Identifier: textbookofoperat1903koch (find matches)
Title: Text-book of operative surgery
Year: 1903 (1900s)
Authors: Kocher, Theodor, 1841-1917 Stiles, Harold J
Subjects: Surgery, Operative Surgery
Publisher: London : Adam and Charles Black
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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assed above the upper border of the muscle, feels for theunder surface of the horizontal ramus of the pubis, below which the artery leaves theobturator foramen accompanied by the— 239. Obturator Nerve, which lies above it (Fig. 144). Thigh—Anterior Surface 240. Femoral Artery. It courses in a line from the middle of Pouparts ligamentdirectly downwards towards the middle of the posterior aspect of the knee-joint, andpasses from the inner towards the posterior surface of the femur at the junction ofthe middle and lower thirds of the bone. The incisions for ligaturing the artery,however, are made along a line extending from the middle of Pouparfs ligament tothe adductor tubercle, because in the lower part the artery is reached not from thefront but from the inner aspect. Common femoral artery (Fig. 145). Incision parallel to and below the middle 3i8 OPERATIVE SURGERY Ilio-psoas mExt. circumflex a Rectus femoris Profunda femoris a Sartorius m.-fg . ( Fascia covering obturator\ ext. m.
Text Appearing After Image:
FIG, 144.—(1) Ligature of profunda femoris artery and external circumflex artery. (2) Ligatureof obturator artery. (3) Ligature of profunda femoris artery. LOWER EXTREMITY 319 third of Pouparts ligament. Ligature of the superficial epigastric artery in thesubcutaneous tissue. Division of the superficial layer of the fascia lata belowPouparts ligament. The artery, along with the origins of the deep epigastric anddeep circumflex iliac arteries, appears below the middle of the ligament lying uponthe pubic bone, where it may be distinctly felt. The crural branch of the genito-crural nerve lies upon the sheath of the vessel. Internal to the artery is the femoralvein ; external to it the fascia covering the ilio-psoas, and beneath the fascia thetrunk of the anterior crural nerve at the outer edge of the psoas. In, the upper third, at the apex of Scarpas triangle (Fig. 145). The skin andfascia lata are divided along the line already mentioned. The sartorius is drawnoutwards. Under this mus

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