Anatomy and topography of the common iliac lymph nodes in human beings in the 1st period of maturity

The investigation of common iliac lymph nodes has been performed in 20 corpses of the first mature age of both sex (5 male and 5 female corpses) of persons died from causes not connected with the lymphatic system diseases, the lower extremities and the pelvic organs. The common iliac lymph nodes with their afferent and efferent lymphatic vessels are revealed by means of interstitial injection into the lower extremities and the pelvic organs and with direct injection into the lymphatic vessels. The form, amount, size and topography of the common iliac lymphatic vessels have been studied. The lymphatic vessels, that go from certain body parts and organs to various subgroups of the common iliac lymph nodes, as well as the lymphatic vessels that connect the nodes both within the subgroup and also between the subgroups. The amount and size of the lymphatic nodes of the lateral subgroup predominate over the nodes of other subgroups of the common iliac lymph nodes; the amount of the common iliac lymph nodes predominates in men, and their size--in women. Amount of these nodes in the right and their size in the left predominate in both sex. Among the common iliac lymph nodes there are no teniform nodes, and efferent lymphatic vessels of the lateral and medial subgroup of the common iliac lymph nodes in 15% of cases run towards the lumbar nodes in the opposite side.     

Anatomy and topography of external iliac lymph nodes in adults]

The investigation of the external iliac lymph nodes has been performed in 152 preparations of corpses of mature persons of both sex, who died from causes not connected with any disease of the lymphatic system, lower extremities and pelvic organs. The external iliac lymph nodes and their afferent and efferent lymphatic vessels have been revealed by means of interstitial injection of the lower extremities and pelvic organs, as well as by means of direct injection of Gerota mass into the lymphatic vessels. Form, amount, dimensions and topography of common iliac lymph nodes have been studied. Lymphatic vessels, running from certain parts and organs of the body to various subgroups of the external iliac lymph nodes have been described, as well as efferent lymph vessels of these nodes. The external iliac lymph nodes are constant formations; the largest of them--lymph nodes of the lacuna--are nodes of the I step for the lower extremity lymph vessels. In 54% of cases in persons of both sex positive (right-sided) asymmetry has been revealed. Total amount of the iliac lymph nodes prevails in men, while their size is greater in women. The size of these nodes in persons of both sex is greater to the left than to the right. There are connections (in 3% of cases) between the external iliac lymph nodes and aortal and lumbar nodes of the opposite side.     

Anatomical variants of the lymphatic vessels connecting the inguinal lymph nodes]

The study of anatomical variants of lymphatic vessels connecting inguinal lymph nodes was carried out on 56 corpses of adult persons of both sex whose deaths were not connected with lesions in the lymphatic system of the pelvis and lower extremities. The inguinal lymph nodes and their afferent and efferent lymphatic vessels were detected by the method of intradermal injection and by the method of direct injection into the lymphatic vessels. It was stated that groups of the inguinal lymph nodes, as well as the nodes in every group determined, can serve as nodes of different stages for afferent lymphatic vessels running from different parts of the body and organs.     

Applied aspects of anatomy of the lumbar lymph nodes and their vessels

Using anatomical and roentgenoanatomical methods in 132 corpses of persons (from newborns up to 83 years of age) the anatomy of the lumbar lymph nodes and their vessels has been studied. Their topography, skeletotopy , amount, dimensions and form have been determined. Afferent and deferent lymphatic vessels in various groups of the lumbar lymph nodes, collateral pathways of lymph outflow to by-pass the lumbar lymph nodes are described. Certain data on the types of the thoracic duct formation are presented.     

Anatomy and topography of the lymphatic vessels and regional lymph nodes of the rectum in newborn infants and children to 3 years of age

In 30 corpses of newborns and children up to 3 years of age, by means of the intratissue and direct injection of the modified Gerota's mass, certain increase in number and size of the superficial inguinal lymph vessels belonging to the superior-medial group, as well as the pararectal and superior rectal lymph nodes has been noted. The diameter of both afferent and efferent lymphatic vessels in the nodes mentioned in children of 1-3 years of age is greater than in the newborns. The number of the afferent vessels running towards these nodes in most cases, regardless the age, prevail over the efferent ones, and the diameter of the latter is greater than in the afferent vessels. The pararectal lymph nodes in 80% of cases are the nodes of the first step for the lymph flowing from the rectum, in 15% - the nodes of the first and second steps, simultaneously, and in 5% - of the third and fourth steps. The superior pararectal lymph nodes in 80% of cases are the nodes of the third and fourth steps, and in 20% of cases - those of the first and second steps for the lymph flowing from the rectum.     

