420 



THE MUSCLES AND FASCIA. 



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 saphenous 

 opening. It is attached, externally, to the 

 crest of the ilium and its anterior superior 

 spine, to the whole length of Poupart's liga- 

 ment 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 downward and 

 outward, forming an arched margin, the falci- 

 form process or boundary (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 be- 

 tween the two, through which the internal 

 saphenous joins the femoral vein. 1 



The fascia should now be removed from the sur- 

 face of the muscles. This may be effected by pinch- 

 ing it up between the forceps, dividing it, and sepa- 

 rating it from each muscle in the course of its fibres. 



The Tensor fasciae femoris arises from the 

 anterior part of the outer lip of the crest of 

 the ilium, and from the outer surface of the an- 

 terior superior spinous process, and part of the 

 outer border of the notch below it, between the 

 Glutens 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 ex- 

 ternal tuberosit of the tibia as a thickened 



1 These parts will be again more particularly de- 

 FIG. 268. Muscles of the iliac and anterior ,, ^V 



femoral region scribed with the anatomy of Hernia. 



