A manual of operative surgery / By Lewis A. Stimson ... and John Rogers.

  • Lewis Atterbury Stimson
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: A manual of operative surgery / By Lewis A. Stimson ... and John Rogers. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    The sciatic, where it crosses the spine of the ischium, lies opposite the junction of the middle and lower thirds of a line joining the tuberosity with the posterior superior spine of the ilium. After division of the skin and faseia, the fibers of the gluteus maximus are separated and held apart with long retractors, the deep fascia torn through, and the artery sought for. The gluteal artery is to be sought for above the pyri- formis muscle at the upper border of the great sacro-sciatic notch, where it can be felt near a small bony tubercle. It is covered by many large veins, which require very care- ful handling. The ligature should be applied as close to the notch as possible. The sciatic and internal j)ii<Jic arteries leave the great sciatic notch at the lower edge of the pyrifbrmis; the former divides almost immediately, the latter reenters the pelvis through the lesser sacro-sciatic notch, lying on the inner side of the sciatic artery during its passage over the spine of the ischium. LIGATURE OF THE FEMORAL ARTERY. Anatomy.—The femoral artery is the continuation of the externa] iliac, and extends in a straight line from a point midway between the anterior superior spine of the ilium ami the symphysis pubis to the ring in the tendon of the adductor magnus about lour finger-breadths above the tubercle of insertion of that muscle on the upper portion of i he inner condyle of the femur. In the first one or two inches of its course it gives off the superficial external pudic, epigastric, and circumflex ilii, and the much larger and more important profunda arteries. The anastoinotica magna arises near it.~ lower cud. The artery is accom- panied throughout l>v the femoral vein, which, at first, lies u|>ii the inner side, and then becomes posterior. They ii separated at first by a distinct septum, which disap- pears in the lower third. The anterior crural nerve emerges from below Poupart'a ligament, about half an inch external to the artery ; it divides up rapidly, and one of