Gynaecology for students and practitioners . aced upon the lateral pelvic wall in the angle formedby the bifurcation of the internal iliac artery, and the iriferior, lyingat a lower level in relation to the uterine artery {see Fig. 46); secondly,the lumbar chain of glands placed upon the lower part of the abdominalaorta and inferior vena cava, and consisting of a 7nedian and two 72 GYNAECOLOGY lateral groups [see Fig. 46). Other deeply placed glands which receivegenital lymphatics are the sacral group, and one or two isolated glandslying between the rectum and the vagina. The only external gla
Gynaecology for students and practitioners . aced upon the lateral pelvic wall in the angle formedby the bifurcation of the internal iliac artery, and the iriferior, lyingat a lower level in relation to the uterine artery {see Fig. 46); secondly,the lumbar chain of glands placed upon the lower part of the abdominalaorta and inferior vena cava, and consisting of a 7nedian and two 72 GYNAECOLOGY lateral groups [see Fig. 46). Other deeply placed glands which receivegenital lymphatics are the sacral group, and one or two isolated glandslying between the rectum and the vagina. The only external glandswhich receive lymphatics from the pelvic organs are the superiorgroup of the superficial inguinal glands placed in the groin. Ac-cordingly, enlargements of lymphatic glands from disease cannot berecognized by clinical examination except in the case of certain areasof the genital tract. From the ovary and Fallopian tube the lymphatics are collectedinto several trunk-vessels which accompany the ovarian artery and LYMPHATICTO INGUINALGLAMDS. LYMPHATICSTO I NTILIAC CLAUDS Fig. 47. The Uterine Lymphatics (Poirier). veins and leave the broad ligament along with them {see Fig. 46).Thence they pass upwards over the pelvic brim in front of the ureter andfinally join the lateral groups of the lumbar glands, those on the leftlying upon the aorta, those on the right side upon the inferior venacava. From the uterus the course of the lymphatic trunks is not so of the fundus and other parts of the uterine body anastomoseto form two or three large trunk-vessels which pass outwards belowthe ovary, and run in company with the ovarian lymphatics of thesame side to the same group of lumbar glands {see Fig. 47). From thefundus another small trunk passes forwards along the round ligament,leaves the abdominal cavity through the internal inguinal ring, and PELVIC BLOOD-VESSELS, LYMPHATICS, AND NERVES 73 finally joins the superior group of the superficial inguinal lymphatics
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
