148 



Anatomy of Skeleton 



indication of the situation of the femoral opening can be found, for the tendinous 

 structure is continued on the bone deep to the vessels. The upper fibres are those 

 arising from the pubis, and by articulating the bones it is seen that they are nearly 

 horizontal in direction and must pass behind the small trochanter, whence the necessity 

 for a bursa on its posterior aspect. 



Adductor brevis lies between the Magnus and the Longus and Pectineus, and can 



be placed more easily if these last two are first 

 put into position. Pectineus is inserted by 

 aponeurosis into the lower part of the small 

 trochanter and the line leading down from 

 it to the linea aspera for about 2 inches or 

 more : Adductor longus is on the continuation 

 of this line, occupying the middle third of 

 the length of the shaft. Adductor brevis 

 can now be placed just outside this line, 

 extending, roughly, about half-way up the 

 level of Pectineus and half-way down that of 

 Longus. Notice that the upper ends of the 

 gluteal ridge and the Adductor magnus 

 insertion and the base of the great trochanter 

 and upper end of small trochanter are all 

 about on the same level : from this it can be 

 understood that the transverse branch of 

 . the external circumflex artery, running round 

 the base of the great trochanter, can pass just 

 above the gluteal insertion, and is on the same 

 level as the internal circumflex, which appears 

 above the Adductor magnus but not close to 

 the bone, because it is internal to the Psoas 

 tendon (Fig. 120). 



The course of the internal circumflex can be 

 understood by articulating the bones and putting 

 the muscles into position on them, as shown in 

 Fig. 121. It is seen to turn back internal to the 

 Psoas and reach the interval above the mass of the 

 Adductors and below the capsule and Obturator 

 externus, and therefore appears behind above the 

 Adductor magnus and below the Quadratus femoris 

 (which covers the Obturator externus behind). 



FIG. 121. Scheme to show the course of the 

 internal circumflex artery. Pectineus 

 is represented as transparent, lying on 

 Obturator externus and upper fibres of 

 Adductor magnus. Upper part of Add. 

 brevis comes in between them, but is too 

 low to be in direct relation with the 

 artery. The artery runs back in the 

 small interval in which it is seen below 

 the capsule and Obt. externus, above or 

 external to Pectineus and Add. magnus ; 

 this interval is covered by Psoas, and the 

 vessels reach it by passing back between 

 Psoas and Pectineus, internal to the 

 former. 



The perforating arteries (Fig. 120) lie close to the bone, so that they run a very short 

 course before breaking up in the substance of Vastus externus. They pierce the various 

 aponeurotic planes attached to the linea aspera, and give branches to the muscles, etc., 

 between these planes. The first pierces Adductor brevis and magnus and tendon of 

 Gluteus maximus ; the second goes through brevis, magnus, Biceps, external septum ; 

 the third and fourth do the same, except that they do not pierce brevis. Occasionally 

 the first may go through the lower part of Pectineus before piercing Adductor brevis. 



Lower End. 



Notice the differences between the condylar masses. The outer is thicker and 

 stronger than the inner, for it has more to do with the direct support of weight and 



