448 The 



with precision, it may be said that the artery begins ' under the middle 

 of Poupart's ligament.' The artery is felt pulsating half an inch to 

 the inner side of the middle of the ligament. 



Unless the subject be fat, the head of the femur may be felt ro- 

 tating in the middle of the base of Scarpa's triangle. It lies beneath the 

 crease which runs from the scrotum to the ilium. When the capsule 

 is distended this crease is partially effaced. The head of the femur 

 has the same direction as the inner surface (tuberosity) of the internal 

 condyle. 



Iff elaton's line is drawn over the buttock from the anterior superior 

 iliac spine to the ischial tuberosity. In the sound limb it just touches 

 the top of the great trochanter, but when injury or disease has seriously 

 damaged the acetabulum or the joint, or the head or neck of the femur, 

 the top of the trochanter may be above that line. It is useful in cases 

 of doubtful dislocation, and of fracture of the neck of the femur. 



Bryant's measurement is made when the patient is lying straight 

 and flat on his back. A string is passed across the front of the 

 abdomen at the level of the iliac spines, and another over the thighs 

 at the tops of the trochanters. These strings ought to be parallel ; 

 but if, from injury or disease, one trochanter be raised, the vertical 

 measurement, C D, between the lines is diminished on that side. 



In measuring- a lower limb it is not expedient to pay too much 

 attention to a difference of one-fourth or one-third inch ; often, indeed, 

 the limbs are unequal in length from birth. In comparing lengths in 

 a child, a good plan is to lay him on his back, and, keeping the pelvis 

 flat and square, and the knees fully extended, to raise the soles of the 

 feet towards the ceiling. A slight difference in the level of soles or 

 of the inner malleoli is then at once manifested. 



When measuring by a tape, the pelvis must first be arranged flat 

 and square ; a line is then taken from each anterior superior iliac 

 spine to the tip of the inner or outer malleolus, the limbs being straight 

 down, or, at any rate, in corresponding positions. 



For the thigh, the measurement is made to the top of the patella, 

 or from the pubic spine to the adductor tubercle (p. 449). For the leg 

 alone, the tape is carried between the malleolus and the upper border 

 of the tibial head. 



Between the front of the iliac crest and the great trochanter is the 

 thick mass of muscle consisting of the tensor fasciae femoris, and of 

 much of the gluteus medius and minimus the three internal rota- 

 tors of the thigh. They are supplied by the superior gluteal nerv 

 (p. 378). 



The tensor fasciae femoris arises from the outer side of the an- 

 terior superior iliac spine, and, passing downwards and backwards, is 

 inserted into the fascia lata about a quarter of the way down the 

 thigh, from which level the thickened ilio-tibial band descends to th 

 outer tuberosity of the tibia. This band receives two-thirds of the i 



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