THE LEG 



363 



Cisterna chyli 



Lumb 



ir lymph , 

 glands'"! 



Crest of ilium ^ .. 

 Common iliac,, 

 lymph gland 



Hypogastric 

 lymph glands' 



which carry lymph to a gland are called afferent lymph vessels, and those 

 which carry it away are efferent lymph vessels. All the lymph from both 

 inferior extremities flows to the commencement of the thoracic duct which 

 lies in the abdominal region in 

 front of the second lumbar verte- 

 bra, where it frequently possesses 

 a dilated extremity called the 

 ci sterna chyli. On its way it 

 passes through a series of glands, 

 and as noxious materials which 

 have entered the lymph vessels 

 may be caught in the glands and 

 there set up inflammation or pro- 

 duce new malignant growths, it is 

 important to bear in mind con- 

 stantly the general positions of the 

 glands and the areas from which 

 they receive lymph. 



There are two sets of lymph 

 vessels and lymph glands in the 

 inferior extremity, the deep and 

 the superficial. 



The deep lymph glands are, 

 (i) the anterior tibial, (2) the 

 popliteal, (3) the deep subinguinal. 

 The anterior tibial gland lies close 

 to the proximal end of the anterior 

 tibial artery in the anterior com- 

 partment of the leg. The popliteal 

 glands lie in the popliteal fossa 

 around the popliteal vessels. The 

 deep subinguinal glands are situ- 

 ated in the femoral triangle, in 

 the femoral canal of the femoral 

 sheath. The deep lymph vessels 

 which pass to the deep glands run 

 along the main blood-vessels, and 

 they carry lymph drained from all 

 the deeper structures of the limb, 

 the muscles, ligaments, bones, and 

 joints. The lymph from the deep 

 parts of the leg, foot, and knee 

 passes through the popliteal glands 

 to the deep subinguinal glands ; 

 that from the medial, anterior, 

 and lateral parts of the thigh is 

 carried to the deep subinguinal 

 glands ; but the lymph from the 

 deep parts of the back of the 

 thigh and the buttock, flowing 

 through lymph vessels which accompany the inferior and superior gluteal 

 vessels, passes into the pelvis to the hypogastric glands, and through 

 them to the common iliac and lumbar glands on its way to the thoracic 

 duct. 



The superficial lymph glands of the inferior extremity are the subinguinal 

 lymph glands to which attention was directed in association with the 



Lymph vessels 

 which convey lymph | 

 to lower medial sul>--< 

 inguinal lymph 

 glands 



Popliteal lymph gland" 

 Lymph vessels which 

 accompany the small, 

 saphenous vein 



FIG. 160. Diagram of the Lymph 

 Vessels of the back of the Inferior 

 Extremity. 



