252 SUEGICAL ANATOMY OF THE 



of the femoral for popliteal aneurism being applied in 

 Scarpa's space. 



An incision is to be made in the course of the vessel 

 about three inches in length, through the integument 

 and fascia lata, until the oblique fibres of the sartorius 

 are recognized. Its edge reached, the muscle is to be 

 pulled upwards, when the aponeurotic fibres bridging 

 over the vessels will be seen. These are to be pinched 

 up and divided on a director, when the artery (and per- 

 haps the internal saphena nerve) will be seen with its 

 vein, which is either behind it, or a little to its outer 

 side, and closely united to it by a dense fibrous invest- 

 ment. Occasionally the anastomotica magna is very 

 large and superficial, and may be mistaken for the main 

 trunk. 



The posterior compartment of the thigh, as formed by 

 the fascia lata, contains the hamstring muscles, the 

 great sciatic nerve, a great deal of fat and cellular tissue, 

 and the terminations of the perforating branches of the 

 deep femoral vessels; it presents but few points of sur- 

 gical interest. 



If amputation through the middle third were performed 

 by means of antero-posterior flaps (the operation to be 

 preferred), the anterior would contain the integuments 

 of the thigh, with the cutaneous nerves and internal 

 saphena vein, the rectus, sartorius, adductor longus, 

 brevis, and gracilis muscles, obturator nerve, femoral 

 vessels, and branches of anterior crural nerve, a portion 

 of the vastus externus, internus, and adductor magnus 

 muscles. The posterior, portion of vastus externus and 

 internus, adductor longus, brevis, and magnus muscles, 

 deep femoral and perforating vessels, the hamstring mus- 

 cles, great sciatic nerve, lesser sciatic nerve, and integu- 



