242 THE MUSCLES AND FASCIA OF THE LOWER LIMB. 



the crest of the ilium, to Poupart's ligament, to the body and rami of the pubis, 

 to the ramus and tuberosity of the ischium, and to the lower margin of the great 

 sacro-sciatic ligament. In the gluteal region it descends on the surface of the 

 glutens medius muscle as far as the upper border of the gluteus maximus, where it 

 divides into two layers, one of which passes on the superficial, the other on the deep 

 surface of that muscle. After encasing the muscle, the layers unite at its lower and 

 external borders. Over the great trochanter, where the layers unite externally, and 

 where also the fascia is much thickened, the greater number of the fibres of the 

 muscle are inserted between the layers. The thickened portion of the fascia may 

 be traced downwards on the outside of the thigh, from the fore part of the crest 

 of the ilium to the outer tuberosity of the tibia. This ilio-tibial band consists 

 of dense glistening parallel fibres, and about the junction of the upper and middle 

 thirds of the thigh it receives also the insertion of the tensor vaginae femoris 

 muscle. On the rest of the thigh the fascia lata varies in thickness. It is thinnest 

 in the upper and inner part of the thigh, where it covers the adductor muscles. 

 At the knee it is considerably strengthened on each side of the patella by tendinous 

 expansions given off from the lower parts of the vasti muscles, and assists in 

 forming the capsular investment of the joint. This part of the fascia is firmly 

 attached to the head of the tibia and to the lateral margins of the patella, but a 

 superficial layer is given off which extends over the front of the latter bone, a 

 synovial bursa of considerable size being interposed. A second smaller bursa is 

 plaoed immediately under the skin covering the patella, and the cavities of the two 

 are sometimes continuous through an aperture in the aponeurosis. Other small 

 bursae are not unfrequently present over the patella or its ligament, or over the 

 tubercle of the tibia. Posteriorly the fascia is continued uninterruptedly over the 

 hamstring muscles and the popliteal space into the fascia of the leg. 



On the front of the thigh, a little below and external to the inner end of 

 Poupart's ligament, is placed the saphenous opening, an aperture in the fascia lata 

 through which the internal saphenous vein passes to join the femoral vein, and 

 which receives special attention from its being the place of exit of femoral hernia. 

 The outer part of this opening lies in front of the femoral artery, and is bounded 

 externally by a crescentic margin, the falciform border, which crosses the surface of 

 the infundibuliform sheath of the femoral vessels. This margin in the middle of its 

 extent is continued into looser tissue, the above-mentioned cribriform fascia, but 

 superiorly and inferiorly it ends in more distinct incurved extremities, the superior 

 and inferior cornua. The inferior cornu, the most completely defined part of the 

 margin, lies in the angle between the internal saphenous and the femoral veins, below 

 their junction ; while the superior cornu forms a larger curve, the inner extremity of 

 which, often called femoral ligament, passing completely to the inner side of the 

 femoral sheath, is attached to the front of Gimbernat's ligament. 



It is customary to call the parts of the fascia lata on the outer and inner sides 

 respectively of the saphenous opening the iliac and pubic portions. The iliac 

 portion is intimately connected above with Poupart's ligament, as well as with the 

 deep layer of the superficial fascia of the abdomen (fascia of Scarpa), and internally 

 forms the falciform margin of the saphenous opening ; the pubic portion (or 

 pectineal fascia}, attached superiorly to the ilio-pectineal line, passes on its outer side 

 deeply behind the sheath of the vessels, with which it is connected, and is continued 

 into the iliac fascia, to be subsequently described. 



The fascia lata is perforated in many places by foramina, which allow the passage 

 of the cutaneous nerves and blood-vessels. 



The fascia lata has various deep processes. One of these, leaving the main fascia 

 at the insertion of the tensor vaginae femoris muscle, passes upwards on the inner 

 side of that muscle as a strong flat band on the surface of the vastus externus, and 



