OF THE LOWER EXTREMITY. 



631 



Superficial 

 inguinal 

 glands. 





2=1, 



The anterior tibial gland is not con- 

 stant in its existence. It is generally 

 found by the side of the anterior tibial 

 artery, upon the interosseous mem- 

 brane at the upper part of the leg. Occa- 

 sionally, two glands are found in this v Y 

 situation. 



The popliteal glands, four or five in 

 number, are of small size ; they surround 

 the popliteal vessels, imbedded in the cel- 

 lular tissue and fat of the popliteal space. 



The deep inguinal glands are placed 

 beneath the deep fascia around the femoral 

 artery and vein. They are of small size, 

 and communicate with the superficial 

 inguinal glands through the saphenous 

 opening. 



The gluteal and ischiatic glands are 

 placed, the former above, the latter below, 

 the Pyriformis muscle, resting on their 

 corresponding vessels as they pass through 

 the great sacro-sciatic foramen. 



The Lymphatic Vessels of the Lower 

 Extremity, like the veins, may be divided 

 into two sets, superficial and deep. 



The superficial lymphatic vessels are 

 placed beneath the integument in the 

 superficial fascia, and are divisible into 

 two groups : an internal group, which fol- 

 low the course of the internal saphenous 

 vein ; and an external group, which ac- 

 company the external saphenous. The 

 internal group, the larger, commence on 

 the inner side and dorsum of the foot; 

 they pass, some in front and some behind, 

 the inner ankle, run up* the leg with the 

 internal saphenous vein, pass with it be- 

 hind the inner condyle of the femur, and 

 accompany it to the groin, where they ter- 

 minate in the group of superficial inguinal 

 lymphatic glands which surround the 

 saphenous opening. Some of the efferent 

 vessels from these glands pierce the cribri- 

 form fascia and sheath of the femoral ves- 

 sels, and terminate in a lymphatic gland 

 contained in the femoral canal, thus estab- 

 lishing a communication between the lym- 

 phatics of the lower extremity and those 

 of the trunk ; others pierce the fascia lata 

 and join the deep inguinal glands. The 

 external group arise from the outer side 

 of the foot, ascend in front of the leg, 

 and, just below the knee, cross the tibia 

 from without inward, to join the lym- 

 phatics on the inner side of the thigh. 

 Others commence on the outer side of 



F IG- 34i._The superficial lymphatics and glands 



the foot, pass behind the outer malleolus, O f the lower extremity. 



