246 



FEMORAL ARTERY. 



other, or to be the most prevalent, for such is 

 the view of the course of the artery given by 

 Haller,* in two of three views in which the 

 relative course of the two vessels is repre- 

 sented, and by Tiedemannf in two of four 

 views. But at other times, when the artery is 

 more tortuous, after descending for a little 

 way external to the femoral, it makes a turn, 

 and passes inward behind it, and thus fre- 

 quently gains the inner side of that vessel 

 before it reaches the adductor longus, after 

 which it again inclines outward toward its 

 destination. Such is the view given of its 

 course by Scarpa,J with which the description 

 of Harrison coincides : it is similarly repre- 

 sented by Tiedemann in fig. 4, tab. xxxiii., 

 and also by Haller in one instance ; but the 

 author is disposed to regard this as a less 

 common disposition, as well from the fre- 

 quency with which he has observed the former 

 one to occur, as from the weight of the autho- 

 rities which have been adduced in favour of 

 that opinion. In other but rare instances the 

 profunda, arising from the inside of the femo- 

 ral, inclines at first inward and becomes in- 

 ternal to it, and then bending outward crosses 

 behind the femoral to its outer side : of this 

 arrangement an instance is furnished by Tiede- 

 mann in fig. 3, tab. xxxiii. And in others 

 the artery does not in the first instance incline 

 sensibly to either side; but arising from the 

 back of the femoral it descends behind that 

 vessel, and does not gain its outer side until 

 it has reached the lower part of the inguinal 

 region. 



When the profunda artery arises very near 

 to or above Poupart's ligament, and from the 

 outer side of the femoral, is large and pursues 

 its ordinary course, two arteries of equal or 

 nearly equal size may be found, at the upper 

 part of the inguinal region, side by side, and 

 upon the same level, and thence liable to be 

 taken, either of them, for the femoral artery. 

 When such an arrangement occurs, the ex- 

 ternal|| of the two vessels will almost certainly 

 be found to be the profunda, for if that artery 

 have once passed inward behind the femoral, 

 it cannot afterward gain the same level with it, 

 so as to be situate at the same time internal to 

 and on the same plane with it : further, as the 

 profunda descends, it recedes from the an- 

 terior surface more than the femoral, in order 

 to pass behind the adductor longus, and thus 

 it gains at the lower part of the region a deeper 

 situation than the other. But inasmuch as the 

 profunda occasionally arises from the inside of 

 the femoral artery, it may be possible for it, 

 in case of high origin, to be the inner of the 

 two vessels adverted to. Such a circumstance, 

 however, if it ever occur, must be extremely 

 rare, but in order to guard against it, the pre- 



* Icones Anatomicae. 



t Tabulae Arteriarum. Tab. xxxi. and fig. 2. 

 tab. xxxiii. 



\ Reflexions et Observations Anatomico-chirur- 

 gicales sur 1'Aneurisme, tab. lere. 



$ Op. cit. 



\\ Harrison, op. cit. vol. ii. p. 165. Hargrave, 

 System of Operative Surgery. 



caution recommended of alternately compres- 

 sing the vessels and ascertaining the effect 

 previous to the application of a ligature, should 

 never be neglected. 



Branches of the profunda artery. The pro- 

 funda gives off a considerable number of 

 branches, some of which being distributed to 

 the muscles, by which the artery passes, and 

 not being remarkable either for their size or 

 their communications, have not received par- 

 ticular names. Those which are most de- 

 serving of attention, whether for their size, 

 the extent and peculiarity of their course, or 

 the anastomoses which they form with other 

 arteries, are five or six in number, viz. two 

 circumflex arteries, and three or at times four 

 perforating arteries. The circumflex arteries 

 are so named because they wind round the 

 upper extremity of the femur, and form an 

 arterial circle around it : they are distinguished 

 by the epithets external and internal, being 

 destined, one to the outer, the other to the 

 inner side of the limb : they are vessels of 

 considerable size and importance because both 

 of the extent of parts which they supply, and 

 of the communications which are established 

 through them between the femoral, the arteries 

 of the pelvis, and those of the lower parts of 

 the limb. 



1. The external circumflex artery at times 

 is the first branch of the profunda; at others 

 it is preceded by the internal circumflex : it is 

 given off from the profunda while it lies on 

 the outside of the femoral at a variable dis- 

 tance from Poupart's ligament, and arises from 

 the outer side of the artery : occasionally it is 

 given off by the femoral itself; it runs directly 

 outward, or outward and downward, in front 

 of the psoas and iliacus muscles; beneath the 

 sartorius and rectus, and either between or 

 behind the divisions of the crural nerve ; and 

 divides after a short course into three branches, 

 viz. an ascending, a descending, and a circum- 

 flex. 



. The first, the ascending branch, runs up- 

 ward and outward toward the superior anterior 

 spinous process of the ilium, between the 

 iliacus internus and the glutceus medius mus- 

 cles, and concealed by the tensor vaginae 

 fernoris: as it proceeds, it gives branches to 

 those muscles; and having reached the outer 

 and back part of the spinous process, it ter- 

 minates in an anastomosis with a branch of 

 the glutreal, and also with the deep cir- 

 cumflex ilii arteries. The anastomosis with 

 the glutceal artery becomes remarkably en- 

 larged when the main vessel is interrupted 

 above the origin of the profunda, as may be 

 seen from Sir A. Cooper's case of femoral 

 aneurism.* 



b. The second, the descending branch, runs 

 downward and outward beneath the rectus 

 muscle, between it and the triceps crural, and 

 divides after a short course for the most part into 

 several branches of considerable size and great 

 length for the supply of those muscles and for 

 establishing communications : the branches are 



* Guy's Hospital Reports, Jan. 1836, pi. 1. 



