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Lymphatic vessels and pelvic nodes
Last reviewed: 18.10.2021
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In the pelvic cavity and on its walls there are lymph nodes, into which the lymph vessels flow from the nearby organs, as well as the lymph vessels of the lower extremities. Depending on the position, the lymph nodes of the pelvis are divided into visceral (internal) and parietal (parietal).
Visceral lymph nodes (nodi lymphatici viscerales) are adjacent to internal organs located in the cavity of the small pelvis. Single lymph nodes are found near the bladder - periocarpal (nodi lymphatici paravesiculares), between the leaves of the broad ligament of the uterus - periarticular (nodi lymphatici parauterine), and somewhat lower - nodi lymphatici paravaginales. On the lateral surfaces of the rectum, near its lower parts, there are near rectum (anorectal) lymph nodes (nodi lymphatici pararectales, s.anorectales), the number of which can be from 1 to 10. The vascular lymphatic vessels from the visceral lymph nodes are directed to the iliac nodes, in a general way, and to the subordinal nodes (under the bifurcation of the aorta). Some lymphatic vessels, including ovaries, follow up to the lumbar lymph nodes.
Parietal lymph nodes (nodi lymphatici parietales) adhere to the walls of the pelvis, located near the large blood vessels. On each side wall of the small pelvis, near the internal iliac artery and vein, there are 4-8 internal iliac lymph nodes (nodi lymphatici iliaci interni).
Next to the upper and lower gluteal arteries lie the gluteal lymph nodes (nodi lymphatici gluteales), through which the lymphatic vessels from the hamstring and gluteal region and from the adjacent walls of the small pelvis are guided through the supra- and sub-tubular orifices. In the course of the constriction vessels and nerves (in about a third of cases), there are occlusal (usually one) lymph nodes (nodi lymphatici obturatorii).
On the front surface of the sacrum, inside of the anterior sacral orifices, there are 2-3 sacral lymph nodes (nodi lymphatici sacrales). They are regional nodes not only for the pelvic wall, but also for the rectum, as it adjoins the posterior surface of the pelvis. Of the named parietal lymph nodes of the small pelvis, the enduring lymphatic vessels are directed to the external and common iliac lymph nodes located near the large iliac blood vessels. External lymph nodes (nodi lymphatici iliaci externi, total 2-12) are located near the external iliac arteries and veins, form a medial, lateral and intermediate (in the furrow between the vessels) chains. The lower of these nodes lies directly behind the inguinal ligament, covering the vascular lacuna and the femoral ring from above.
The lymphatic vessels of the internal and external iliac lymph nodes are directed to the common iliac nodes (nodi lymphatici iliaci communes), which in the amount of 2-10 lie on the side wall of the pelvis next to the common iliac artery and vein and also form the lateral, intermediate and medial chains. The medial chain of the common iliac lymph nodes ends with 1-2 nodes common to the right and left sides. These nodes are located directly at the beginning of the common iliac arteries from the abdominal part of the aorta - under the bifurcation of the aorta and are called the podortal lymph nodes (nodi lymphatici subaortici).
The lymphatic vessels that carry the common iliac and podortal nodes are directed to the lumbar lymph nodes that lie near the abdominal part of the aorta and the inferior vena cava.
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