248 



FEMORAL ARTERY. 



destination; it enters the articulation beneath 

 the transverse ligament, through the notch at 

 the internal and inferior part of the margin of 

 the acetabulum, over which the ligament is 

 thrown ; supplies the adipose structure which 

 occupies the bottom of the socket, and is con- 

 ducted by the ligamentum teres to the head of 

 the femur, in which it is ultimately distributed. 

 That part of the artery which reaches the head 

 of the femur is of very inconsiderable size, and 

 is the source upon which the nutrition of that 

 part depends in fracture of the neck of the bone 

 within the capsule. Lastly, upward and back- 

 ward the artery sends off a considerable and 

 regular branch which is usually described as 

 one of its terminating branches, but which, in 

 the opinion of the author, may with more pro- 

 priety be considered as belonging to its middle 

 stage. It passes upward and outward between 

 the obturator externus and the quadratus mus- 

 cles to the trochanteric fossa, where it is dis- 

 tributed to the muscles inserted behind the 

 trochanter, viz. to those which have been just 

 mentioned; to the obturator internus, the 

 gemelli, the pyriformis, the glutcei medius and 

 minimus, and to the back of the ilio-femoral 

 articulation, and where it inosculates with the 

 glutceal, sciatic, and external circumflex arte- 

 ries. Jt may be appropriately called the poste- 

 rior trochanteric* branch. 



After its passage between the quadratus and 

 the adductor magnus, the circumflex artery 

 divides, in the posterior region of the thigh, 

 into an ascending and a descending branch. 

 The former passes upward to the origin of the 

 biceps, semi - membranosus and tendinosus 

 muscles, and to the glutceus maximus ; the 

 latter downward to the former muscles, to the 

 adductor magnus, and to the sciatic nerve. 

 They communicate with the sciatic, the exter- 

 nal circumflex, and superior perforating arte- 

 ries. 



The perforating arteries are three or four in 

 number. They are given off backward by the 

 profunda, below the origin of the circumflex 

 arteries, and are denominated numerically first, 

 second, third, &c. They all pass from the an- 

 terior to the posterior region of the thigh by 

 perforating the adductor magnus, and at times 

 also the adductor brevis, whence their name ; 

 they divide for the most part into ascending 

 and descending branches, and are consumed 

 partly in the supply of that region, and partly 

 in establishing a chain of communications be- 

 tween the arteries of the trunk and the main 

 artery at the upper and the lower parts of the 

 thigh. 



3. The first perforating artery arises from the 

 profunda immediately below the lesser trochan- 

 ter, nearly opposite the lower margin of the 

 pectinalis : it passes backward, descending a 

 little below the lower margin of the pectinalis, 

 either between it and the upper one of the ad- 

 ductor brevis, or through an aperture in the 

 latter muscle : it next perforates the adductor 

 magnus close to the linea aspera, and so gains 

 the posterior region of the thigh, where it 



* Scarpa, op. cit. 



divides into two or three large branches, of 

 which one ascends and is distributed to the 

 glutceus maximus, communicating with the 

 glutceal, sciatic, and circumflex arteries; ano- 

 ther descends, supplies the long head of the 

 biceps, the semi-membranosus and semi-tendi- 

 nosus, and communicates with the inferior per- 

 forating arteries ; and the third runs downward 

 and outward into the vastus externus, through 

 which it descends, communicating at the same 

 time with the external circumflex artery. The 

 artery also gives branches to the sciatic nerve, 

 and, during its passage from the front to the 

 back of the thigh, to the pectinalis and the ad- 

 ductors. According to Harrison, " this artery 

 is sometimes a branch of the internal circum- 

 flex ; its course is nearly parallel to that vessel, 

 and is separated from it by the tendon of the 

 pectinaeus muscle, the first perforating artery 

 passing below that tendon, while the circumflex 

 artery runs superior to it." 



4. The second perforating artery is generally 

 the largest of those vessels: it arises a short 

 distance below the first, and passes through 

 both the adductors brevis and magnus ; it then 

 divides, like the former, into ascending and de- 

 scending branches : the former are distributed 

 to the glutreus maximus, the vastus externus, 

 and the tensor vaginae, likewise anastomosing 

 with the first perforating, the glutceal, sciatic, 

 and circumflex arteries: the latter are distri- 

 buted to the biceps, semi-membranosus, and 

 semi-tendinosus, the vastus externus, and the 

 integuments of the back of the thigh, and in- 

 osculate with the inferior perforating and with 

 branches of the popliteal artery. The artery 

 also gives branches to the adductor muscles 

 and to the sciatic nerve and the nutritious artery 

 of the femur, which enters a canal to be ob- 

 served in the linea aspera, at the junction of 

 the first and second thirds of the thigh, leading 

 obliquely upward into the bone. The second 

 perforating artery at times does not pass 

 through the adductor brevis, but when the first 

 does so, it generally runs inferior to it, perfora- 

 ting the adductor magnus only. 



5. The third perforating artery is smaller 

 than either of the former, and arises lower 

 down ; according to Harrison, at the upper 

 edge of the adductor longus muscles, it passes 

 through the adductor magnus, and divides in 

 the same manner as the others : its branches 

 are also similarly distributed, and anastomose 

 with the second perforating artery from above, 

 and with branches of the popliteal from below. 



When a fourth perforating artery exists, it 

 pursues a similar course and is distributed 

 similarly to the last. The perforating branches 

 of the profunda are subject to much variety 

 with regard to number, size, and precise course 

 and distribution ; so much so that they hardly 

 admit a definite description : the preceding ac- 

 count has been taken from a comparison of the 

 most approved authorities with the subject, in 

 order, as far as possible, to embrace their nu- 

 merous irregularities. 



Beside those branches, which have been 

 enumerated, to which proper name have Keen 

 given, the profunda artery gives off during its 



