240 



FEMORAL ARTERY. 



and deeper layer of the fascia. The canal 

 thus formed, to which the author would apply, 

 with Cloquet, the term femoral canal, is 

 widest at its upper extremity, i. e. at Poupart's 

 ligament; from whence, as it descends, it 

 contracts in width until it has passed the 

 entrance of the saphena, beyond which it 

 continues of nearly uniform capacity to its 

 termination. The diminution in the transverse 

 extent of the canal is due to the direction 

 of the line of union between the superficial 

 lamina of the iliac portion and the pubic 

 portion of the fascia, which, as has been 

 already stated, inclines outward as it descends 

 from the pectineal line of the pubis to the 

 point at which the saphena joins the femoral 

 vein. In the interval between Poupart's 

 ligament and the junction of the two veins 

 the superficial lamina is thinner, less aponeu- 

 rotic, and more of a cellular character than 

 other parts of the fascia ; but it is subject to 

 much variety in this respect : in all cases it 

 is thinner and weaker internally than externally, 

 but in some it is throughout distinct and un- 

 broken, unless by the passage of vessels, and 

 presents aponeurotic characters as decidedly as 

 many other parts of the expansion ; while in 

 others it is cellular, indistinct, and even fatty, 

 not easily distinguishable from the subcuta- 

 neous structure, and so thin as to seem de- 

 ficient toward its inner part, or to have its 

 line of union with the pubic portion inter- 

 rupted at one or more points. The extent 

 and connections of this portion of the fascia 

 will be most satisfactorily displayed by first 

 detaching Poupart's ligament, upon its abdo- 

 minal side, from the fascia trans versalis as it 

 descends beneath the ligament, and then care- 

 fully insinuating the handle of a knife down- 

 ward beneath the ligament and the superficial 

 lamina of the iliac portion of the fascia lata, 

 between them and the prolongation of the 

 fascia transversalis : this done, the superficial 

 lamina may, with the guidance of the instru- 

 ment beneath it, be satisfactorily traced. 



The fourth structure, by which the femoral 

 artery is covered in the first stage of its course, 

 is the prolongation of the fascia transversalis. 

 The two abdominal fasciae, the transversalis 

 and the iliaca, which are, at every other part 

 of the crural arch, either identified and united, 

 or inserted into bone, are separated in the in- 

 terval between the middle of Poupart's and 

 the base of Gimbernat's ligament, and de- 

 scend into the thigh, the former in front of or 

 superficial to the femoral vessels, beneath Pou- 

 part's ligament and the superficial lamina of 

 the iliac portion of the fascia lata ; the latter 

 behind or deeper than the vessels, between 

 them and the psoas and pectinalis muscles, 

 constituting or continued into the pubic or 

 deep portion of the fascia lata. The two fasciae 

 thus leave an aperture beneath Poupart's liga- 

 ment, through which the vessels escape from 

 the abdomen, and at the same time inclose 

 them between them ; the prolongation of the 

 transversalis covering them in front, the iliac 

 and pubic portion of the fascia lata situate 

 behind them. As it descends upon the vessels, 



the prolongation from the transversalis is united 

 to the fascia iliaca and iliac portion of the 

 fascia lata upon their outside; and to the pubic 

 portion upon their inside, in the same manner 

 as the superficial lamina of the iliac portion, 

 and within it in reference to the femoral canal : 

 it may therefore be viewed in one of two lights 

 with regard to that canal, viz. either as de- 

 scending into it superficial to the vessels, and 

 entering into the constitution of its anterior 

 wall, or as concurring with the other fasciae to 

 form, beneath the superficial lamina of the 

 iliac portion of the fascia lata, a sheath, in 

 which the vessels are immediately contained. 

 The latter is the view which has been adopted 

 by anatomists, and the appellation femoral has 

 been given to the sheath so formed. Like the 

 superficial lamina of the iliac portion of the 

 fascia lata, the prolongation of the fascia trans- 

 versalis is wider at Poupart's ligament, and 

 diminishes in width as it descends to the junc- 

 tion of the saphena and femoral veins : hence 

 the femoral sheath is considerably larger supe- 

 riorly than inferiorly, does not embrace the 

 vessels closely at their entrance into the thigh, 

 and but for the aponeurotic expansion described 

 by Colles, and termed by Cloquet the crural 

 septum, would be open toward the abdomen ; 

 but in proportion as they descend, it invests 

 them more closely until it reaches the entrance 

 of the saphena, at which point its connection to 

 them is intimate, and from whence the prolon- 

 gation seems to the author to be continued down- 

 ward into the dense thin cellular or nbro-cellular 

 investment, by which the artery and vein are 

 surrounded and connected together within the 

 femoral canal during the remainder of their 

 course through the thigh. From Sir A. Coo- 

 per's account of the prolongation it would 

 appear that it terminated, or cannot be traced 

 further than two inches below Poupart's liga- 

 ment. Sir Astley says, " these vessels pass 

 down within the sheath for about two inches, 

 after which they carry with them a closely 

 investing fascia derived from the fascia lata." 

 By the " closely investing fascia," the author 

 understands the proper sheath of the vessels, 

 which has been adverted to, and with which 

 the prolongation of the fascia transversalis 

 appears to him to be identified. According to 

 Professor Harrison,* " it soon becomes thin 

 and indistinct, and is lost in the cribriform 

 part of the fascia lata;' 7 but in this view of its 

 termination the author cannot concur ; the pro- 

 longation is doubtless connected to the cribri- 

 form fascia (the superficial lamina of the iliac 

 portion of the fascia lata) by the vessels, which 

 traverse both structures, but it is notwith- 

 standing separable, without much difficulty, 

 from it, by means of the proceeding already 

 recommended for the display of that part 

 a proceeding equally applicable to that of the 

 distinct existence and the connections of the 

 expansion in question ; the superficial lamina 

 being at the same time, as directed by Colles, 

 divided from above downward, and its parts 

 held to either side, inasmuch as a thin cellular 



* Dublin Dissector, p. 153. 



