Those deviations have been accounted repe titions of similar irregularities in the brachial. artery, than which, however, they are far less frequent. It is a matter to be regretted that neither in the case of Bell, nor in that of Houston, has any account been given of the disposition of the artery of the upper extremi ties or of the other thigh.
Branches of the ,femoral artery. —The branches given of by the femoral artery are numerous; but the trunk of the vessel being itself intended for the supply of the leg and foot, the branches which it gives to the thigh are, with the exception of one intended speci ally for the nutrition of that part, inconsider able in size. The artery gives branches to the integuments of the abdomen, to the glands and other structures in the groin, to the external organs of generation, to the muscles in the vicinity of which it passes, to the inner side of the knee; and, lastly, it gives the large branch, adverted to, for the supply of the thigh, and by which those inosculations with other arteries are formed, by means of which chiefly an in terruption in the course of the main vessel is compensated. Those which have received names are five, viz. 1. the superficial epigas tric ; 2. the superficial or external pudic ; 3. the superficial anterior iliac; 4. the profunda; and 5. the superficial superior internal articular arteries.
Of those the first four arise from the artery within its first stage ; the epigastric, iliac, and pudic being given off immediately or at a very short distance below Poupart's ligament; and the profunda at a greater although a variable distance from that part.
I. The superficial cpigastrie artery (artere sous-cutanie abdominale, Cloquet; inguinale, Chaussier;) ordinarily arises from the front of the femoral, immediately below Poupart's liga ment. Sometimes it is given off from a branch common to it and either one or both the ex ternal pudics; or it may proceed from the pro funda.-1- It first comes forward through the fascia lata, and then ascends over Poupart's ligament upon the inferior part of the abdomen, superficial to the aponeurosis of the external oblique muscle, and enclosed in the subcuta neous cellular stratum. Its course is irregular, at times nearly parallel* to that of the deep epigastric within the abdominal wall ; at others ascending directly upon the abdomen ; in ge neral it pursues the latter course. It is consi
derably smaller than the deep epigastric artery, and is concerned altogether in the supply of superficial parts, and in establishing commu nications with other vessels. Its first branches are distributed to the inguinal glands and co verings: during its ascent upon the abdomen it gives to either side branches which supply the superficial structures, and inosculate through the ventral foramina with branches of the inter nal epigastric from within ; and it terminates by communicating with the same and with those of the internal mammary, and of the inferior intercostals. It is, unless in case of disease, a small vessel, and of consequence only from being exposed to be divided in cer tain operations, viz. that for inguinal hernia, or that for tying the external iliac artery.
2. The superficial or external pudic arteries (scrotales ou vulvaires, Chauss.) are generally two, distinguished into superficialt and deep, or superior I and it lerior: of those distinc tions the latter seems preferable, inasmuch as they are both equally superficial in their dis tribution, .and the .difference between them in this particular amounts to no more than that the second continues longer beneath the fascia lata than the first. They arise in general either directly from the femoral, or from a trunk com mon to them with the superficial epigastric, with which they are of nearly equal size.
The superior is given off immediately below Poupait's ligament; comes through the fascia lata, and at the same time gives branches to the inguinal glands; runs, superficial to the fascia, inward and also upward toward the pubes; and either divides into two, one of which as cends above, the other, the more considerable, continues below that part; or, as it proceeds, it gives off small branches which ascend above the pubis, and supply the superficial struc tures upon the inferior middle part of the ab dominal wall; while it is itself continued to the scrotum and side of the penis, the coverings of which it supplies; or labium in the female. Its branches communicate with those, which the external organs of generation receive also from the internal pudic artery, and with branches of the epigastric arteries. This branch is usually divided in the operations for either inguinal or femoral hernia.