Age and variability in the inguinal lymph nodes of adult humans]

Lymphatic nodes on the anterior surface of the femur, in the region of the femoral triangle were studied in 56 corpses of humans of either sex from 31 to 82 years of age, dead of accidental causes or of diseases not related to lymphatic nodes. The investigation was carried on by the method of interstitial and direct injection of the Gerota's mass to some regions of foot skin, external genitalia and the skin of the anterior wall of the abdomen. It has been established that the size of inguinal lymphatic nodes (both superficial and profound) in humans of either sex, are in direct dependence on the age of the person. The amount of inguinal lymphatic nodes in young people prevails over that in old people. The external diameter of the afferent and efferent vessels in elderly humans is greater than in young ones. The amount of afferent lymphatic vessels to inguinal lymphatic nodes in most cases prevails over the amount of efferent ones, independent of age and sex. The external diameter of the former is greater than that of the latter.     

Lymph node topography and various features of the metastasis of malignant kidney tumors

Due to investigations of 102 renal preparations performed on corpses of mature persons, topographic peculiarities of the lymph nodes, getting lymph from the left and right kidneys, are revealed. Every lymph node of the left kidney gets greater amount of lymphatic vessels than every node of the right kidney. The lymph, running from the right kidney, usually gets through a less number of the subsequently arranged nodes up to the thoracic duct, as compared to the lymph, that runs from the left kidney. A typical position for the node, which the renal lymphatic vessels get into, is the fatty tissue in the area of the angle formed by the aorta edge and the inferior wall of the corresponding renal artery. The lymphatic nodes of the right kidney are arranged in the fatty tissue more compact than the left ones. These peculiarities, revealed by morphological investigations, are proved by analysis of 114 case histories of persons suffering from malignant neoplasms in the kidneys.     

Individual and sex variation in the inguinal lymph nodes in man]

Under investigation were the lymph nodes on the anterior surface of the femur in the area of the femural triangle in 96 preparations of lower extremities of corpses of people of either sex in the age from 31 to 82 years. The Gerota's mass was injected into the skin of feet, external genitalia and the skin of the lower part of the anterior wall of the abdomen. It was established that the total amount of the inguinal lymph nodes in men was greater than in women, the size of the superficial nodes in women was greater than of those in men, while the size of profound lymph nodes in men was greater than in women. The amount of the inguinal lymph nodes was proportional to the Skerly's index and the dimensions were inversely proportional to their amount. The amount of inguinal lymph nodes in persons of either sex of a dolichomorphic type of figure was greater than in persons of a brachymorphic type. The dimensions of the nodes in persons of brachymorphic type of figure were predominant.     

Anatomy of lymph nodes situated adjacent to the axilla in adult humans]

In 50 right and 50 left upper extremities examined in adult persons of both sex at the age of 28-90 years, delto-thoracic lymph nodes were revealed in 30% (right) and in 22% (left), and interthoracic lymph nodes--in 6% (right) and in 12% (left). The lymph nodes in question were revealed by the method of section after interstitial injection of Gerota's blue intradermally to fingers, palm, back of the hand deltoid area, lateral thoracic surface (at the level of the 6th intercostal space) and to the external part of the mammary gland. Injection was also performed into lymphatic vessels revealed by means of the interstitial injection. The delto-thoracic nodes were stated to situate in both the delto-thoracic sulcus and the delto-thoracic triangle. These vessels are situated along the course of the lateral collector of the free upper extremity. Deferent vessels of the delto-thoracic nodes flow into the apical axillary lymph nodes, into the deep and superficial cervical nodes, into the interthoracic lymph nodes and also into the subclavicular or into the jugular vein near a corresponding venous angle. Interthoracic lymph nodes, situated between musculus pectoralis major and minor, get their lymphatic vessels from lateral, inferior and central axillary nodes, from delto-thoracic nodes and also those lymphatic vessels that go from the mammary gland area. Deferent vessels of the interthoracic nodes flow into the apical axillary nodes.     

