142 



DISSECTION OF THE THIGH. 



Ilio-tibial 

 band. 



Apertures 

 in fascia. 



Processes 

 between the 

 muscles. 



Connected 

 with bone 

 at upper 

 part of 

 thigh, 



difference at 

 lower part. 



Bands on 

 sides of 

 patella ; 

 outer 

 strong, 



inner weak. 



Replace 

 flaps of 

 skin. 



Saphenous 

 opening : 



situation 

 and 



size; 



no defined 

 border on 

 inner side ; 



on outer 

 side the 

 falciform 

 margin, 



It is strongest on the outer aspect of the limb, where it receives 

 the insertion of the tensor vaginas femoris, and most of the glutens 

 maximus muscle. This thickened part (ilio-tibial band) is attached 

 above to the hip-bone, and below to the outer tuberosity of the tibia 

 and the outer side of the patella, and helps to keep the knee-joint 

 straight in standing, as explained on p. 113. 



Numerous apertures exist in the fascia for the transmission of the 

 cutaneous nerves and vessels ; and the largest hole is near Poupart's 

 ligament, to permit the passage of the internal saphenous vein. 



Processes prolonged from the deep surface form septa between, 

 and fibrous sheaths around, the several muscles. Two of the pro- 

 cesses are larger than the rest, and are named outer and inner 

 inter-muscular septa of the thigh ; they are fixed to the femur, so as 

 to limit on the sides the extensor of the knee. The position of 

 these partitions is marked by white lines on the surface. 



At the top of the thigh the fascia is fixed to the prominent borders 

 of the pelvis. Thus, it is connected externally with the iliac crest, 

 and internally with the body of the pubis and the margin of the 

 pubic arch. Behind, it is joined to the lower end of the sacrum 

 and coccyx ; and in front, to Poupart's ligament between the pubis 

 and the iliac crest. Behind the knee-joint the fascia passes un- 

 interruptedly to the leg ; but in front of the articulation it blends 

 with an expansion from the extensor muscle, and is continued over 

 the joint and the patella, though separated from that bone by a 

 bursa, to be inserted into the heads of the tibia and fibula. 



On each side of the patella is a band of almost transverse fibres 

 (retinaculum), which is attached to and supports the knee-cap. 

 The outer, thick and strong, is continuous externally with the ilio- 

 tibial band, and joins the insertion of the vastus externus at its 

 attachment to the patella : it guides the patella outwards when the 

 joint is bent. The inner band, of slight strength, is fixed to the 

 patella lower than the other, and unites with the insertion of the 

 inner vastus. 



Directions. The flaps of skin which were removed from the front 

 of the thigh, to follow the cutaneous vessels and nerves, are to be 

 now stitched together to keep moist the subjacent parts ; and the 

 saphenous opening is to be learnt. 



The SAPHENOUS OPENING in the fascia lata (fig. 54, /, p. 137), is 

 an oval aperture, which is situate rather internal to the middle line of 

 the thigh. It measures about half an inch in width, and one inch 

 and a half in length. Its upper extremity (superior cornu) is at 

 Poupart's ligament ; and its lower extremity (inferior cornu) is 

 distant from that structure about one inch and a half, and presents 

 (when dissected) a well-defined margin. 



Internally, the saphenous opening has not any distinct margin, 

 for the membrane here (called the pubic portion of the fascia lata) is 

 continued outwards over the subjacent muscle (pectineus), and 

 behind the femoral vessels, to form the back of the crural sheath. 



Externally, the fascia lata (iliac portion} forms a semilunar border, 

 when detached, the concavity of which is turned downwards and 



