THE THIGH 177 



Four of the cutaneous nerves of the thigh have been found 

 to send twigs to the skin over the knee-joint, viz. the anterior 

 division of the lateral cutaneous nerve of the thigh, the inter- 

 mediate cutaneous, the anterior division of the medial cutane- 

 ous, and the saphenous nerve. These nerves communicate 

 with each other and form an interlacement which is situated 

 over the patella, the ligamentum patellae, and proximal part 

 of the tibia. It is termed the patellar plexus. 



On the medial side of the thigh two minute cutaneous nerve twigs some- 

 times make their appearance which do not belong to any of the above 

 main cutaneous trunks. One appears below the ilio-inguina'l nerve, and is 

 a twig from the perineal branch of the posterior cutaneous nerve of the 

 thigh ; the other pierces the deep fascia at the middle of the medial area of 

 the thigh, and comes from the obturator nerve. 



Dissection. After the cutaneous nerves have been cleaned the remains 

 of the superficial fascia must be removed in order that the fascia lata may 

 be studied. 



Fascia Lata. This is the name which is given to that 

 portion of the general aponeurotic investment of the lower 

 extremity which clothes the thigh and preserves its figure. 

 The dissector will be struck with the marked difference in 

 strength which it shows on the lateral and medial aspects of 

 the thigh. Laterally it is so dense and strong that it appears 

 to be more tendinous than aponeurotic in its character. The 

 reason of this is that the tensor fasciae latae muscle and the 

 greater portion of the glutaeus maximus are inserted into it 

 upon this side of the limb. The strong band thus formed 

 goes under the name of the tractus iliotibialis, from its being 

 attached above to the crest of the ilium, and below to the 

 lateral condyle of the tibia and to the head of the fibula. 

 It acts as a powerful brace, on the lateral aspect of the 

 limb, which, in the erect posture, helps to steady the pelvis 

 and at the same time keep the knee-joint firmly extended. 

 Medially, the fascia lata is so exceedingly delicate and thin 

 that the subjacent muscular fibres shine through it, and it 

 is very apt to be removed with the superficial fascia unless 

 care be exercised in the dissection. 



Superiorly, around the root of the limb, the fascia lata is 

 attached to the inguinal ligament and the bones of the pelvis. 

 Posteriorly, it is continuous with the glutaeal aponeurosis, and 

 through this it is fixed to the coccyx, sacrum, and crest of the 

 ilium. On the lateral side it is attached to the crest .of the 

 ilium ; and on the medial side to the body of the pubis, the 



VOL. i 12 



