THE ANTERIOR FEMORAL REGION 



507 



\ > 



/ 1. Dissection of 

 \ femoral hernia, 

 Jj and Scarpa's 

 triangle. 



2. Front of thigh. 



a vertical incision from the centre of this, along the middle of the thigh to below the knee-joint; 

 and a transverse incision from the inner to the outer side of the leg, at the lower end of the ver- 

 tical incision. The flaps of integument having be.-n removed, the superficial and deep fasciae 

 should be examined. The more advanced student should commence the study of this region by 

 an examination of the anatomy of femoral hernia and Scarpa's triangle, the incisions for the 

 dissection of which are marked out in Fig. 379. 



Superficial Fascia. The superficial fascia forms a continuous layer over the 

 whole of the thigh. It consists of areolar tissue, containing in its meshes much 

 fat, and is capable of being separated into two or more layers, between which are 

 found the superficial vessels and nerves. It 

 varies in thickness in different parts of the 

 limb; in the groin it is thick, and the two 

 layers are separated from one another by the 

 superficial inguinal lymph nodes, the internal 

 saphenous vein, and several smaller vessels. 

 One of these two layers, the superficial, is 

 continuous above with the superficial fascia of 

 the abdomen. Internally it is continuous with 

 the superficial fascia of the perineum. The 

 deep layer of the superficial fascia is a very thin 

 fibrous layer, best marked on the inner side of 

 the long saphenous vein and below Poupart's 

 ligament. It is placed beneath the subcuta- 

 neous vessels and nerves and upon the surface 

 of the fascia lata. It is intimately adherent to 

 the fascia lata a little below Poupart's ligament. 

 It covers the saphenous opening (Fig. 380) 

 in the fascia lata, being closely united to the 

 margins of the opening, and is connected to 

 the sheath of the femoral vessels. The portion 

 of the fascia covering this aperture is perfo- 

 rated by the internal saphenous vein and by 

 numerous bloodvessels and lymphatic vessels; 

 hence, it has been termed the cribriform fascia 

 (fascia cribrosa). The cribriform fascia adheres 

 closely both to the superficial fascia and to the 

 fascia lata, so that it is described by some anato- 

 mists as part of the fascia lata, but is usually 

 considered (as in this work) as belonging to the 

 superficial fascia. It is not until the cribriform 

 fascia has been cleared away that the saphenous 

 opening is seen, so that this opening does- not 



in ordinary cases exist naturally, but is the _ r *-- >> "' 



result of dissection. A large subcutaneous buTSS^'(bursa prae'patellaris subcutanea) 

 s found in the superficial fascia over thejmteli^^an^J, another (bursa trochanterica 

 subcutanea} in the superficial fascia over the g^sfe^rochanter. 



The Deep Fascia, or Fascia Laa (Fi^t&U). The deep fascia of the thigh is 

 exposed on the removal of the superficial fascia, and is named, from its great 

 extent, the fascia lata; it forms a uniform investment for the whole of this region 

 of the limb, but varies in thickness in different parts; thus, it is thicker in the upper 

 and outer part of the thigh, where it receives a fibrous expansion from the Gluteus 

 maximus muscle, and where the Tensor fasciae femoris is inserted between its 

 layers; it is very thin behind, and at the upper and inner part where it covers 

 the Adductor muscles, and again becomes stronger around the knee, receiving 



3. Front of leg. 



4- Dorsum of foot. 



FIG. 379. Dissection of lower., extremity. 

 Front view. " 



