45 2 The TJiigh 3 



of its receiving the insertion of the tensor fasciae femoris and two- 

 thirds of thegluteus maximus ; it passes as the ilio-tibial band (p. 450 

 from the iliac crest to the outer tuberosity of the tibia and head of 

 fibula. At the back of the thigh the fascia is thinner, and as it 

 ascends it gives one layer over gluteus maximus and one beneath. 

 Investing the lower part of the thigh, it is attached to the condyles of 

 the femur and sends intermuscular septa to the condylar ridges. 



Covering in the popliteal space it is continued on as the deep 

 fascia of the back of the leg ; but from the front of the thigh it does 

 not reach below the knee, being gradually blended with the fibres 

 of the quadriceps extensor, and with the periosteal covering of the 

 articular ends of the bones. Guided by the fascia, abscess beneath 

 the gluteus maximus may wander down the thigh and through the 

 popliteal space into the calf. 



The saphenous opening is about an inch below the inner end of 

 Poupart's ligament, but its site is not usually marked upon the surface 

 of the limb. It has a definite superior border formed by a sickle- 

 shaped (falciform} process, which, coming from the pubic spine, sweeps 

 outwards over the vessels to become continuous with that part of the 

 fascia which covers the pectineus, and which slopes upwards and out- 

 wards beneath the vessels to join the sheath of the psoas. This latter 

 part is \\\e pubic piece of the fascia lata ; it is on a plane posterior to 

 the outer piece, which, from its having come from the region of the 

 iliac crest, is called the iliac piece. (Note well that the iliac piece of 

 the fascia lata is not the iliac fascia, p. 307.) This arrangement of the 

 fascia lata in two planes which, though continuous below, are sepa- 

 rated by the thickness of the common femoral vessels above, is to 

 permit the saphenous vein to continuously discharge its contents into 

 the common femoral vein, even when the thigh is extended and 

 everted. 



As the falciform process arches over the vessels it is connected with 

 the front of the crural sheath (p. 313). 



When the thigh is extended and the fascia lata in the groin is 

 tight, and is dragging down Poupart's ligament, the falciform process 

 is rendered hard and sharp ; and when the thigh is flexed and rotated 

 inwards the process is slackened. In attempting to reduce a femoral 

 hernia without flexing the thigh, the bowel may be bruised against 

 the sickle-shaped band. 



Femoral hernia (p. 3 12) descends in the innermost compartment of 

 the crural sheath, having the iliac part of the fascia lata in front of it, 

 and the pubic part behind. At about an inch below the ligament 

 the crural sheath ends by blending with the sheath of the vessels. As 

 a femoral hernia can descend no farther along the vessels than where 

 these sheaths blend, it bulges forwards through the saphenous opening, 

 taking the anterior layer of the crural sheath and the cribriform fascia 

 in front of it ; it then curls round the falciform process and on to the 



