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Lymphatic vessels and nodes of the lower limb
Last reviewed: 18.10.2021
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On the lower extremity, the surface lymphatic vessels located above the superficial fascia are distinguished, and deep ones located near the deeply lying blood vessels (arteries and veins), as well as popliteal and inguinal lymph nodes.
Superficial lymphatic vessels of the lower limb are formed from the capillary nets of the skin and subcutaneous base and form the medial, lateral and posterior groups in the lower limb. Lymphatic vessels of the medial group (8-12) originate in the skin of the I, II, III fingers, the back surface of the medial edge of the foot, the medial and posteromedial surfaces of the shin, and then are guided along the large saphenous vein to the superficial inguinal lymph nodes. Lymphatic vessels of the lateral group (1-6) are formed in the region of the IV and V fingers, the lateral part of the rear of the foot and the lateral side of the tibia. Somewhat below the knee joint they join the vessels of the medial group. The posterior group consists of lymphatic vessels (3-5), which begin in the skin of the plantar side of the lateral margin of the foot and calcaneal region. Then these lymphatic vessels, accompanying a small subcutaneous vein, reach popliteal lymph nodes (nodi lymphatici popliteales), located in most cases in the number of 1-3 in the middle or lower parts of the popliteal fossa, near the popliteal artery and vein.
Deep lymph vessels of the lower limb are formed from the lymphatic capillaries of the muscles, joints, synovial bags and vaginas, bones and nerves, accompany the large arteries and veins of the shin and thigh and are directed to the deep inguinal lymph nodes. Deep lymphatic vessels of the foot and lower leg also flow into the popliteal lymph nodes. Between the superficial and deep lymphatic vessels of the lower limb there are numerous anastomoses that perforate the superficial fascia.
The inguinal lymph nodes (nodi lytnphatici inguinales), to which the lymph vessels of the lower limb, the external genitalia, the skin of the lower part of the anterior wall of the abdomen, the gluteal region, are located in the region of the femoral triangle, somewhat below the inguinal ligament. The nodes lying on the surface plate of the broad fascia of the thigh (4-20) are the superficial inguinal lymph nodes (nodi lymphatici inguinales siperficiales). The upper subgroup of these nodes is located in a chain along the inguinal ligament, somewhat below it. Lymph nodes of the middle subgroup lie on the lattice fascia and around it, and the nodes of the lower subgroup are on the surface sheet of the wide fascia of the thigh, where it forms the lower horn of the subcutaneous gap of this fascia.
Deep inguinal lymph nodes (nodi lymphatici inguinales profundi) in the number from 1 to 7 are located in the iliac comb, near the femoral artery and vein. The uppermost of these nodes (the Pirogov-Rosenmuller node) lies in the deep femoral ring, on the medial semicircle of the femoral vein. The endometrial lymph nodes through the vascular lacuna of the thigh are directed to the pelvic cavity, to the external iliac lymph nodes. Lymphatic vessels, lymph nodes, lymphatic system
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