1 88 INFERIOR EXTREMITY 



fascia lata should be left undisturbed, so as to maintain as far as possible 

 the natural position of parts. 



Trigonum Femorale (O.T. Scarpa's Triangle). This is the 

 name which is given to the triangular hollow which lies in 

 the proximal part of the thigh below the inguinal ligament 



The lateral boundary is formed by the sartorius muscle, as 

 it runs distally and medially across the thigh from the 

 anterior superior spine of the ilium ; the medial boundary 

 is constituted by the prominent medial margin of the adductor 

 longus muscle. These muscles meet below to form the apex of 

 the triangle. The inguinal ligament forms the base of the 

 triangle. 



The contents of the space must now be displayed by remov- 

 ing the fatty areolar tissue which surrounds them. The 

 femoral vessels should first be cleaned. Remove the remains 

 of the femoral sheath and define the various branches which 

 proceed from the vessels in so far as they are seen within the 

 limits of the triangular space. Be careful not to injure the 

 small twig of the femoral nerve which supplies the pectineus ; 

 it passes medially behind the vessels a short distance distal 

 to the inguinal ligament. In this part of its course the 

 femoral artery gives off ( i ) the three superficial inguinal vessels, 

 which have already been observed ramifying in the superficial 

 fascia of the groin of the subinguinal region ; (2) the deep 

 external pudendal, which runs medially over the pectineus ; 

 (3) the large profunda femoris. 



The profunda femoris comes off from the lateral side of 

 the femoral artery about one and a half inch below the 

 inguinal ligament. It inclines distally and medially behind 

 the femoral trunk, and soon leaves the space by passing 

 posterior to the adductor longus. The lateral and medial 

 circumflex arteries of the thigh will be seen to arise from the 

 profunda femoris within the femoral triangle. 



The a. circumflex femoris later alis (O.T. external circumflex) 

 should be traced laterally as it passes amongst the branches 

 of the femoral nerve, to disappear under cover of the lateral 

 boundary of the space. The a. circumflex femoris medialis 

 (O.T. internal circumflex} passes from view, shortly after its 

 origin, by sinking posteriorly through the floor of the space 

 between the pectineus and psoas muscles. The veins corre- 

 sponding to these arteries must be cleaned at the same time. 



Certain nerves are also to be found in this space, viz. (i) 



