SUPERFICIAL EXAMINATION 5 



trochanter. Two slight and elongated elevations are seen to converge 

 and meet at the third trochanter. These elevations are due to the 

 underlying arms of the superficial gluteal muscle. Running obliquely 

 downwards and forwards behind the imaginary line indicating the 

 direction of the femur are three elevations which are caused by the 

 bellies of the three divisions of the triceps abductor femoris or biceps 

 femoris muscle. The most anterior of the three bellies takes a course 

 which is almost exactly parallel to that taken by the femoral axis, whilst 

 the remaining two take courses which approach progressively nearer 

 the vertical direction. 



An imaginary line connecting the external angle of the ilium and 

 the summit of the great trochanter will, with the axis of the femur, form 

 sides including an angle which is mainly filled by the quadriceps 

 extensor cruris muscles. The normal bulk of these muscles should be 

 carefully noted, since there is a marked falling away in this region in 

 advanced cases of paralysis of the anterior crural nerve. A delicate 

 sheet-like muscle runs from the angle of the haunch almost vertically 

 downwards to be inserted into the fascia of the thigh. This is the 

 tensor vagina femoris muscle. 



Attention should next be directed to the region of the stiile joint, 

 and the first point which strikes one here is the prominence in front of 

 the joint caused by the patella. The bone should be carefully manipu- 

 lated, its outline mapped out, and its vertical movement on the trochlea 

 of the femur demonstrated to the observer's satisfaction by taking the 

 limb up and flexing and extending the joint. In this manner also the 

 lips of the trochlea may be made more apparent to the touch. On the 

 anterior aspect of the patella a broad flattened tendon should be found. 

 This is the tendon of the quadriceps or crural muscles, the action of 

 which is transmitted to the limb through the medium of the straight 

 ligaments of the patella. 



Below the patella is a transverse indentation. This invites most 

 careful observation, since a symptom of several afi^ections of the stifle 



