i yo INFERIOR EXTREMITY 



the divided fascia the two layers can be easily distinguished. 

 Insinuate the fingers between the fascia of Scarpa and the 

 pearly-looking tendon of the external oblique muscle. Little 

 resistance will be encountered, as it is only bound down by some 

 lax areolar tissue. The fingers can be readily carried down- 

 wards behind the fascia of Scarpa as far as the inguinal liga- 

 ment. Here it will be found that they can force their way 

 no farther. The passage of the hand into the thigh is barred 

 by the blending of the fascia of Scarpa with the fascia lata, 

 along an oblique line immediately below the inguinal ligament. 

 At this level, therefore, it ceases to exist. The fatty super- 

 ficial layer of Camper, however, as we have said, is continued 

 onwards as the superficial fascia of the thigh. 



When urine is effused under the superficial fascia of the 

 anterior abdominal wall, the attachment of the fascia of 

 Scarpa to the fascia lata prevents its passage downwards in 

 front of the thigh. 



Dissection. In the superficial fascia, blood-vessels, glands, lymph 

 vessels, and nerves are embedded, and these must now be dissected out. 

 First look for the great saphenous vein. It will be found running proxi- 

 mally from the posterior border of the medial condyle of the femur to a 

 point about one and a half inches distal and lateral to the pubic tubercle, 

 where it passes through the fossa ovalis into the femoral triangle to join the 

 femoral vein. It is not desirable to define the opening in the fascia femoris 

 through which it passes until a later stage of the dissection. Several 

 tributaries join the great saphenous vein at this point, and these should 

 be dissected along with the small superficial arteries of the groin which 

 accompany them. 



The large lymph glands of the groin must also be dissected out from 

 the fatty tissue in which they lie. In doing this care must be taken to 

 preserve as many as possible of the minute thread-like lymph vessels 

 which enter and leave the glands. A small artery and vein should also be 

 traced to each gland. 



Superficial Inguinal Vessels. Three minute arteries, 

 termed the superficial epigastric, the superficial external 

 pudendal and the superficial circumflex iliac, pierce the fascia 

 femoris below the inguinal ligament, and radiate from each 

 other for the supply of the lymph glands and integument of 

 the subinguinal region. They all spring from the femoral 

 artery immediately after it enters the thigh. 



Art. Pudenda externa superficial . The superficial external 

 pudendal comes forward through the fascia cribrosa (a thin 

 fascial layer, which is spread over the fossa ovalis), and runs 

 medially and upwards across the spermatic cord. It supplies 

 the skin of the scrotum and penis. 



