272 FASCIA OF THE LOWER EXTREMITY. 



fascia is strengthened at its point of division into slips, by strong fasciculi 

 of transverse fibres, and the arched interval left between the slips gives 

 passage to the tendons of the flexor muscles. The arches between the 

 fingers transmit the digital vessels and nerve, and lumbricales muscles. 



FASCIJE OF THE LOWER EXTREMITY. 



The superficial fascia contains between its t\vo layers the superficial 

 vessels and nerves of the lower extremity. At the groin these two layers 

 are separated from each other by the superficial lymphatic glands, and the 

 deep layer is attached to Poupart's ligament, while the superficial layer is 

 continuous with the superficial fascia of the abdomen. 



The deep fascia of the thigh is named, from its great extent, the fascia 

 lata; it is thick and strong upon the outer side of the limb, and thinner 

 upon its posterior side. That portion of fascia which invests the gluteus 

 maximus is very thin, but that which covers in the gluteus medius is ex- 

 cessively thick, and gives origin by its inner surface, to the superficial 

 fibres of that muscle. The fascia lata is attached superiorly to Poupart's 

 ligament, the crest of the ilium, sacrum, coccyx, tuberosity of the ischium, 

 ramus of the ischium, and pubes ; in the thigh it is inserted into the linea 

 aspera, and around the knee is connected with the prominent points of 

 that joint. It possesses also two muscular attachments, by means of the 

 tensor vaginae femoris, which is inserted between its two layers on the 

 outer side, and the gluteus maximus, which is attached to it behind. 



In addition to the smaller openings in the fascia lata which transmit the 

 small cutaneous vessels and nerves, there exists at the upper and inner 

 extremity of the thigh, an oblique foramen, which gives passage to the 

 superficial lymphatic vessels, and the large subcutaneous vein of the lower 

 extremity, the internal saphenous vein, and is thence named the saphenous 

 opening. The existence of this opening has given rise to the division of 

 the upper part of the fascia lata into t\vo portions, an iliac portion and a 

 pubic portion. 



The iliac portion is situated upon the iliac side of the opening. It is 

 attached to the crest of the ilium, and along Poupart's ligament to the 

 spine of the os pubis, whence it is reflected downwards and outwards, in 

 an arched direction, and forms a falciform border, which constitutes the 

 outer boundary of the saphenous opening. The edge of this border im- 

 mediately overlies, and is reflected upon the sheath of the femoral vessels, 

 and the lower extremity of the curve is continuous w T ith the pubic portion. 



The pubic portion, occupying the pubic side of the saphenous opening, 

 is attached to the spine of the os pubis and pectineal line ; and, passing 

 outwards behind the sheath of the femoral vessels, divides into tw r o layers ; 

 the anterior layer is continuous with that portion of the iliac fascia which 

 forms the sheath of the iliacus and psoas muscles, and the posterior layer 

 is lost upon the capsule of the hip joint. 



The interval between the falciform border of the iliac portion and the 

 opposite surface of the pubic portion is closed by a fibrous layer, which is 

 pierced by numerous openings for the passage of lymphatic vessels, and is 

 thence named cribriform fascia. The cribriform fascia is connected with 

 the sheath of the femoral vessels, and forms one of the coverings of femoral 

 hernia. When the iliac portion of the fascia lata is removed from its at- 

 tachment to Poupart's ligament and is turned aside, the sheath of the 

 vessels (the femoral or crural canal) is brought into view ; and if 



