rilE THIGH 



1173 



three-quarters of an inch (18 mm.) lielow the level of the femoral head, and, Avhen 

 the femur is extended, is a little below the centre of the hip-joint. This part of 

 the bone is covered by the gluteus medius. The slightness of the prominence of 

 the great trochanter in the living subject compared with that in the skeleton is 

 explained by fig. 738, which shows how the descending gluteus medius and 

 minimus fill up the space between the ilium and trochanter. 



Nelaton's line. — This most useful guide is a line drawn from the anterior 

 superior sj)iiie to the most prominent part of the tuberositv of the ischium. In 

 normal limbs, the top of the great trochanter just touches this line. In dislocation, 

 fractures of the neck, and in wasting of the neck, as in osteo-arthritis, the relation 

 of the trochanter to Nelaton's line becomes altered. 



The top of the great trochanter is a guide in Mr. Adams's operation for division 



Fig. 73s.— Transverse Sectiox of the Hip-joint and its Relations. 



(One third.) (P.raune.) 



AyTERIOR CRURAL 

 yERVE IX SCB- 



STANCE OF ILIA- 



CUS IXTERNUS 

 External iliac artery — 



ILIUM '-- 



Obturator internus 



Adductor magnus ~ 



Obturator externus 



Adductor longus ~ 

 Adductor brevis - 



Gluteus minjmua 

 Gluteus medius 



Ilio-paoaj 



of the neck of the femur, the puncture being made and the saw entered one inch 

 (25 nnn. ) above and about one inch in front of this point. 



Bryant's triangle. — Mr. Bryant makes use of the following in deciding the 

 position of the great trochanter. The i)atient being flat on his l)ack. (1) a line is 

 dropped vertically on to the couch from the anterior sui»erior s])ine; (2) from the 

 top of the great trochanter a straight line in the long axis of the thigh is drawn to 

 meet the first; (3) to complete the triangle, a line is drawn from the anterior 

 superior spine to the top of the trochanter. This line is practically Nelaton's. 

 The second line will be found diminished on the damaged or diseased side. 



Muscular prominences. — The tensor vagina? femoris (ilio-aponeurotic muscle) 

 forms a prominence beginning just outside the sartorius and reaching downwards 

 and somewhat backwards to the strong fascia lata, three to four inches (7o to 100 

 mm.) below the great trochanter. Below this jxiint. as far as the outer tuberosity 

 of the tibia, the strong ilio-til)ial band can be felt. The sartorius, the chief land- 



