THE ANTERIOR FEMORAL REGION 509 



intermuscular septum (septum intermuscidare laterals) is the stronger. It extends 

 from the insertion of the Gluteus maximus to the outer condyle, separates the 

 Vastus externus in front from the short head of the Biceps femoris behind, and 

 gives partial origin to these muscles; the internal intermuscular septum (septum 

 intermusculare mediale), the thinner of the two, separates the Vastus interims 

 from the Adductor and Pectineus muscles. Besides these there are numerous 

 smaller septa, separating the individual muscles and enclosing each in a distinct 

 sheath. At the upper and inner part of the thigh, a little below Poupart's ligament, 

 a large, oval-shaped aperture is observed; it transmits the internal saphenous vein 

 and other smaller vessels, and is termed the saphenous opening (fossa ovalis) 

 (Fig. 380). This opening is covered by a portion of the deep layer of the super- 

 ficial fascia, the cribriform fascia. In order more correctly to consider the mode 

 of formation of this aperture, the fascia lata in this part of the 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 saphe- 

 nous 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 iliopectineal line in conjunction with Gimbernat's 

 ligament. From the spine of the os pubis it is reflected downward and outward, 

 forming an arched margin, the falciform process or the falciform margin of Burns 

 (jnargo f aid for mis}. This margin overlies and is adherent to the superficial 

 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 

 femoral ligament, or the ligament of Hey, is the point at which the falciform process 

 joins the base of Gimbernat's ligament. 



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, the pubic portion 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 iliopectineal line, where it becomes continu- 

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

 portion of the fascia lata passes superficial to 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. 



Applied Anatomy. The iliqtibial band at a point between the crest of the ilium and the 

 great trochanter is so tense that it is impossible to sink the fingers deeply in this region. Dr. 

 Allis points out that in fracture of the neck of the femur the great trochanter mounts toward 

 the iliac crest, the iliotibial band relaxes, and the fingers can be sunk deeply into the space 

 between the great trochanter and the iliac crest. Shortening is thus indicated. This is known 

 as Allis' sign. A Psoas abscess usually points at the termination of the Psoas muscle, but the 

 tuberculous pus may be directed down the thigh beneath the fascia lata, and it may reach the 

 popliteal space or may go even lower. 



The Tensor fasciae femoris (m. tensor fasciae latae) (Fig. 381) arises from the 

 anterior part of the outer lip of the crest of the ilium, from the outer surface of 

 the anterior superior spine, and part of the outer border of the notch below it, 

 between the Gluteus medius and Sartorius, and from the surface of the fascia 

 covering the Gluteus medius. It is inserted between two layers of the fascia lata, 

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

 the fascia is continued downward to the external tuberosity of the tibia as a thick- 

 ened band, the iliotibial band. 



The Sartorius (m. sartorius'} (Fig. 381), the longest muscle in the body, is flat, 

 narrow, and ribbon-like; it arises by tendinous fibres from the anterior superior 



