Lymphatic vessels and nodes of the lower limb

On the lower limb, there are superficial lymphatic vessels, lying above the superficial fascia, and deep ones, located next to the deep blood vessels (arteries and veins), as well as popliteal and inguinal lymph nodes.

The superficial lymphatic vessels of the lower limb are formed from the capillary networks of the skin and subcutaneous tissue and form the medial, lateral and posterior groups in the lower limb. The lymphatic vessels of the medial group (8-12) originate in the skin of the 1st, 2nd and 3rd toes, the dorsal surface of the medial edge of the foot, the medial and posteromedial surfaces of the shin, and then run along the great saphenous vein to the superficial inguinal lymph nodes. The lymphatic vessels of the lateral group (1-6) are formed in the area of the 4th and 5th toes, the lateral part of the dorsum of the foot and the lateral side of the shin. Slightly below the knee joint, they join the vessels of the medial group. The posterior group consists of the lymphatic vessels (3-5), which originate in the skin of the plantar side of the lateral edge of the foot and the heel area. Then these lymphatic vessels, accompanying the small saphenous vein, reach the popliteal lymph nodes (nodi lymphatici popliteales), located in most cases in the amount of 1-3 in the middle or lower parts of the popliteal fossa, near the popliteal artery and vein.

The deep lymphatic vessels of the lower limb are formed from the lymphatic capillaries of the muscles, joints, synovial sacs and sheaths, bones and nerves, accompany the large arteries and veins of the leg and thigh and go to the deep inguinal lymph nodes. The deep lymphatic vessels of the foot and leg also flow into the popliteal lymph nodes. There are numerous anastomoses between the superficial and deep lymphatic vessels of the lower limb, piercing the superficial fascia.

The inguinal lymph nodes (nodi lytnphatici inguinales), to which the lymphatic vessels of the lower limb, external genitalia, skin of the lower part of the anterior abdominal wall, and gluteal region are directed, are located in the region of the femoral triangle, slightly below the inguinal ligament. The nodes lying on the superficial 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, slightly below it. The lymph nodes of the middle subgroup lie on the ethmoid fascia and around it, and the nodes of the lower subgroup are on the superficial leaflet of the broad fascia of the thigh, where it forms the lower horn of the subcutaneous cleft of this fascia.

Deep inguinal lymph nodes (nodi lymphatici inguinales profundi) in the amount of 1 to 7 are located in the iliopectineal groove, near the femoral artery and vein. The uppermost of these nodes (Pirogov-Rosenmüller node) lies in the deep femoral ring, on the medial semicircle of the femoral vein. The efferent lymphatic vessels of the inguinal lymph nodes through the vascular lacuna of the thigh are directed into the pelvic cavity, to the external iliac lymph nodes.lymphatic vessels, lymph nodes, lymphatic system

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