398 ABDOMEN 



three glands placed one on each side and one in front of the 

 external iliac artery, and immediately above the inguinal liga- 

 ment. The medial gland receives the deep femoral lymph 

 vessels ; into the anterior gland is poured the lymph which 

 is drained from the district supplied by the inferior epigastric 

 artery ; whilst the lateral gland receives the lymph from the 

 district supplied by the deep circumflex iliac artery. The 

 efferent vessels from the lower group enter the higher group 

 of glands, and from those the lymph is passed on to the 

 common iliac and lumbar glands. 



The common iliac glands lie alongside the common iliac 

 arteries. They receive the efferents of the external iliac and 

 hypogastric glands, and their own efferents pass to the lumbar 

 lymph glands. 



The glands in relation to each side of the aorta and 

 inferior vena cava are both numerous and large, and are 

 called the lumbar lymph glands. Their efferent vessels 

 terminate in two common lumbar lymph trunks, which open 

 into the cisterna chyli. 



Cisterna Chyli (O.T. Receptaculum Chyli). The cisterna 

 chyli is the dilated commencement of the thoracic duct. It is 

 placed upon the bodies of the first and second lumbar vertebrae, 

 in the interval between the right crus of the diaphragm and the 

 aorta. To bring it into view, it is necessary to separate the 

 right crus from the lumbar vertebrae and pull it aside. When 

 fully displayed, the Cisterna chyli is seen to be a narrow elon- 

 gated sac, about two inches in length, which receives at its 

 lower end the two common lumbar lymph trunks, whilst, 

 superiorly, it contracts and becomes the thoracic duct. 

 About its middle it is joined, anteriorly, by the intestinal 

 lymph trunk. Entering it near its upper end are two lymph 

 trunks which carry lymph from the lower intercostal glands ; 

 they reach it by passing downwards through the aortic 

 opening. The vena azygos lies along its right side, but the 

 cisterna chyli is easily distinguished from the vein by the 

 whiteness of its walls. The thoracic duct enters the thorax 

 by passing through the aortic opening of the diaphragm. 



Vena Azygos. The azygos vein (O.T. vena azygos major] 

 takes origin as the continuation of the right ascending lumbar 

 vein (p. 408), or from the back of the inferior vena cava. 

 It will be found in the interval between the right crus of the 

 diaphragm and the aorta, upon the right side of the cisterna 



