Lymphatic nodes and vesselsof the lower limb

In this note, we are going to discuss the main groups of lymph nodes of the lower limb and the lymphatic drainage pathways from various tissues in this region.

Lymphatic nodes and vessels of the lower limb

The lymphatic vessels of the lower limb are divided into two groups: superficial and deep.

The superficial lymphatic vessels are located above the superficial fascia and collect lymph from the skin and subcutaneous fat.

They are classified into three groups:

The medial group, which drains lymph from the 1st, 2nd, and 3rd toes, the medial side of the dorsum of the foot, and the medial surface of the leg. These vessels follow the course of the great saphenous vein.

The lateral group, which collects lymph from the 4th and 5th toes, the lateral side of the dorsum of the foot, and the lateral surface of the leg. These vessels join the medial group in the upper third of the leg.
The posterior group, which drains lymph from the skin of the sole and the posterior surface of the leg. These vessels accompany the small saphenous vein.

The deep lymphatic vessels of the lower limb drain lymph from the muscles, fasciae, bones, nerves, and joints, following the paths of the major arteries and veins of the leg and thigh.

Lymphatic vessels from both the superficial and deep groups form numerous anastomoses, creating an extensive network for lymphatic drainage. This network directs lymph to several groups of regional lymph nodes.

Popliteal lymph nodes are divided into superficial and deep groups.

They are located in the lower part of the popliteal fossa, receiving lymph from the superficial and deep lymphatic vessels of the leg and foot. Then they direct lymph to the deep inguinal lymph nodes.

Superficial inguinal lymph nodes are situated within the femoral triangle, on the superficial layer of the fascia lata.

They collect lymph from the medial group of the superficial lymphatic vessels, from the skin of the lower abdomen, external genitalia, and gluteal region. Then, lymph is drained into the deep inguinal lymph nodes.

Deep inguinal lymph nodes are located beneath the fascia lata in the iliopectineal sulcus around the femoral vessels.

One significant node in this group, the proximal deep inguinal node of Cloquet or Rosenmüller, is adjacent to the medial wall of the femoral vein, covering the entrance to the femoral canal.

The deep inguinal nodes collect lymph from the deep lymphatic vessels and superficial inguinal nodes, directing it through the vascular lacuna into the external iliac lymph nodes.

Efferent vessels from the external iliac nodes transport lymph to the common iliac nodes and then to the lumbar nodes.

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