220 THE INFERIOR EXTREMITY 



A faint sulcus at the proximal extremity of the anterior 

 region is the boundary line between the inguinal region of the 

 abdomen and the subinguinal region of the thigh. The 

 resistance felt deep to the sulcus is due to the ligamentum 

 inguinale, which is attached, at the lateral and superior end 

 of the sulcus, to the anterior superior iliac spine, and, at its 

 inferior and medial end, to the pubic tubercle. From the 

 anterior superior iliac spine the iliac crest can be traced 

 backwards to the posterior superior spine ; from the pubic 

 tubercle the ringer should be carried medially, along the pubic 

 crest, to the upper end of the symphysis pubis. Next, the finger 

 should be passed downwards, along the front of the symphysis 

 pubis, to the apex of the pubic arch and thence downwards and 

 backwards along the rami of fas. pubis and ischium, which mark 

 the superior boundary of the medial femoral region, to the tuber 

 ischiadicum. About ten centimetres below the highest part 

 of the iliac crest, and on the plane of the pubic crest, is 

 the trochanteric region, indicated by an eminence due to the 

 prominence of the trochanter major of the femur. Above the 

 trochanteric region, and between it and the iliac crest is the 

 region of the hip (regio coxce), and below the troehanteric region is 

 the lateral femoral region. At the distal end of the anterior 

 part of the thigh is the regio genu anterior. In the centre of 

 the anterior part of the knee lies the patella or knee- cap, the 

 outline of which can be seen as well as felt. From the distal 

 end of the patella the ligamentum patella should be followed 

 to the tuberosity of the tibia. 



At the distal end of the lateral region of the thigh the 

 outline of the lateral condyle of the femur is easily recognised. 

 Directly distal to it is the lateral condyle of the tibia, and at 

 the distal and posterior part of the latter is the head of the 

 fibula. The tendon which can be traced proximally from the 

 head of the fibula, on the border line between the lateral 

 and posterior femoral regions, is the tendon of the biceps 

 femoris ; and the dense, longitudinal band of fascia immedi- 

 ately anterior to the tendon of the biceps is the ilio-tibial 

 tract of the fascia lata a fascial band which is more easily 

 distinguishable in the living than in the dead body. 



At the distal end of the medial part of the thigh is the 

 outline of the medial condyle of the femur, which should be 

 palpated ; and immediately distal to it the medial condyle 

 of the tibia is easily recognised beneath the integument. 



