508 THE MUSCLES AND FASCIA 



thigh is described as consisting of two portions an iliac portion and a pubic 

 portion. 



The iliac portion is all that part of the fascia lata on the outer side of the 

 saphenous opening. It is attached, externally, to the crest of the ilium and 

 its anterior superior spine, to the whole length of Poupart's ligament as far 

 internally as the spine of the os pubis, and to the pectineal line in conjunction 

 with Gimbernat's ligament. From the spine of the os pubis it is reflected down- 

 ward and outward, forming an arched margin, the boundary or falciform process 

 (superior cornu) of the saphenous opening ; this margin overlies and is adherent 

 to the anterior layer of the sheath of the femoral vessels : to its edge is attached 

 the cribriform fascia ; and, below, it is continuous with the pubic portion of the 

 fascia lata. 



The pubic portion is situated at the inner side of the saphenous opening : at 

 the lower margin of this aperture it is continuous with the iliac portion ; traced 

 upward, it covers the surface of the Pectineus, Adductor longus, and Gracilis 

 muscles, and, passing behind the sheath of the femoral vessels, to which it is 

 closely united, is continuous with the sheath of the Psoas and Iliacus muscles, 

 and is attached above to the ilio-pectineal line, where it becomes continuous with 

 the iliac fascia. From this description it may be observed that the iliac portion 

 of the fascia lata passes in front of the femoral vessels, and the pubic portion 

 behind them, so that an apparent aperture exists between the two, through which 

 the internal saphenous joins the femoral vein. 1 



The fascia should now be removed from the surface of the muscles. This may be effected 

 by pinching it up between the forceps, dividing it, and separating it from each muscle in the 

 course of its fibres. 



The Tensor vaginse femoris arises from the anterior part of the outer lip of 

 the crest of the ilium, and from the outer surface of the anterior superior spinous 

 process, between the Gluteus medius and Sartorius. It is inserted into the fascia 

 lata about one-fourth down the outer side of the thigh. From the point of inser- 

 tion the fascia is continued downward to the head of the tibia as a thickened band, 

 the ilio-tibial band. 



Relations. By its superficial surface, with the fascia lata and the integument ; 

 by its deep surface, with the Gluteus medius, Rectus femoris, Vastus externus, 

 and the ascending branches of the external circumflex artery; by its anterior 

 border, with the Sartorius, from which it is separated below by a triangular space, 

 in which is seen the Rectus femoris ; by its posterior border, with the Gluteus 

 medius. 



The Sartorius, the longest muscle in the body, is flat, narrow, and ribbon-like ; 

 it arises by tendinous fibres from the anterior superior spinous process of the 

 ilium and the upper half of the notch below it, passes obliquely across the upper 

 and anterior part of the thigh, from the outer to the inner side of the limb, then 

 descends vertically, as far as the inner side of the knee, passing behind the inner 

 condyle of the femur, and terminates in a tendon which, curving obliquely 

 forward, expands into a broad aponeurosis inserted into the upper part of the 

 inner surface of the shaft of the tibia, nearly as far forward as the crest. This 

 expansion is inserted into the bone by an inverted U-shaped aponeurosis: part 

 of it is inserted behind the attachment of the Gracilis and Semitendinosus, and 

 another part, arching over the upper border of the tendon of the Gracilis, is inserted 

 into the tibia in front of these muscles. An oifset is derived from the upper margin 

 of this aponeurosis, which blends with the fibrous capsule of the knee-joint, and 

 another, given off from its lower border, blends with the fascia on the inner side 

 of the leg. 



The relations of this muscle to the femoral artery should be carefully examined, 

 as it constitutes the chief guide in tying the artery. In the upper third of the 

 thigh it forms the outer side of a triangular space, Scarpas triangle, the inner 



1 These parts will be again more particularly described with the anatomy of Hernia. 



