THE THIGH 



1441 



line dropped vertically from the pubic tubercle. This and the other structures 

 concerned in femoral hernia are fully described under this section (vide supra, 

 p. 1398). The course of the great saphenous vein is given below, p. 1456. 



Line of femoral artery. — A line drawn from the mid-point between the anterior 

 superior spine and the symphysis pubis to the adductor tubercle will correspond 

 with the course of this vessel. The sartorius usually crosses it 10 cm. ( 3 to 4 in.) 

 below the inguinal (Poupart's) ligament. The profunda artery arises usually 

 3.7-5 cm. (1^ to 2 in.) below Poupart's ligament. 



The incision for tying the femoral in the femoral trigone should be about 7.5 cm. (3 in.) 

 long, in the line of the artery, and begins about 7. .5 cm. (.3 in.) below the inguinal hgament, and 

 runs over the apex of the triangle. The femur is flexed sUghtly, abducted and rotated laterally. 

 The fascia lata being divided, the sartorius, readily recognised by its direction, is drawn later- 

 ally. The closely subjacent sheath must be opened on its lateral side. Structures that may 

 be seen are a vein joining the great saphenous, the anterior cutaneous, saphenous nerve, and 

 that to the vastus mediahs. The collateral circulation (fig. 1156) is mainly through the following 



Fig. 1160. — Section of Thigh through upper Part of Hunter's Canal. (W. A.) 



Lymph-spaces 



Saphenous nerve 



Femoral artery, with 



small venae comit- 



antes (femoral vein 



deeper) 



Sheath of vessels 



Great saphenousvein 



Lymph-spaces 

 Superficial fascia 



Deep fascia contin- 



I ued over back of 



' thigh as superficial 



layer of deep fascia 



Middle layer of deep 

 fascia 



Deep layer of deep 

 fascia (muscular 

 aponeurosis) 



Sciatic nerve Vein 



channels: — (1) The lateral and medial circumflex above, with the genu suprema and lower 

 muscular branches of the femoral, and the articular of the popliteal. (2) The perforating 

 branches of the profunda above, with the vessels below first given. (3) The comes nervi ischia- 

 dici with the articular of the popliteal. 



The femoral vein lies, below the inguinal ligament, immediately to the medial 'side of the 

 artery. From this point on the vein gets to a somewhat deeper plane, though still very close to 

 the artery, and graduaUy inclining backward, hes behind its companion at the apex of the tri- 

 angle, and below Ues somewhat laterally to it. 



From the apex of the femoral trigone (Scarpa's triangle) a depression runs 

 down along the medial aspect of the thigh, corresponding to the groove already 

 mentioned between the vastus medialis muscle and the adductors. Along this 

 groove lies the sartorius, and beneath it the adductor (Hunter's) canal, a triangu- 

 lar inter-muscular gap with its apex toward the linea aspera, and its base or roof 

 formed by the fibrous expansion which ties together its boundaries, viz., the adduc- 

 tor longus and magnus and the vastus medialis. 



The vein, which in the upper part of the canal Ues behind the artery, separating it from 

 the three adductors, lower down inclines more and more to the lateral side. The saphenous nerve 

 lies also in the canal, but not in the sheath. The above-mentioned space terminates at about 

 the junction of the middle and lower thirds of the thigh, in the opening in the adductor magnus 



91 



