LYMPHATICS OF ABDOMEN AM) PELVIS 661 



the unus follow the course of the periiueul lyiii})liutics through the fork to the inuer- 

 niost superlieial inguinal glands. 



The superficial lymphatics of the penis hegin in the prepuce, and thence pass 

 hackwards to the corona glandis, where they form a ring arountl the glans. This 

 ring receives the su})erticial lynipliatics from the glans, and the lynnjhatics from 

 the anterior two-thirds of the urethra which run from hehind forwards. From the 

 glans three main lymphatic channels run hackwards under the integuments of the 

 penis, one on the dorsum, and one on each side of the organ. At the root of the 

 penis the dorsal lym|)hatic vessel divides into a right and a left branch, each branch 

 passing with the lateral lymphatic vessel of the corresi)onding side to the superficial 

 inguinal glands. The deep h'mphatics of the penis pass with the dorsal vein m\o 

 the ]»('lvis, where they join the lymphatic glands about the internal iliac arten,'. 



The lymphatics of the scrotum in the male, and of the parts corresponding 

 thereto in the female, and the lymphatics of the other external generative organs 

 in the female, run with the superticial external i>udic arteries to the superficial 

 inguinal glands. It will be-noted that the lymphatics of the testicle pass with the 

 spermatic artery to the lumbar glands. 



The superficial lymphatics of the perinaeum run upwards over the adductor 

 muscles, through the fork Ijrtweeii tht- thighs, and join the superficial inguinal 

 glands. 



(2 ) The deep parietal lymphatics. — The deep lymphatics of the anterior and 

 lateral abdominal walls accompany the parietal vessels to the back of the abdomen, 

 where they end in the deep glands. Thus some follow the deep epigastric artery to 

 the external iliac glands; others the deep circumflex iliac artery also to the external 

 iliac glands; and others, again, the ilio-lumbar and lumbar arteries to the lateral 

 lumbar glands. The last are also joined by the lymphatics from the muscles of the 

 back and from the spinal cord. The deep lymphatics from the ui)per part of the 

 abdominal wall pass, with the superior epigastric artery, into the thorax, where 

 they end in the internal mammary lymphatic glands. 



The deep lymphatics of the pelvic walls accompany the parietal vessels, and 

 hence are found with the obturator, sciatic, gluteal, pudic, and sacral arteries. 

 They end in the glands surrounding the internal iliac artery, and in the sacral glands. 



2. The parietal lymphatic glands lie, for the most part, along the back of the 

 abdomen and pelvis, and are known, from their position, as the external iliac, internal 

 iliac, sacral, lumbar, and cceliac glands. 



The external iliac lymphatic glands lie along the course of the external iliac 

 and connnon iliac arttrit-s an<l veins. They are three to five or more in numl)er. 

 They receive the lymphatics from the inguinal glands and femoral glands, and 

 the deep lymphatic vessels accompanying the deep epigastric and deep circum- 

 flex iliac arteries and veins from the anterior and lower abdominal walls. Their 

 efferent vessels join the lumbar glands. They communicate with the internal iliac 

 glands. 



The internal iliac glands are situated in the course of the internal iliac artery 

 and its branches. They vary from nine to twelve or more in number, the largest 

 being situatetl at the upper part of the great sciatic foramen. They receive the 

 lymphatics from the muscles of the pelvis and the lymi)hatics corresponding to the 

 branches of the internal iliac artery. Thus the greater number of the ]ymi)hatics 

 from the pelvic viscera, from the deeper j)arts of the perina-um, and from the 

 hinder and deeper parts of the scrotum or labia majora, the deejt lymphatics of the 

 penis and posterior part of the urethra, the deep lymphatics from the gluteal 

 region, and some of the lymphatics from the adductor muscles of the upper i»art 

 of the thigh, join these glands. Their efferent ves.sels pass to the lumbar glands. 



The sacral glands are situated in the hollow of the sacrum, four or five being 

 placed in the meso-rectal fohls op))Osite its promontory. They receive the lym- 

 phatics from the rectum and the hinder walls of the pelvis. They join the lumbar 

 glands. 



The lumbar glands lie beneatli the peritoneum, at the back of the abdomen, 

 on the front and sides of the lumbar vertebra. They are usually divided intotliree 

 groups, a median and two lateral; but these freely connnunicate witii one another 

 across the aorta and vena cava. 



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