ANTERIOR FEMORAL REGION. 1081 



may examine the three compartments into which this sheath is divided, and 

 which contain respectively the artery, the vein, and a lymphatic gland ; the 

 latter blocking up the crural aperture between the femoral vein and Gimber- 

 nat's ligament, through which femoral hernia descends. All the relations of 

 these parts are to be carefully studied with special reference to the operations 

 for strangulated femoral hernia (p. 1036). 



The incision on the inner side of the thigh is now to be prolonged down- 

 wards towards the middle line beyond the knee, and the dissection of the 

 front of the thigh continued. The two middle and the two internal 

 cutaneous branches of the anterior crural nerve, together with the branch 

 from the internal saphenous nerve to the integument of the knee, and the 

 internal saphenous vein, will be dissected out, and the fascia lata in front 

 of the thigh made clean (p. 664). The fascia is then to be removed, and 

 the communications of the internal cutaneous, internal saphenous, and 

 obturator nerves sought in the lower part of the inner aspect of the thigh 

 (p. 666). Scarpa's triangle is now to be cleaned, and the dissection of the 

 femoral vessels both in that space and in the after part of their course is to 

 be studied (p. 434). Towards its termination below the middle of the thigh, 

 the femoral artery will be observed to be covered by a tendinous expansion, 

 which conceals it for a part of its course before it pierces the tendon of the 

 adductor magnus muscle : in the passage so formed, known as Hunter's 

 canal, the femoral artery, which is accompanied by the internal saphenous 

 nerve, will be seen to give off the anastomotic branch (p. 293). 



The deep femoral artery should be dissected as far as the upper border of 

 the adductor longus muscle ; and the origins of its first branches are to be 

 brought into view, viz. : the internal circumflex artery, dividing into 

 ascending, transverse, and descending branches. One or both of the circum- 

 flex arteries often arise from the femoral artery immediately above the origin 

 of the deep femoral (p. 438). The sartorius muscle is to be cleaned, and 

 likewise the gracilis muscle, and the surface of the other adductors ; the 

 relations of the inferior tendons of the sartorius, gracilis, and semitendinous 

 muscles may also be exposed (pp. 273 and 276). The student will then 

 direct his attention to the outer part of the thigh near the hip. He will 

 there dissect the fascia lata from the remaining part of the gluteus medius 

 muscle, and from the tensor vaginse femoris muscle, leaving at first a strip 

 of the fascia extending down to the knee on the outside of the leg, and he 

 will afterwards expose the deeper band of the fascia which passes inwards to 

 the hip-joint from within the upper part of the muscle (pp. 273 and 292). 

 He will also find the branch of the gluteal nerve to the tensor vaginse 

 femoris by dissecting between it and the gluteus medius muscle (p. 667). 

 Let him divide successively the tensor vaginae femoris and the remains of 

 the gluteus medius and minimus, and dissect the two last muscles down to 

 their inferior attachments, so as to exhibit the bursse between them and the 

 trochanter major, and the connection of the gluteus minimus with the cap- 

 sule of the hip-joint (p. 268). While engaged with this proceeding, he will 

 be enabled to dissect more particularly the ascending and transverse branches 

 of the external circumflex artery, and to examine their anastomoses with the 

 gluteal artery (p. 438). Let him then clean the rectus muscle, trace its 

 anterior and posterior heads close to their origins, and observe the positions 

 of the limb in which they are respectively tightened (p. 274). The trunk 

 of the anterior crural nerve is now to be cleaned, its branches to the 

 extensor muscles are to be dissected, the internal saphenous nerve laid bare 

 as far as the knee, and the slender twigs to the pectineus muscle seen 