Individual and age-related differences in the anatomy of the main deferent lymphatic vessels of the human heart and their applied significance

One hundred human hearts of various age have been investigated. Structure, size of their main deferent lymphatic vessels are defined by the organ's form, sex and age of the persons. According to the position signs, extreme forms of their topography have been revealed. In the left--the course in the adventitia of the anterior wall of the pulmonary trunk and of the ascending aorta. In the left--the course in the adventitia of the right lateral wall of the ascending aorta and of the pulmonary trunk. The number of the extraorganic vessels, that bring lymph out of the heart, is from 1 up to 3. The anastomoses made between certain parts of the lymph nodes and the extraorganic lymphatic vessels in the transplanted and removed hearts are more economic.     

Segmented lymph nodes in man

Segmentary lumbar, posterior pancreato-duodenal and inferior tracheobronchial lymph nodes have been investigated macro- and microscopically. The segmentary lymph nodes reach 12 X 45 X 45 mm, 10 X 25 X 100 mm in size. Most often these nodes are found among the posterior pancreato-duodenal lymph nodes (92%). They represent a conglomerate of smaller lymph nodes growing together and having their own capsule, parenchyma, sinuses, afferent and deferent lymph vessels and are united into one large node.     

Topography of the aorto-iliac fragment and the ilio-caval confluence in man

By means of selective injection of blood vessels with water suspension of red lead and subsequent angiography, topography of the aortal bifurcation in the area of the vena cava formation has been studied in corpses of persons of both sex at the age 25-102 years and in 100 corpses of fetuses (the second half of pregnancy). Position, diameters of the arteries and veins situating in these areas, as well as branching or connection angles of the vessels are directly dependent on age. The data obtained on topography of the blood vessels and on their interrelations with position of the ureters and between themselves are of essential importance for operative approaches to the pelvic organs.     

Lymphatic vessels in the capsule of the lymph node

By means of the injection method the lymphatic vessels, running to the lymph nodes of various localization, have been studied. Their architectonics in the lymph node capsule is revealed. In the capsule the afferent vessels make peculiar broom-like formations. They are named terminal arborizations of afferent lymphatic vessels (TAALV). Two types of such arborizations are described: palm-like, peculiar for the somatic type of the lymph nodes, and tree-like, specific for visceral nodes. The TAALV diameter is 15-20 mcm. They come across the nodal capsule, penetrating it obliquely with numerous holes. In the TAALV wall myocytes are revealed. Together with the capsule muscular elements they might play a role of the most important factors in the mechanism of lymph circulation.     

The relationship between the lymphatic vessels of the nerves of the human lower extremity and the perineural spaces]

The lymphatic vessels and perineural spaces of superficial and profound nerves of the extremity were studied on the material of 50 lower extremities of corpses of humans by the method of intratissue and direct injection. Initial lymphatic capillaries and extraorganic lymphatic vessels and their paravasal plexuses were found. It is concluded that closed lymphatic capillaries having no immediate connection with the perineural space are the roots of the lymphatic bed in the nerve.     

Effect of gravitational loads in different directions on the structure of the lymphatic bed of the pelvic extremities in the rabbit in vivo]

The method of lymphorentgenography was used in order to study alterations in the lymph vessels of pelvic extremities of rabbits at different terms (from 1 week up to 6 months) after exposure to gravitation stresses of different directions, value and duration. After exposure to stresses of cranio-caudal direction the amount of vessels increased. They had weel pronounced sinuosity and clearly protruding valves. The diameter of the vessels was more than normal and was equal to 0,3-0,8 mm. Popliteal lymph nodes were also increased up to 12,6-6,7 mm. Within 6 months after stresses these changes retained. Stresses of caudal-cranial direction during all periods of observation (from 1 week up to 6 months) caused dilatation of vessels (0,3-0,6 mm), their sinuosity and enlargement of popliteal lymph nodes up to 10,5-6,2 mm. All these changes returned to normality within 6 months. Thus, most pronounced and resistant morphological changes of the lymphatic bed were caused by greatest endurable stresses of cranio-caudal direction.     

