THE THIGH 169 



SUPERFICIAL DISSECTION. 



This dissection comprises the examination of the following 

 parts : 



1. Superficial fascia. 



2. Vena saphena magna and its tributaries. 



3. Art. Pudenda externa superficialis. 



4. Art. Epigastrica superficialis. 



5. Art. Circumflexa ilium superficialis. 



6. Lymph glands and vessels. 



7. The fossa ovalis. 



8. Cutaneous nerves. 



9. The fascia femoris. 

 10. The bursae patellae. 



Reflection of the Skin. Incisions, (i) From the anterior superior 

 iliac spine along the line of the inguinal ligament to the symphysis pubis ; 

 (2) from the medial extremity of the first incision distally along the margin 

 of the scrotum, then along the junction of the medial with the posterior 

 aspect of the thigh and across the medial aspect of the knee to the level of 

 the tuberosity of the tibia ; (3) from the distal end of the vertical incision 

 transversely across the anterior surface of the leg to its lateral border. 

 The quadrilateral flap of integument thus mapped out must be raised 

 carefully from the subjacent superficial fascia and turned laterally, particular 

 care being taken in the region of the knee to avoid injury to the patellar 

 plexus of cutaneous nerves. 



Panniculus Adiposus (Superficial Fascia). The fatty super- 

 ficial fascia which is now exposed is continuous with the 

 corresponding layer on the front of the abdomen, and it 

 is regarded by some anatomists as being composed of two 

 layers. This subdivision is needless and artificial. In the 

 lower part of the abdominal wall, above the inguinal liga- 

 ment, it is true the superficial fascia presents two distinct 

 strata one a fatty layer continuous, over the inguinal liga- 

 ment, with the superficial fascia of the anterior part of the 

 thigh, and sometimes termed the fascia of Camper the other, 

 a deeper layer, firm and membranous and devoid of fat, 

 called the fascia of Scarpa. As this latter fascial stratum 

 is attached to the fascia femoris (deep fascia of the thigh) 

 immediately below the inguinal ligament, it is necessary that 

 it should receive some attention. 



To demonstrate the fascia of Scarpa the dissectors of the 

 lower extremity and abdomen should work in conjunction with 

 each other. A transverse incision should be made through 

 the entire thickness of the superficial fascia on the front of 

 the abdomen, from the anterior superior spine of the ilium to 

 the medial line of the body. On raising the lower edge of 



