550 THE LYMPHATICS OF THE LOWER LIMB. 



muscle and end in the popliteal glands. From the middle line of the back of 

 the thigh lymphatics pass round on both sides to reach the inguinal glands. 



The deep-seated lymphatics of the lower limb are associated in their 

 whole course with the deep blood-vessels. In the leg they consist of three 

 divisions, namely, anterior tibial, posterior tibial, and peroneal. Neither these nor 

 the superficial absorbents pass through any lymphatic gland in the leg, unless it be 

 those lymphatics which accompany the anterior tibial artery, near which a small 

 anterior tibial gland is sometimes found on the front of the interosseous membrane 

 above the middle of the leg. The several sets of deep lymphatics in the leg enter 

 the lymphatic glands situated in the popliteal space. The efferent vessels from 

 those glands are joined by other lymphatics in contact with the branches of the 

 femoral artery, and enter the deep inguinal glands. Other deep lymphatics derived 

 from the muscles of the gluteal region, and many proceeding from the adductor 

 muscles of the thigh, enter the cavity of the pelvis in company with the gluteal, 

 sciatic, and obturator arteries, and terminate in a series of glands placed along the 

 internal iliac vessels. The deep lymphatics of the buttock are sometimes interrupted 

 by two or three small glands, situated in the neighbourhood of the great sacro-sciatic 

 foramen ; and the obturator set usually traverse a gland placed against the wall of 

 the pelvis about an inch behind the inner opening of the obturator canal. 



The superficial lymphatics of the lower part of the trunk converge 

 to the superficial inguinal glands, the direction of some of them being indicated by 

 the superficial circumflex iliac and epigastric, and the external pudic arteries. Exter- 

 nally they converge to the groin from the gluteal region and from the lumbo-sacral 

 area of the back, those from the latter part communicating with others which 

 pass upwards to the axillary glands. Anteriorly they descend from the lower 

 part of the surface of the abdomen, mingling about the level of the umbilicus 

 with vessels which ascend towards the axillary glands. 



The superficial lymphatics of the perineum are joined by vessels proceed- 

 ing from the mesial part of the buttock, and course round the inner side of the thigh 

 to enter the innermost glands of the superior inguinal group. The deep lymphatics 

 of the perineum rim with the pudic vessels to the internal iliac glands. 



The superficial lymphatics of the penis usually form one large median 

 dorsal trunk, and a variable number (commonly four or five) of smaller vessels on 

 each side. The latter pass from the prepuce and he skin of the organ, and termi- 

 nate in the internal glands of the superior inguinal set. The median trunk is 

 formed at the cervix penis by the union of right and left vessels which collect the 

 lymphatics from the skin of the glans and the mucous lining of the urethra, and 

 form a plexus on each side of the frsenum ; in front of the suspensory ligament the 

 trunk bifurcates, and its two divisions pass with the lateral vessels to the superior 

 inguinal glands. 1 The deep-seated lymphatics of the penis pass with the pudic vessels 

 under the pubic arch, and end in the glands on the internal iliac artery. 



The lymphatics of the scrotum are very numerous, and pass to the superficial 

 inguinal glands along the course of the external pudic arteries. 



The lymphatics of the external generative organs in the female present a 

 disposition similar to that existing in the male. 



LYMPHATICS OF THE PELVIS AND ABDOMEN. 



The external iliac lymphatic glands, from three to five, lie along the 

 external iliac vessels, two or three of large size being placed immediately above 



1 Sappey, op. cit,; Gr. Marchant, "Recherches sur les lymphatiques des teguments des organes 

 genitaux chez 1'homme," Bull. Soc. Anat. Paris, 1889. 



