THE LYMPH GLANDS AND VESSELS OF THE ABDOMEN AND PELVIS 701 
usually small and are scattered along the posterior mediastinum chiefly above the 
cesophagus. They receive afferent vessels from the cesophagus, 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 pelvine) 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 giands 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 iliac lymph glands (Lgg. iliace intern) 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 iliac lymph glands (Lge. iliacze externe) 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 (Legg. sacrales) are small nodes situated along the 
borders of the sacrum and on its pelvie 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 (Lge. ischiadicze) 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. 
