THE LYMPH GLANDS AND VESSELS OF THE ABDOMEN AND PELVIS 701 



usually small and are scattered along the posterior mediastinum chiefly above the 

 oesophagus. They receive afferent vessels from the oesophagus, mediastinum, 

 diaphragm, pleura, and liver. The efferents go to the bronchial and anterior medi- 

 astinal lymph glands, partly to the thoracic duct directly. 



Sometimes one or two small glands are situated in the acute angle between the 

 posterior vena cava and the diaphragm; and the occurrence is recorded of a gland 

 between the apex of the pericardium and the sternal insertion of the diaphragm. 



THE LYMPH GLANDS AND VESSELS OF THE ABDOMEN AND PELVIS 

 The abdominal and pelvic lymph glands (Lgg. abdominales et pelvinse) consist 

 of two main groups, parietal and visceral. The parietal glands lie in the subserous 

 or subcutaneous tissue; they receive the lymph vessels from the abdominal and 

 pelvic walls, from parts of the viscera, and from the proximal lymph glands of the 

 pelvic limbs. The visceral glands lie on the walls of the viscera or in the peritoneal 

 folds which connect the organs with the wall or with adjacent viscera. They receive 

 all or most of the lymph vessels from the organs with which they are connected. 

 The parietal glands comprise the following: 



1. The lumbar lymph glands (Lgg. lumbales) lie along the course of the abdom- 

 inal aorta and posterior vena cava (Fig. 575). Some are placed along the ventral 

 surface and sides of the vessels, others above. A few small glands may be found 

 above the sublumbar muscles. The small nodes which are situated at the hilus 

 of the kidneys are often termed the renal lymph glands (Lgg. renales). They re- 

 ceive afferent vessels from the lumbar wall of the abdomen and the paired viscera 

 (kidneys, adrenals, genital organs), also the inguinal vessels and the efferents of the 

 iliac glands. Their efferents go to the thoracic duct, constituting the lumbar trunks 

 of origin of that vessel. 



2. The internal Uiac lymph glands (Lgg. iliacae internee) are grouped about the 

 terminal part of the aorta and the origins of the iliac arteries (Fig. 575). Their 

 afferent vessels come chiefly from the pelvis, pelvic viscera, and tail, and they re- 

 ceive efferent vessels of the external iliac and deep inguinal glands. 



3. The external Uiac lymph glands (Lgg. iliacse externae) form a group on either 

 side on the iliac fascia, at the bifurcation of the circumflex iliac artery (Fig. 575). 

 Their afferent vessels come from the flank and abdominal floor, the lateral surface 

 of the thigh, and the prefemoral glands. The efferent vessels go to the lumbar and 

 internal iliac glands. 



4. The sacral lymph glands (Lgg. sacrales) are small nodes situated along the 

 borders of the sacrum and on its pelvic surface. They receive afferents from the 

 roof of the pelvis and from the tail, and their efferent vessels pass to the internal 

 iliac glands. 



5. The superficial inguinal lymph glands (Lgg. inguinales superficiales) lie on 

 the abdominal tunic in front of the external inguinal ring (Fig. 582). ' They form 

 an elongated group along the course of the subcutaneous abdominal artery, on 

 either side of the penis in the male, above the mammary glands in the female; 

 in the latter they are often termed mammary. Their afferents come from the 

 medial surface of the thigh, the abdominal floor, the sheath, penis, and scrotum in 

 the male, and the mammary glands in the female. The efferent vessels ascend 

 through the inguinal canal and go to the deep inguinal, internal iliac, and lumbar 

 glands. 



6. The ischiatic lymph glands (Lgg. ischiadicae) are small nodes on the upper 

 part of the sacro-sciatic ligament along the course of the posterior gluteal artery. 

 They receive lymph from the adjacent parts and from the popliteal glands, and send 

 efferents to the sacral and internal iliac glands. 



1 In rare cases two or three of these glands are found behind the ring. 



