FEMORAL 581 



practical jjoint to rcniciul)or is that it is more usual to luoct with a short than with 

 a long connnon femoral, and that, if the superficial femoral is tied at the apex of 

 Scarpa's triangle — i.e. the spot where the inner edge of the sartorius comes into 

 contact with the adductor longus — there is nearly always a sufficient length of that 

 vessel ahove tlie ligature to ensure a firm internal clot, and consequently, as far as 

 this point is concerned, a successful result. 



(3) The relations of the superficial femoral artery in Hunter's canal. — 

 Hunter's canal is the somewhat triangularl}^ shaped space bounded by the vastus 

 internus on the outer side, the adductors longus and magnus on the inner side, and 

 by an aponeurosis thrown across from the adductors to the vastus in front. 

 Below, the canal terminates at the opening in the adductor magnus; above, its 

 limit is less well defined, as here the aponeurosis between the muscles becomes less 

 tendinous, and gradually fades away into the perimuscular fascia. The transverse 

 direction of the fibres of the aponeurotic covering at the lower two-thirds of the 

 canal is characteristic, and serves as a rallying point in tying the artery in 

 this part of its course. Lying superficial to the aponeurosis is the sartorius 

 muscle. The superficial femoral artery as it lies in this canal has the following 

 relations: — 



In front, in addition to the skin, superficial and deep fascia, are the sartorius 

 muscle and the aponeurotic fibres of the canal. The internal saphenous nerve 

 crosses the artery from without inwards, lying in the wall of the canal. 



Behind is the angle of meeting of the vastus internus and the adductors. 



The femoral vein lies behind the artery, but gets a little external to it at the 

 lower part of the canal. It is here very firmly and closely attached to the artery, 

 embracing it as it were on its po.sterior and external aspect. Hence it is very liable 

 to be punctured on ligaturing the artery in this part of its course. Such an acci- 

 dent is best avoided by opening the sheath of the vessels well to the inner side of 

 the front of the artery, and by keeping the point of the aneurysm needle closely 

 applied to the vessel in passing it from without inwards between the vein and the 

 artery. There are sometimes two veins, which then more or less surround the 

 artery. 



To its inner side is the adductor longus above and the adductor magnus 

 below. 



To its outer side is the vastus internus, the nerve to the vastus internus, and 

 at the lower part of the canal the femoral vein. 



Vdrldtions in the Femoral Artery 



The most important variations in the femoral artery are : — (A) The femoral arising from 

 the sciatic or internal iliac, and pa.ssing out of the pelvis and down the back of the thiirh with 

 the great sciatic nerve to the popliteal space ; the external iliac under these circumstances ending 

 in the profunda or external circumflex, or some other branch of the femoral. (B) A dduble 

 condition of the femoral artery below tlie origin of the profunda ; the vessel re-uniting lower 

 down the thigh. (C) A vas aberrans given off from the iimer side of the common femoral or 

 external iliac, and joining the femoral lower down. (D) The vein may remain to the inner side 

 of the arteiy its whole distance through the thigh, or it may be double, especially in Hunter's 

 canal. There is often a plexiform arrangement of the vein around the artery in this situation. 

 (E) The variations in the origin of the profunda have been already mentioned. 



Branches of the Femoral Artery 



The femoral artery gives off the following branches: — 



A. From the com'mon femoral : — (1) The superficial epigastric; (2) the super- 

 ficial circumflex iliac; (3) the superficial external i)udic; (4) the deep external 

 pudic; and (5) the profunda. 



B. From the superficial femoral in Scarpa's triangle:— (1) Muscular l>ranchcs; 

 and (2) the saphenous branch. 



C. From the superficial femoral in Hunter's canal: — O) Muscular branches; 

 and (2) the anastomotica magna. 



