THE FEMORA L AR TER I ' ( ;s9 



triangle into Hunter's canal, the Iliacus and Pectineus muscles lie behind it for 

 a short distance (Fig. 482). 



That portion of the femoral artery which extends from Poupart's ligament 

 to the origin of the profunda is sometimes named the common femoral. 



PLAN OF THE RELATIONS OF THE FEMORAL ARTERY IN HUNTER'S CANAL. 



In front. 



Skin, superficial and deep fasciae. 

 Internal cutaneous nerve. 

 Sartorius. 



Aponeurotic covering of Hunter's canal. 

 Internal saphenous nerve. 



Inner side. S ~\ Outer side - 



Adductor longus. / Femoral ] tng saphenous nerve. 



Adductor magnus. \ Arter y- / Nerve to Vastus mternus. 



Sartorius. i, astus internus. 



remoral vein (below). 



Behind. 



Femoral vein (above). 

 Profunda artery and vein. 

 Pectineus and Iliacus (high up). 

 Adductor longus. 

 Adductor magnus. 



Peculiarities, Double Femoral Reunited. Several cases are recorded in which the femoral 

 artery divided into two trunks below the origin of the profunda, and became reunited near the 

 opening of the Adductor magnus so as to form a single popliteal artery. One of them occurred 

 in a patient operated upon for popliteal aneurism. 



Change of Position. A few cases have been recorded in which the femoral artery was 

 .situated at the back of the thigh, the vessel being continuous above with the internal iliac, escap- 

 ing from the pelvis through the great sacrosciatic foramen, and accompanying the great sciatic 

 nerve to the popliteal space, where its division occurred in the usual manner. The external 

 iliac in these cases was small, and terminated in the profunda. 



Position of the Vein. The femoral vein is occasionally placed along the inner side of the 

 artery, throughout the entire extent of Scarpa's triangle, or it may be divided so that a large 

 vein is placed on each side of the artery for a greater or less extent. 



Surface Marking. The upper two-thirds of a line drawn from a point midway between 

 the anterior superior spine of the ilium and the symphysus pubis to the adductor tubercle on 

 the inner condvle of the femur, with the tliiirh abducted and rotated outward, will indicate the 

 course of the femoral artery. 



Applied Anatomy. Compression of the femoral artery, which is constantly requisite in 

 amputations and other operations on the lower limbs, and also for the cure of popliteal aneurisms, 

 is most effectually made immediately below Poupart's ligament. In this situation the artery is 

 very superficial, and is merely separated from the ascending ramus of the os pubis by the Psoas 

 muscle; so that the surgeon, by means of his thumb or a compressor, may effectually control the 

 circulation through it. This vessel may also be compressed in the middle third of the thigh by 

 placing a compress over the artery, beneath the tourniquet, and directing the pressure from 

 within outward, so as to compress the vessel against the inner side of the shaft of the femur. 



The application of a ligature to the femoral artery may be required in the cases of wound or 

 aneurism of the arteries of the leg, of the popliteal or femoral j 1 and the vessel may be exposed 

 and tied in any part of its course. The great depth of this vessel at its lower part, its close con- 

 nection with important structures, and the density of its sheath render the operation in this 

 situation one of much greater difficulty than the application of a ligature at its upper part, where 

 it is more superficial. 



Ligation of the common femoral artery is usually considered unsafe, on account of the con- 

 nection of large branches with it viz., the deep epigastric and the deep circumflex iliac arising 

 just above Poupart's ligament; on account of the number of small branches which arise from 

 it in its short course; and on account of the uncertainty of the origin of the profunda femoris, 

 which, if it arise high up, would be too close to the ligature for the formation of a firm coag- 



iim. The profunda sometimes arises higher than the point above mentioned, and rarely 



1 Ligation of the femoral artery has been also recommended and performed for elephantiasis of the leg and 

 acute inflammation of the knee-joint (Maunder, Clin. Soo. Trans., vol. ii, p. 37). 



44 



