THE THIGH 191 



more distally it is crossed by the medial cutaneous branch 

 (O.T. internal cutaneous) of the femoral nerve, which runs 

 along the medial border of the sartorius muscle. Posterior 

 to the artery are the psoas and pectineus, but it is separated 

 from the psoas by the femoral sheath and the nerve to the 

 pectineus, and from the pectineus by fatty areolar tissue in 

 which lie the profunda femoris artery and the femoral vein. 

 Upon the lateral side of the femoral artery is the femoral 

 nerve 1 but not in apposition with it, as a small portion of 

 the psoas intervenes. The femoral vein changes its position 

 with reference to the artery, as it is traced distally. In 

 the proximal part of the space it lies on the same plane 

 and to the medial side of the artery, but distally it becomes 

 more deeply placed and gradually assumes a position posterior 

 to the artery. 



The branches which the femoral artery gives off in the femoral 

 triangle have already been enumerated (p. 188). One of 

 these, viz. the deep external pudendal, may now be traced to 

 its destination. 



Art. Pudenda Externa Profunda (Deep External Pudic). 

 This is a small twig which arises from the medial side of 

 the femoral, a short distance below the inguinal ligament. 

 It extends medially, upon the pectineus and adductor longus 

 muscles, and, piercing the fascia lata, ends, according to 

 the sex, in the integument of the scrotum or of the labium 

 pudendi. 



Dissection. The fascia lata may now be removed from the distal two- 

 thirds of the anterior and medial parts of the thigh. This can best be 

 effected by dividing it along the middle line of the limb, and throwing it 

 laterally and medially. Preserve undisturbed the thickened band of fascia 

 (tractus ilio-tibialis) on the lateral side of the thigh. 



In cleaning the sartorius muscle several of the nerves of the thigh will 

 be found intimately related to it, and must be carefully dissected. The 

 intermediate cutaneous nerve (O.T. middle cutaneous) frequently pierces 

 its proximal border, and then proceeds distally in front of it ; the anterior 

 branch of the medial cutaneous crosses it more distally, whilst the posterior 

 branch of the same nerve is carried distally along its posterior border. 

 Near the knee it lies superficial to the saphenous nerve, which ultimately 

 comes to the surface between it and the gracilis. A short distance above 

 this the sartorius is pierced by the infrapatellar branch of the saphenous 

 nerve. Lastly, about the middle of the thigh, there is formed under 

 cover of the sartorius, an interlacement of fine nerve twigs derived from 

 the posterior branch of the medial cutaneous, the saphenous nerve, and 

 the obturator nerve. On raising the sartorius from subjacent parts this 

 must be looked for. 



The different portions of the quadriceps extensor muscle must also be 

 cleaned ; and the branches which the femoral nerve gives to them, and 



