34-O Anatomy Applied to Medicine and Surgery. 



inches in length, so that, its centre shall correspond to 

 the apex of Scarpa's triangle. A large branch of the long 

 saphenous vein, the external femoral cutaneous, will be 

 exposed and may have to be divided between two liga- 

 tures, if it cannot be drawn aside. The deep fascia is in- 

 cised and the sartorius is exposed. This muscle will be 

 identified by the direction of its fibres, running as they do, 

 downwards and inwards. Should fibres be met with, 

 passing downwards and outwards, they are part of the ad- 

 ductor longus muscle and the artery must besought for, 

 farther outwards. The sartorius is drawn outwards, 

 and the finger seeks for the pulsation of the vessel. 

 Branches of the internal cutaneous nerve will be found in 

 front of the artery while the nerve to the vastus internus 

 and the long saphenous will lie on the outer side of the 

 vessel. The sheath of the vessel is opened and the needle 

 passed from within outwards. 



Ligation of the Femoral in Hunter's Canal. An in- 

 cision about three inches in length is made along the 

 line of the artery about the middle third of the thigh. 

 After the division of the superficial fascia, in which run, 

 nearly in line with the incision, the anterior branch of the 

 internal cutaneous nerve and the long saphenous vein, the 

 deep facia is brought into view, and, on being incised, the 

 sartorius is exposed, and, having been identified by the di- 

 rection of its fibres, which, here, run vertically downwards, 

 is drawn inwards. Should the fibres of the muscle, that 

 presents itself, run, downwards and outwards, it is prob- 

 ably the vastus internus that is exposed, especially if the 

 incision has been made too far outwards, or it may be the 

 adductor longus, if the incision be too far inwards ; the situ- 

 ation of the artery as evidenced by the pulsations, will 

 assist in telling whether it be the one or the other muscle, 

 and, in which direction to continue the dissection. After 



