the lumbar glands ; the lymphatics 

 from the lower part of the vagina join those of the external genitals and pass to 

 the superficial inguinal glands. In the unimpregnated uterus they are small, but 

 during gestation they become very greatly enlarged. 



The lymphatic vessels of the testicle consist of two sets, superficial and deep : the 

 former commence on the surface of the tunica vaginalis, the latter in the epididy- 

 mis and body of the testis. They form several large trunks which ascend with 

 the spermatic cord, and, accompanying the spermatic vessels into the abdomen, 

 terminate into the lumbar glands ; hence the enlargement of these glands in 

 malignant disease of the testis. 



The lymphatic vessels of the kidney arise on the surface, and also in the inte- 

 rior of the organ ; they join at the hilum, and, after receiving the lymphatic vessels 

 from the ureter and suprarenal capsules, open into the lumbar glands. 



The lymphatic vessels of the liver are divisible into two sets, superficial and deep. 

 The former arise in the subperitoneal areolar tissue over the entire surface of the 

 organ. Those on the convex surface may be divided into four groups : 1. Those 

 which pass from behind forward, consisting of three or four branches, which 

 ascend in the falciform ligament and unite to form a single trunk, which passes up 

 between the fibres of the Diaphragm, behind the ensiform cartilage, to enter the 

 anterior mediastinal glands, and finally ascends to the root of the neck, to ter- 

 minate in the right lymphatic duct. 2. Another group, which also incline from 

 behind forward, are reflected over the anterior margin of the liver to its under 

 surface, and from thence pass along the longitudinal fissure to the glands in the 

 gastro-hepatic omentum. 3. A third group incline outward to the right lateral 

 ligament, and, uniting into one or two large trunks, pierce the Diaphragm, and 

 run along its upper surface to enter the anterior mediastinal glands, or, instead 

 of entering the thorax, turn inward across the crus of the Diaphragm and open 

 into the commencement of the thoracic duct. 4. The fourth group incline out- 

 ward from the surface of the left lobe of the liver to the left lateral ligament, 

 pierce the Diaphragm, and, passing forward, terminate in the glands in the ante- 

 rior mediastinum. 



1 Curnow states that they are confined to the hase of the organ. 



