136 



DISSECTION OF THE THIGH. 



patella ; 



condyles 

 of the 

 femur ; 



tuberosities 

 of the tibia. 



The ham 

 behind. 



Dissection. 



Take up 

 skin at the 

 top of the 

 thigh. 



Superficial 

 fascia : 



how formed 



thickness 

 varies. 



To raise the 



superficial 



fascia. 



Relations of 



superficial 



fascia. 



Dissection 



joint, when it is half-bent, the rounded prominent patella may be 

 perceived ; this bone is firmly fixed while the limb is kept in the 

 bent position, but is moved with great freedom when the joint is 

 extended, so as to relax the muscles inserted into it. On each side 

 of the patella is the projection of the condyle of the femur, that on 

 the inner side being the larger. If the fingers are passed along the 

 sides of the patella while the joint is half bent, they will be con- 

 ducted to the tuberosities of the head of the tibia, and to a slight 

 hollow between it and the femur. 



Behind the joint is a slight depression over the situation of the ham 

 or popliteal space ; and on its sides are firm boundaries, which are 

 formed by the tendons (hamstrings) of the flexor muscles of the knee. 



Dissection. The limb being placed as 'before directed, the student 

 begins the dissection with the examination of the subcutaneous fatty 

 tissue with its nerves and vessels. 



At first the integument is to be reflected only from the hollow on 

 the front of the thigh below Poupart's ligament. An incision about 

 five inches in length, and only skin deep, is to be made from the 

 pubis along the inner border of the thigh (fig. 1, B, 9 , p. 3). At 

 the lower end of the first incision, another cut is to be directed out- 

 wards across the front of the limb to the outer aspect ( 10 ) ; and, at the 

 upper end, the knife is to be carried along the line of Poupart's 

 ligament as far as the crest of the ilium. The piece of skin included 

 by these incisions is to be raised and turned outwards, without taking 

 with it the subcutaneous fat. 



The subcutaneous fatty tissue, or the superficial fascia, forms a 

 general investment for the limb, and is constructed of a network of 

 areolar tissue, with fat or adipose substance amongst the meshes. 

 As a part of the common covering of the body, it is continuous with 

 that of the neighbouring regions ; consequently it may be followed 

 inwards to the scrotum or the labium according to the sex, and 

 upwards on the abdomen. Its thickness varies in different bodies, 

 according to the quantity of fat in it ; and when well developed it 

 may be divided into separate layers. Its relations will be made 

 more evident by the following dissection. 



Dissection. To reflect the superficial fascia, incisions similar to 

 those made in the skin are to be employed ; and the separation from 

 the subjacent structures is to be begun below, where the large 

 saphenous vein, and a condensed or membranous appearance on the 

 under surface, will mark the depth of the stratum. The layer of 

 fat may be thrown outwards readily by a few touches of the knife, 

 when the superficial vessels and inguinal lymphatic glands will come 

 into view. 



The subcutaneous layer decreases in thickness, and becomes more 

 fibrous near Poupart's ligament ; and on its under aspect it has a 

 smooth and membranous surface. It conceals the superficial vessels 

 and the inguinal glands, and is separated by these from Poupart's 

 ligament*. 



Dissection (fig. 54). The inguinal glands and the superficial 

 vessels are next to be cleaned by the removal of any surrounding 



