298 SURGICAL APPLIED ANATOMY. [Chap. xvi. 



of the internal mammary, and the abdominal divisions 

 of the lumbar arteries. The superficial vessels are 

 of small size, although Verneuil reports a case of 

 fatal haemorrhage from the superficial epigastric 

 vessel. 



The superficial veins on the front of the abdomen 

 are numerous, and are very distinct when varicose. 

 A lateral vein, extending from the axilla to the groin, 

 uniting the axillary and femoral veins, is often 

 rendered in this way very prominent. The sur- 

 face abdominal veins may take no part as alternative 

 blood channels in cases of obstruction of the inferior 

 vena cava. Clinical experience shows that these veins 

 may be also enormously varicose in instances where 

 the inferior cava is qiiite patent. In one case under 

 my care there was extensive varicosity of the surface 

 veins from the pectoral region to the groin that in- 

 volved one side of the body only. It has been shown, 

 moreover, that the valves of these vessels are so 

 arranged that the blood in the surface veins above the 

 navel goes to the axilla, while that in the veins of the 

 subumbilical region runs to the groin. 



SchifF has shown that certain small veins con- 

 nect the portal vein with the epigastric veins at the 

 umbilicus. 



As regards the surface lymphatics of the front of 

 the abdomen, it may be said in general terms that 

 those above the umbilicus go to the axillary glands, 

 and those below to the glands of the groin. 



Nerves. The abdominal wall is supplied by the 

 lowest seven dorsal or intercostal nerves, and by the 

 first two lumbar nerves. These nerves run obliquely 

 to the long axis of the abdomen downwards and 

 inwards from the sides to the middle line. Their 

 direction is represented by a continuation of tho 

 lines of the ribs : they are placed parallel to one 

 another and at fairly equal distances apart. It ia 



