THE THIGH 221 



The tendons behind the medial condyle of the femur are 

 more easily felt in the living than the dead body ; they are 

 the tendons of the semitendinosus and semimembranosus 

 muscles. The less easily palpated tendon of the adductor 

 magnus should be distinguished as it descends to the proximal 

 border of the medial femoral condyle. 



The dissector should verify all these points of surface 

 anatomy not only on the dead body but also on the bodies 

 of himself and his friends, and he should examine them 

 repeatedly until he is quite familiar with them both by sight 

 and by touch. 



THE ANTERIOR FEMORAL AND MEDIAL FEMORAL REGIONS 

 AND THE ANTERIOR REGION OF THE KNEE. 



Superficial Dissection. This dissection comprises the 

 examination of the following parts : 



1. Superficial fascia. 



2. The great saphenous vein and its tributaries. 



3. The superficial external pudendal artery. 



4. The superficial epigastric artery. 



5. The superficial circumflex iliac artery. 



6. Lymph glands and vessels. 



7. The fossa ovalis. 



8. Cutaneous nerves. 



9. The fascia femoris (deep fascia of the thigh). 

 10. The bursse patellae. 



Dissection. Reflection of the Skin. Incisions. (i) From 

 the anterior superior iliac spine along the line of the inguinal 

 ligament to the symphysis pubis ; (2) from the medial extremity 

 of the first incision downwards along the margin of the scrotum, 

 then along the junction of the medial with the posterior aspect 

 of the thigh and across the medial aspect of the knee to the 

 level of the tuberosity of the tibia ; (3) from the distal end of the 

 vertical incision transversely across the anterior surface of the 

 leg to its lateral border. The quadrilateral flap of integument, 

 thus mapped out (9, Fig. 104), must be raised carefully from 

 the subjacent superficial fascia and turned laterally, particular 

 care being taken in the region of the knee to avoid injury to 

 the patellar plexus of cutaneous nerves. 



To make a clean incision through the skin hold the scalpel 

 at right angles to the surface and force the point through the 

 skin into the subjacent soft superficial fascia at the point of 

 commencement of the incision, then incline the blade to an 

 angle of forty-five degrees and, pressing firmly on the back of 

 the blade with the forefinger, draw it along the line of incision. 

 When the opposite end of the incision is reached bring the 

 scalpel to a right angle with the surface again and withdraw it. 



