618 THE BLOOD-VASCULAR SYSTEM 



the lateral side. Just above the sartorius, the artery is crossed by the most medial of the anterior 

 cutaneous branches of the femoral nerve. The fascia transversalis, which is continued down- 

 ward into the thigh beneath the inguinal ligament, is also in anterior relation, but it soons be- 

 comes indistmguishable from the sheath of the vessel. 



Behind, the artery rests from above upon the tendon of the psoas muscle, which separates 

 it from the brim of the pelvis and capsule of the hip-joint; the pectineus, and adductor longus. 

 The artery is partially separated from the pectineus by the femoral vein and the profunda vein 

 and artery, and from the adductor longus by the femoral vein which is almost directly behind 

 the artery near the apex of the femoral trigone. The sinall nerve to the pectineus crosses 

 behind the artery to reach its medial side. 



A similar prolongation to that derived from the fascia transversalis in front, descends be- 

 hind the vessel from the iUac fascia; but this, like the anterior prolongation or fascia, soon blends 

 with the sheath of the vessels. * 



To the medial side is the femoral vein. This is separated above from the artery, where 

 the two vessels lie in the femoral sheath, by a thin fascial septum. Below, the vein is some- 

 what behind tlie artery. 



To the lateral side. — Above, the common stem of the femoral (anterior crural) nerve is 

 about 1 cm. (^ in.) lateral to the' artery. When the femoral nerve gives off its branches, the 

 saphenous nerve and the nerve to the vastus medialis accompany the artery on the lateral 

 side. 



The adductor canal is the somewhat triangularly shaped space bounded by the vastus 

 medialis on the lateral side, the adductors longus and magnus posteriorly, and by an aponeurosis 

 thrown across from the adductors to the vastus medially and in front. Below, the canal 

 terminates at the tendinous opening in the adductor magnus; above, its limit is less well defined, 

 as here the aponeurosis between the muscles becomes less tendinous, and gradually fades away 

 into the perimuscular fascia. The transverse direction of the fibres of the aponeurotic covering 

 at the lower two-thirds of the canal is characteristic, and serves as a rallying-point in tying the 

 artery in this part of its course. Lying superficial to the aponeurosis is the sartorius muscle. 

 The femoral artery, in the adductor (Hunter's) canal, has the following relations : — 



In front, in addition to the skin, superficial and deep fascia, are the sartorius muscle and the 

 aponeurotic fibres of the canal. The saphenous nerve crosses in front of the artery from the 

 lateral to the medial side, lying in the wall of the canal. 



Behind, the artery is in contact with the adductor longus, and just above the opening in 

 the adductor magnus, usually with the latter muscle. 



The femoral vein hes behind the artery, but gets a Httle lateral to it at the lower part of 

 the canal. It is here very firmly and closely attached to the artery, embracing it as it were on 

 its posterior and lateral aspect. Hence it is very liable to be punctured on ligaturing the artery 

 in this part of its course. Such an accident is best avoided by opening the sheath of the vessels 

 well to the medial side of the front of the artery, and by keeping the point of the aneurysm needle 

 closely applied to the vessel in passing it between the vein and the artery. There are some- 

 times two veins, which then more or less surround the artery. 



To the lateral side are the vastus mediahs, the nerve to the vastus medialis, and at the lower 

 part of the canal, the femoral vein. 



Branches of the Femoral Artery 



The branches of the femoral artery are: — 



(1) The superficial epigastric; (2) the superficial circumflex iliac; (3) the 

 external pudendal; (4) the inguinal; (5) the profunda; (6) muscular branches; 

 and (7) the suprema genu (anastomotica magna). 



(1) the superficial epigastric artery [a. epigastrica superficialis], comes off 

 from the femoral about 1.2 cm. (| in.) below the inguinal ligament. At its origin 

 it is beneath the fascia lata, but almost at once passes through this fascia, or else 

 through the fossa ovalis, and courses in an upward and slightly medial direction 

 in front of the external oblique muscle almost as far as the umbilicus. 



It ends in numerous small twigs, which anastomose with the cutaneous branches from the 

 inferior epigastric and internal mammary. In its course it gives off small branches to the in- 

 guinal ghuids and to the skin and superficial fascia;. Running with it is the superficial epigastric 

 •\fein, which ends in the great saphenous just before the latter passes through the fossa ovalis 

 (saphenous opening). 



(2) The superficial circumflex iliac artery [a. circumflcxa ilium superficialis], 

 (fig. 496), usually smaller than the sui)erficial epigastric, arises either in common 

 with that vessel, or else as a separate branch from the femoral. It passes laterally 

 over the iliacus, and, soon perforating the fascia lata a little to the lateral side of 

 the fossa ovalis, runs more or less parallel to the inguinal ligament about as far 

 as the crest of the ilium, where it ends in branches which anastomose with the 

 deep circumflex iliac artery. 



In its course it gives off branches to the iliacus and sartorius muscles, to the inguinal glands, 

 and to the fascia and skin. Its companion vein ends in the great saphenous veinjust before the 

 latter passes through the fossa ovalis (saphenous opening). 



