THE ANTERIOR FEMORAL REGION. 



419 



Z 12 



1. Dissection of 

 femoral hernia, 

 and Scarpa's 

 triangle. 



2. Front of thigh. 



3. Front of leg. 



and is named, from its great extent, the fascia lata ; it forms a uniform invest- 

 ment for the whole of this region of the limb, but varies in thickness in different 

 parts ; thus, it is thicker in the upper and outer part of the thigh, where it receives 

 a fibrous expansion from the Gluteus maximus 

 muscle, and the Tensor fasciae femoris is in- 

 serted between its layers : it is very thin 

 behind, and at the upper and inner part where 

 it covers the Adductor muscles, and again be- 

 comes stronger around the knee, receiving fibrous 

 expansions from the tendon of the Biceps ex- 

 ternally, and from the Sartorius internally, 

 and Quadriceps extensor cruris in front. The 

 fascia lata is attached, above and behind, to 

 the back of the sacrum and coccyx ; exter- 

 nally, to the crest of the ilium ; in front, to 

 Poupart's ligament and to the body of the os 

 pubis ; and internally, to the descending ramus 

 of the os pubis, to the ramus and tuberosity of 

 the ischium, and to the lower border of the 

 great sacro-sciatic ligament. From its attach- 

 ment to the crest of the ilium it passes down 

 over the Gluteus medius muscle to the upper 

 border of the Gluteus maximus, where it splits 

 into two layers, one passing superficial to and 

 the other beneath this muscle. At the lower 

 border of the muscle the two layers reunite. 

 Externally the fascia lata receives the greater 

 part of the tendon of insertion of the Gluteus 

 maximus, and becomes proportionately thick- 

 ened. The portion of the fascia lata arising 

 from the front part of the crest of the ilium, 

 corresponding to the origin of the Tensor 

 fasciae femoris, passes down the outer side 

 of the thigh as two layers, one superficial to 

 and the other beneath this muscle ; these at 

 its lower end become blended together into a 

 thick and strong band, having first received the 

 insertion of the muscle. This band is continued 

 downward, under the name of the ilio-tibial band, to be inserted into the external 

 tuberosity of the tibia. Below, the fascia lata is attached to all the prominent 

 points around the knee-joint viz., the condyles of the femur, tuberosities of the 

 tibia, and head of the fibula. On each side of the patella it is strengthened by 

 transverse fibres given off from the lower part of the Vasti muscles, which are 

 attached to and support this bone. Of these the outer is the stronger, and is con- 

 tinuous with the ilio-tibial band. From the inner surface of the fascia lata are 

 given off two strong intermuscular septa, which are attached to the whole length 

 of the linea aspera and its prolongations above and beloAV : the external and 

 stronger one, which extends from the insertion of the Gluteus maximus to the 

 outer condyle, separates the Vastus externus in front from the short head of the 

 Biceps behind, and gives partial origin to these muscles ; the inner one, the thinner 

 of the two, separates the Vastus internus from the Adductor and Pectineus mus- 

 cles. Besides these there are numerous smaller septa, separating the individual 

 muscles and enclosing each in a distinct sheath. At the upper and inner part of 

 the thigh, a little below Poupart's ligament, a large oval-shaped aperture is observed 

 after the superficial fascia has been cleared off: it transmits the internal saphenous 

 vein and other smaller vessels, and is termed the saphenous opening. In order more 

 correctly to consider the mode of formation of this aperture, the fascia lata in this 



4. Dorsum of foot. 



FIG. 252. Dissection of lower extremity. 

 Front view. 



