FEMORAL ARTERY. 



249 



course others less regular and less considerable, 

 which are distributed to the muscles in its 

 vicinity. Those are a branch to the pectinalis 

 and adductor muscles, and one or more to the 

 vastus internus and cruraeus muscles : it has 

 been elsewhere stated that the descending 

 branches of the external circumflex, destined 

 to the last-named muscles, and one of those to 

 the vastus externus, at times also arise from the 

 profunda itself. After having given off the last 

 perforating artery, the profunda, very much 

 reduced in size, continues its descent behind 

 the adductor longus muscle, inclining at the 

 same time outward, and external to the femoral 

 artery : it passes through the adductor magnus 

 a little above the passage of the femoral into 

 the ham, giving it small branches; then tra- 

 verses the origin of the short head of the biceps, 

 giving it also branches ; and, lastly, enters into 

 the outer part of the vastus externus, through 

 which it descends frequently to near the knee, 

 distributing branches to the muscle, and anasto- 

 mosing with the descending branches of the 

 external circumflex and with the external arti- 

 cular artery. The termination of the profunda 

 is by some* called the fourth perforating 

 artery. 



The profunda resembles very much in its 

 course and termination the superior profunda 

 or musculo-spiral branch of the brachial artery, 

 to which it may be considered analogous. 



Immediately before the femoral artery passes 

 into the popliteal space, it gives off its fifth and 

 lowest branch. This is usually called the 

 anastomotica magna artery, but there being no 

 more reason to apply the epithet anastomotic 

 to it than to the other branches of the femora, 

 and the great anastomotic artery of the thigh 

 being in reality the profunda, the name given 

 to it by Tiedemann seems much to be preferred, 

 viz. superficial superior internal articular. 

 It arises from the front of the femoral at the 

 inferior part of its last stage, and immediately 

 escapes from within the femoral canal, passing 

 through its anterior wall at the same time with 

 the saphenus nerve, as the femoral itself is 

 about to pass into the ham. Having come 

 through the aponeurosis forming the wall of the 

 canal, it descends for some distance toward the 

 inside of the knee parallel to the tendon of the 

 adductor magnus and anterior to it in company 

 with the saphenus nerve, and covered by the 

 sartorius muscle. After a short course it divides 

 into two branches. One of these runs down- 

 ward and forward, in front of the adductor 

 magnus, toward the patella ; enters the vastus 

 internus and traverses it in its course ; divides 

 within it into two branches, of which one runs 

 between the muscle and the bone, and supplies 

 the periosteum of the femur and the capsule of 

 the articulation, anastomosing at the same time 

 with the deep articulars ; the other continues 

 its course through the vastus, supplying the 

 muscle, until it reaches the side of the tendon 

 of the extensors : it then becomes superficial to 

 the tendon, and descends upon the front of the 

 patella, ramifying freely upon it, supplies the 



* Scarpa, op. cit. p. 17, 18. 



integuments and other superficial structures of 

 the articulation on its anterior part, and com- 

 municates freely with the other articular arte- 

 ries. 



The second branch, into which the superfi- 

 cial articular divides, descends posterior to the 

 tendon of the adductor, in company with the 

 saphenus nerve, and covered by the sartorius : 

 as it descends, it gives branches to the ham- 

 string muscles, the semi-membranosusandsemi- 

 tendinosus, and also to the sartorius : when it 

 has reached the inner side of the knee, it divides 

 into two, of which one passes forward beneath 

 the aponeurosis, upon the internal condyle of 

 the femur, divides into branches which supply 

 the superficial structures of the joint upon its 

 inside, can be traced forward beneath the pa- 

 tella, and form free communications with the 

 other articular arteries, more particularly with 

 the inferior internal one : the second descends 

 to the leg, escapes from beneath the tendon of 

 the sartorius, and then, turning forward, rami- 

 fies over the internal surface of the tibia below 

 its tubercle, supplies the insertions of the mus- 

 cles and the coverings, and communicates with 

 branches of the internal articular and of the 

 tibial recurrent arteries. The superficial supe- 

 rior internal articular artery is variable in size : 

 at times it is of very considerable magnitude ; 

 at others it is small, or even absent altogether, 

 its place being supplied by a branch of the 

 popliteal artery. Its distribution also varies 

 with its size, the extent of the former being 

 proportioned to the latter. 



The course of the artery diverges but little 

 from that of the femoral, and the relation of the 

 saphenus nerve to it is almost the same as that 

 which the nerve holds to the latter vessel : 

 hence, when the branch is large, it is liable to 

 be mistaken in the operation of tying the main 

 vessel, particularly in case of wound of the 

 arteiy, for the femoral itself. The description 

 of the articular artery here given has been 

 taken from the plate of Tiedemann, in which 

 the vessel is represented with its most extended 

 distribution. 



The femoral artery also gives off, during its 

 descent through the thigh, beside the branches 

 which have been described, several others to 

 the muscles which are in its vicinity ; above, it 

 sends branches to the sartorius, iliacus, and 

 pectinalis ; and in the middle of the thigh to 

 the vastus internus on the one hand, and to the 

 adductor muscles on the other. Those branches 

 are for the most part inconsiderable in size, 

 and have not received names, but they are de- 

 serving of attention, inasmuch as they coope- 

 rate in the collateral circulation, more particu- 

 larly the second set, through which the femoral 

 artery is generally preserved pervious, after 

 ligature below the origin of the profunda, during 

 a greater or less extent of the interval between 

 the ligature and the popliteal artery, by means 

 of the anastomoses between the branches in 

 question and the circumflex arteries. 



The adequacy of the collateral circulation in 

 the thigh to the maintenance and nutrition of 

 the limb after the interruption of the femoral 

 artery, has been so long established that it is 