Anatomo-topographic features of the deep lymph nodes of the neck in adult humans]

Profounod cervical lymph nodes were studied on 35 corpses and 30 complexes of organs of the head and neck in adult man by method of dissection after a preliminary injecting the lymphatic vessels and nodes. Under study were the lymph nodes of the anterior part (prelaryngeal, prethyroid, pretracheal and paratracheal groups) which are disposed under the pretracheal lamina of the cervical fascia. The lymph nodes of the lateral area of the neck are concentrated along the internal jugular vein, accessory nerve and the transversal artery of the neck. The lymph nodes disposed along the internal jugular vein are divided into 3 groups: superior, medial and inferior. The lymph nodes disposed in the lateral area of the neck are of different types. The obtained data can be used for decoding data of lymphography.     

Observations upon rhinoceros cervical lymphatics

As an initial contribution to rhinoceros lymphangiology observations are presented upon the disposition of the lymphatic vessels and nodes associated with the larynx, thyroid gland and parathyroid glands of an adult male Indian rhinoceros (Rhinoceros unicornis). A detailed account is given of the topography and connexions of the anterior and intermediate groups of cervical lymph nodes and of the lymph drainage of certain cervical organs. The presence is reported, upon inter-nodal afferent pathways, of specialised and hitherto undescribed formations of a lympho-haemal nature and the functional significance of these is suggested.     

Topographo-anatomic basis for the reconstruction of lymphatic passages and the reinnervation of transplanted kidneys

Topographic anatomy of the deferent lymphatic vessels and the regional lymph nodes of the kidneys have been studied in 35 dogs. Basing on the topographoanatomical investigations performed the authors suggest a rational technique for restoring the lymph outflow combined with the reinnervation of the renal transplant. They suggest to take the right kidney together with the dorsocaval lymph nodes, and the left--with the left lateroaortal lymph nodes simultaneously cutting out the fascial-fatty graft with the nerves situating over the ventral surface of the renal hilar vessels. The lymph outflow is suggested to be restorted by means of anastomosis between the regional lymph nodes of the renal transplant and the iliac node, or the nearest vein, and to innervate the transplant--by means of stitching the fascial-fatty grafts of the anostomized blood vessels.     

Characteristics of the regional lymphatic system of the external genitals in dogs in experimental studies

In the experiment performed on 80 mongrel female dogs by means of morphological and roentgenographical methods the structure of the lymphatic bed, pathways of lymph outflow and localization of the regional lymph nodes of the external genitals have been studied in the norm, at inflammation and at malignant tumors. Normal lymph outflow (53 animals) from the external genitals occurs via direct, cross and roundabout pathways. The regional nodes of the I order are inguinal lymph nodes and all the pelvic nodes, anorectal ones including. A part of vessels, without getting the lymph nodes mentioned, get into the retrosternal, caudal lumbar lymph nodes and the lumbar trunk. The cross of the lymphatic pathways occurs via the anterior, posterior commissures, at the level of the inguinal lymph nodes and within the limits of the pelvis. At an acute inflammation (24 animals) besides those mentioned above, roundabout vessels in the middle third of the femur are constantly revealed. They get into the femoral collector, and the vessels in the inferior third of the femur come into the popliteal lymph nodes. At malignant tumors of the external genitals (3 animals), besides all the pathways of the lymph outflow mentioned above, the femoral-crural roundabout pathway appears, it is connected with the lymphatic collector of the crus. Some vessels of the external genitals, combining with the vessels of the vagina, urethra and urinary bladder, get into the lumbar trunk and into the caudal lumbar lymph nodes. Increasing amount of all groups of the lymph nodes is noted.(ABSTRACT TRUNCATED AT 250 WORDS)     

Anatomy of the lymph vessels and nodes of the head and neck in green marmosets]

In 50 mature green monkeys, the lymphatic system of the skin on the hairy part of the skull (occipital, parietal, frontal) and on the face was studied. The lymphatic vessels of cranial and cervical organs flow into submental, submandibular (anterior, medial, posterior) lymph nodes and into profound cervical (cranial, medial, caudal) lymph nodes. Lymph nodes together with efferent lymphatic vessels form lymph collectors of the neck which follow the blood vessels branching: superficial jugular, profound jugular and paratracheal network.