546 ABDOMEN 



Vena Iliaca Externa (External Iliac Vein). This, the con- 

 tinuation of the femoral vein, enters the pelvis by passing up- 

 wards behind the inguinal ligament. It lies at first along the 

 medial side of the artery of the same name, but on a plane 

 somewhat posterior to it, and higher up on the right side it gets 

 completely behind the artery. At the level of the lumbo- 

 sacral articulation it ends by joining the hypogastric vein in 

 the formation of the common iliac vein. Immediately before 

 its termination it passes to the lateral side of the hypogastric 

 artery between the artery and the psoas magnus muscle. 

 Its tributaries are the veins corresponding to the deep circum- 

 flex iliac artery and the inferior epigastric artery. 



Deep Lymph Glands. The dissector has, doubtless, 

 noticed a chain of lymph glands in connection with the 

 external iliac artery, the common iliac artery, and also extend- 

 ing upwards upon the vertebral column in relation to the 

 aorta and inferior vena cava. The external iliac glands are in 

 two groups a lower and an upper. The former consists of 

 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 lymphatic 

 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 these the lymph is passed on to the 

 common iliac and lumbar glands. 



The glands in relation to either side of the aorta and 

 inferior vena cava are both numerous and large, and are 

 called the median lumbar glands. Their efferent vessels 

 terminate in two common lumbar lymphatic trunks, which 

 open into the cisterna chyli. 



Cisterna Chyli (O.T. Receptaculum Chyli). This 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 dis- 

 played, the cisterna chyli is seen to be a narrow elongated 

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

 end the two common lumbar lymphatic trunks, whilst 



