150 



DISSECTION OF THE THIGH. 



afterwards 

 behind it. 



as the artery, and is similarly named ; its position to that vessel, 

 however, is not the same throughout. Beneath Poupart's ligament 

 it is on the inner side of the arterial trunk, and on the same level, 

 and is supported on the pubis between the psoas and pectineus 

 muscles ; but it soon winds behind the artery, and is placed 

 between the main trunk and its deep branch. In this space it 

 receives the internal saphenous and deep femoral veins, and a 

 small branch running with the deep external pudic artery. 



Muscles on 

 the thigh, 



Vessels. 



Nerve. 

 Take the 



the C front of 

 the thigh, 



Follow out 



serve nerves 



Dissect the 

 or&> 



and clean 



Dissect 

 fascia f 



DEEP PARTS OF THE FRONT OF THE THIGH. 



The muscles on the front of the thigh are to be learnt next : they 

 are the sartorius and the extensor of the knee ; and at the upper end 

 of the thigh is the small tensor of the fascia lata. Four muscles are 

 combined in the extensor, viz., rectus, crureus, vastus externus, and 

 vastus interims. 



The external circumflex branch of the profimda artery lies 

 amongst the muscles and supplies them with branches ; and a large 

 nerve, the anterior crural, furnishes offsets to them. 



Dissection. To proceed with the deep dissection, the limb is to 

 ^ je reta i ne( ^ * 11 tne same position, as before, and the flaps of skin on 

 the front of the thigh are to be thrown aside. The fascia lata is 

 to be cut along the middle line of the thigh and knee, and to be 

 reflected to each side nearly to the same extent as the skin. Over 

 the knee-joint the student is to note its attachment to the edges of 

 the patella, and its union with a prolongation from the tendon of 

 the extensor muscle of the knee. 



In raising the inner piece of the fascia, the narrow sartorius 

 muscle should be followed to its insertion into the tibia ; and 

 to prevent its displacement it should be fixed with stitches 

 along both edges. Care should be taken of the small nerves 

 in contact with the sartorius, viz., a plexus beneath it at the 

 middle of the thigh from the saphenous, internal cutaneous and 

 obturator ; two branches of the internal cutaneous below its 

 m ^^ e one cross i n g the surface, and the other lying along the 

 inner edge of the muscle ; and the trunk of the long saphenous 

 nerve escaping from beneath it near the knee, with the patellar 

 branch of the same perforating it rather higher. 



Internal to the sartorius some strong muscles (adductors) are 

 inclined downwards from the pelvis to the femur. The student is to 

 lay bare the fore part of these muscles (fig. 58) ; and beneath the most 

 superficial (adductor longus), near where it touches the sartorius, 

 he is to seek a branch of the obturator nerve to the plexus before 

 mentioned in the middle of the thigh. On the outer side of the 

 sartorius is the large extensor of the knee, in cleaning which the 

 knee is to be bent, to make tense the fibres. 



The smaller muscle at the upper and outer part of the thigh 

 (tensor fasciae femoris) is also to be cleaned ; and a strip of the 

 fascia, corresponding with the width of the muscle, should be left 



