FEMORAL ARTERY. 



241 



or adipose stratum is interposed between them. 

 The last particular in the disposition of the 

 prolongation of the fascia trans versalis, having 

 reference to the femoral artery, is, that it is 

 connected to the back of the femoral canal 

 (the pubic portion of the fascia lata posterior 

 to the vessels) by two septa or partitions, 

 placed, one between the artery and vein, upon 

 the inside of the former ; the other internal to 

 the latter, between it and the femoral ring: 

 by those the abdominal aperture of the femoral 

 sheath is divided into three compartments: 

 an external one occupied by the artery, a mid- 

 dle one by the vein, and an internal by the 

 lymphatics, and at times by a gland. The 

 two former are so protected that the occurrence 

 of hernia through them is rare ; in the case of 

 the first probably impossible; but the internal, 

 whether from weakness or deficiency of pro- 

 tecting provisions, allows its protrusion, and 

 hence the relation of the femoral vessels, and 

 more particularly of the artery to the neck of 

 the sac of femoral hernia, upon the outer side 

 of which it is always situate, separated from it 

 by the vein. 



At the lower part of the first stage the artery 

 is crossed obliquely by the most internal of the 

 deep branches of the crural nerve, which for 

 distinction sake might be called internal geni- 

 cular : it enters the femoral canal on the out- 

 side of the vessels above, at a variable distance 

 from Poupart's ligament; descends from 

 without inward upon the front of the artery 

 within the canal ; and escapes from it below 

 on the inside of the vessel under cover of the 

 sartorius. Situate, as the nerve is, within the 

 femoral canal, upon the front of the artery, 

 and closely connected to it by the femoral 

 sheath, it is very likely, unless care be taken 

 to avoid it, to be included in a ligature at the 

 same time with the vessel : it will not, how- 

 ever, be always encountered, inasmuch as it 

 crosses the artery, and at a point higher or 

 lower in different subjects. 



At times a second branch of the crural 

 nerve crosses the artery in like manner as the 

 former and lower down, but it is not to be 

 always observed. 



Posteriorly in its first stage the artery rests, first 

 upon the inner margin of the psoas magnus, 

 from which it is separated by the deep lamina 

 of the iliac portion of the fascia lata: while 

 so related, it is situate over the anterior surface of 

 the os innominatum, external to the iliopec- 

 tineal eminence, having the two structures, 

 already mentioned, interposed.* Below the 



* In this the author has ventured to differ from 

 the account usually given of the relation of the 

 artery to the os innominatum, according to which 

 (Boyer, Cloquet,) the vessel must be understood 

 to be situate internal to the point mentioned, being 

 said to lie upon the os pubis ; but in his opinion 

 this is not correct. The artery lies on the psoas, 

 which is not internal to the eminence, and upon 

 the deep lamina of the iliac portion of the fascia 

 lata covering the muscle, which at its most internal 

 part is inserted into the eminence ; consequently 

 the vessel, which lies on the lamina, must be ex- 

 ternal to that point of bone, and observation will 

 be found to confirm this view. 

 VOL. II. 



os innominatum it is placed over the head of 

 the femur, from which it is separated by the 

 same parts, and also by the capsular ligament 

 of the articulation, and the synovial bursa, 

 which exists between the front of the capsule, 

 and the psoas and iliacus muscles. There are 

 then in this situation two resisting surfaces 

 against which compression of the vessel may 

 be effected; and here also, as observed by 

 Harrison, a tumour with pulsation may occur 

 in case of effusion either into the bursa simply, 

 or into the joint, when a communication exists 

 between the former and the synovial membrane 

 of the latter. 



Having passed the margin of the psoas and 

 the head of the femur, the artery corresponds 

 to the tendon of the psoas and iliacus, to the 

 pectinalis, and to a small portion of the ad- 

 ductor brevis, which parts it crosses obliquely 

 in its descent : it is not, however, in contact 

 with them, but is separated from them by a 

 space of some depth occupied by cellular 

 structure and vessels. The distance of the 

 artery from the muscles varies according to 

 circumstances : when the thigh is extended or 

 rotated inward, it is increased; when, on the 

 other hand, it is flexed or rotated outward,* 

 it is diminished : in the former case, the artery 

 is brought nearer to the anterior surface of the 

 thigh by the extension, and by the rotation 

 the lesser trochanter, which is in the middle 

 and deepest part of the space, is carried back- 

 ward from that surface. 



The vessels which occupy the interval be- 

 tween the artery and the muscles are the pro- 

 funda vein, the circumflex veins, and the 

 femoral vein in part, they being next to the 

 artery and immediately behind it ; posterior to 

 them are, at times, the profunda artery, and 

 at the upper part, according to circumstances, 

 one or other of the circumflex arteries, when 

 arising, as in ordinary, from it. 



External to the artery in its first stage are 

 the psoas and iliacus muscles, the sartorius, 

 the rectus, and the upper extremity of the 

 vastus internus muscles ; from all which it is 

 separated by the wall of the femoral canal. 

 At the entrance of the artery into the thigh, 

 and for about an inch below Poupart's liga- 

 ment, the crural portion of the genito-crural 

 nerve is contained within the femoral canal in 

 immediate apposition with the vessel upon its 

 outer side. External to it are situate also the 

 crural nerve above, and itssaphena branch below. 

 Except in rare instances, the profunda artery 

 lies on the outer side of the femoral during a 

 greater or less extent of its first stage; but it 

 is, unless occasionally near to its origin, at the 

 same time posterior to it, and is subject to 

 varieties in its relation which will be more 

 particularly detailed in the description of that 

 vessel. 



Internally the artery corresponds, though at 

 a distance, to the pectinalis and adductor mus- 

 cles. The femoral vein at the upper part is 

 very nearly upon the same level ; the artery, 

 however, is somewhat anterior to it, probably 



* Harrison. 



