Anatomy, Surgical and topographical -- Atlases; Surgery -- Atlases; Surgery, Operative -- Atlases
In the upper region of the thigh the fascia lata is divided into two
parts--viz., H, the iliac part, and L, the pubic. The iliac part, H,
which is external, and occupying a higher plane than the pubic part, is
attached to Poupart's ligament along its whole extent, from C to D, Pl.
28; that is, from the anterior iliac spinous process to the crista
pubis. From this latter point over the upper and inner part of the
thigh, the iliac division of the fascia appears to terminate in an edge
of crescentic shape, h; but this appearance is only given to it by our
separating the superficial fascia with which it is, in the natural state
of the parts, blended. The pubic part of the fascia, L, Pl. 28, which is
much thinner than the iliac part, covers the pectineus muscle, and is
attached to the crest and pectineal ridge of the os pubis, occupying a
plane, therefore, below the iliac part, and in this way passes outwards
beneath the sheath of the femoral vessels, K I, Pl. 29. These two
divisions of the fascia lata, although separated above, are united and
continuous on the same plane below. An interval is thus formed between
them for the space of about two inches below the inner third of
Poupart's ligament; and this interval is known as the "saphenous
opening," L h, Pl. 28. Through this opening, the saphena vein, O, Pl.
29, enters the femoral vein, I.
From the foregoing remarks it will appear that no such aperture as that
which is named "saphenous," and described as being shaped in the manner
of L h, Pl. 28, with its "upper and lower cornua," and its "falciform
process," or edge, h, exists naturally. Nor need we be surprised,
therefore, that so accurate an observer as Soemmering (de Corporis
Humani Fabrica) appears to have taken no notice of it.
Whilst the pubic part of the fascia lata passes beneath the sheath of
the femoral vessels, K I, Pl. 29, the iliac part, H h, blends by its
falciform margin with the superficial fascia, and also with N n, the
sheath of the femoral vessels. The so-called saphenous opening,
therefore, is naturally masked by the superficial fascia; and this
membrane being here perforated for the passage of the saphena vein, and
its tributary branches, as also the efferent vessels of the lymphatic
glands, is termed "cribriform."
The femoral vessels, K I, contained in their proper sheath, lie
immediately beneath the iliac part of the fascia lata, in that angle
which is expressed by Poupart's ligament, along the line C D above; by
the sartorius muscle in the line C M externally; and by a line drawn
from D to N, corresponding to the pectineus muscle internally. The
femoral vein, I, lies close to the outer margin of the saphenous
opening. The artery, K, lies close to the outer side of the vein; and
external to the artery is seen, L, the anterior crural nerve, sending
off its superficial and deep branches.
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