236 SURGICAL ANATOMY OF 



fat. Next the fascia lata is to be divided, when the 

 oblique fibres at the edge of the sartorius will be seen, 

 and which are to be drawn aside in order to give room. 

 Some branches of the anterior crural nerve are generally 

 spread out over the course of the vessel, and occasionally 

 the internal saphena nerve crosses it at this point. The 

 sheath is next to be opened, only so much so as to allow 

 of the easy passage of the aneurism needle round the 

 vessel, and to avoid wounding more of the vasa vasorum 

 than is absolutely necessary, thus interfering with the 

 nutrition of its coats. The needle should be passed from 

 within outwards. 



Collateral Circulation after Ligature of the Femoral 

 Artery in Sear pa's Space. The external circumflex from 

 the profunda anastomoses with the gluteal and circum- 

 flex iliac, the internal circumflex with the obturator 

 ischiatic, and superior perforating, and the vessels in the 

 popliteal space with the comes nervi ischiadici. 



The tumors in Scarpa's space, which might be mis- 

 taken for aneurisms, are enlarged glands, cysts, psoas 

 abscess, enlargement of the bursa below the psoas, and 

 hernia. Femoral hernise lie to the inner and upper side 

 of the vessels; psoas abscesses point external to them. 

 Inguinal hernise may be mistaken for crural, owing to 

 the circumstance that adhesions taking place from any 

 cause between the aponeuroses may divert their course ; 

 it is far more common for crural hernise to resemble in- 

 guinal (vide Crural Hernia). 



SURGICAL ANATOMY OF THE GLUTEAL REGION. 



This region is of great surgical importance from its 

 intimate relations with the hip-joint, and the control the 

 muscles have over its several movements ; it has for its 



