Lymph Vessels of the Muscles of the Pelvic Limbs

The lymph vessels of the muscles of the pelvic limbs, including the lumbar muscles and their tendons, mostly drain to the medial iliac lymph node, the hypogastric lymph nodes, and the popliteal lymph node, with minimal additional drainage to the lumbar aortic lymph nodes (including the cranial lumbar aortic lymph node). If a lateral sacral lymph node is present, a small number of the lymph vessels draining these muscles will also drain into this lymph node. Likewise, when a deep inguinal lymph node is present, some of the muscular lymph vessels that ascend in the femoral canal may additionally enter this lymph node. If the deep inguinal lymph node is absent, which is often the case, these lymph vessels will all drain directly to the medial iliac lymph node. Nonetheless, even if the deep inguinal lymph node is present, none of the lymph vessels may drain into it. The lymph vessels of the Achilles, the superficial and deep flexor tendons, and Mm. interossei pedis behave in the following manner with respect to the medial femoral lymph node: if the lymph node is present, then some of the lymph vessels drain to it. The lymph vessels of some of the lumbar muscles (M. psoas minor, M. ileopsoas, and M. quadratus lumborum) drain to both the lumbar aortic lymph nodes and the medial iliac lymph node, while those of M. psoas minor and M. quadratus lumborum drain to the hypogastric lymph nodes.

Of the remaining thigh muscles, the lymph vessels of the M. tensor fasciae latae, M. gracilis, M. pectineus, M. adductor, M. sartorius, and Mm. gemelli drain to the medial iliac lymph node, and additionally to the deep inguinal lymph node, when present. The lymph vessels of the M. obturator internus drain to the hypogastric lymph nodes, the lymph vessels of the Mm. glutei and the M. obturator externus to the medial iliac lymph node and possibly to the deep inguinal lymph node and the hypogastric lymph nodes, the lymph vessels of the M. quadriceps to the medial iliac lymph node and possibly to the deep inguinal lymph node and popliteal lymph node, the lymph vessels of the M. biceps femoris, M. semitendinosus, and M. semimembranosus to the medial iliac lymph node, and, when a deep inguinal lymph node is present some drain to it, as well as to the hypogastric and popliteal lymph nodes. It was also observed that the Mm. gemelli lymph vessels drain to the lateral sacral lymph node.

The lymph vessels of the muscles located on the lower leg, the M. tibialis anterior, M. extensor digitalis longus, M. extensor digitalis lateralis, M. peroneus longus, M. gastrocnemius, M. flexor digitalis sublimis and profundus, and the M. popliteus, drain to the medial iliac lymph node, and usually to the deep inguinal lymph node, when present. The lymph vessels draining the tendons and tendon sheaths of the M. extensor digitalis longus drain to the popliteal lymph node, those of the extensor digitalis lateralis, peroneus longus and M. tibialis anterior drain to the popliteal lymph node, the medial iliac lymph node and possibly to the deep inguinal lymph node, those of the M. gastrocnemius and M. flexor digitalis sublimis and profundus drain into the popliteal lymph node, the medial iliac lymph node, and possibly into the deep inguinal and medial femoral lymph nodes.

For the muscles of the foot, the lymph vessels of the extensor digitalis pedis brevis and the Mm. interossei drain to the medial iliac lymph node, the popliteal lymph node, and possibly to the deep inguinal and medial femoral lymph nodes as well.