Henry Gray (18251861). Anatomy of the Human Body. 1918.
magnus, where it divides into numerous muscular branches which are distributed to the Adductor magnus and the Adductor brevis when the latter does not receive a branch from the anterior division of the nerve. It usually gives off an articular filament to the knee-joint.
The articular branch for the knee-joint is sometimes absent; it either perforates the lower part of the Adductor magnus, or passes through the opening which transmits the femoral artery, and enters the popliteal fossa; it then descends upon the popliteal artery, as far as the back part of the knee-joint, where it perforates the oblique popliteal ligament, and is distributed to the synovial membrane. It gives filaments to the popliteal artery.
The Accessory Obturator Nerve (n. obturatorius accessorius) (Fig. 823) is present in about 29 per cent. of cases. It is of small size, and arises from the ventral divisions of the third and fourth lumbar nerves. It descends along the medial border of the Psoas major, crosses the superior ramus of the pubis, and passes under the Pectineus, where it divides into numerous branches. One of these supplies the Pectineus, penetrating its deep surface, another is distributed to the hip-joint; while a third communicates with the anterior branch of the obturator nerve. Occasionally the accessory obturator nerve is very small and is lost in the capsule of the hip-joint. When it is absent, the hip-joint receives two branches from the obturator nerve.
The Femoral Nerve (n. femoralis; anterior crural nerve) (Fig. 827), the largest branch of the lumbar plexus, arises from the dorsal divisions of the second, third, and fourth lumbar nerves. It descends through the fibers of the Psoas major, emerging from the muscle at the lower part of its lateral border, and passes down between it and the Iliacus, behind the iliac fascia; it then runs beneath the inguinal ligament, into the thigh, and splits into an anterior and a posterior division. Under the inguinal ligament, it is separated from the femoral artery by a portion of the Psoas major.
Within the abdomen the femoral nerve gives off small branches to the Iliacus, and a branch which is distributed upon the upper part of the femoral artery; the latter branch may arise in the thigh.
In the thigh the anterior division of the femoral nerve gives off anterior cutaneous and muscular branches. The anterior cutaneous branches comprise the intermediate and medial cutaneous nerves (Fig. 825).
The intermediate cutaneous nerve (ramus cutaneus anterior; middle cutaneous nerve) pierces the fascia lata (and generally the Sartorius) about 7.5 cm. below the inguinal ligament, and divides into two branches which descend in immediate proximity along the forepart of the thigh, to supply the skin as low as the front of the knee. Here they communicate with the medial cutaneous nerve and the infrapatellar branch of the saphenous, to form the patellar plexus. In the upper part of the thigh the lateral branch of the intermediate cutaneous communicates with the lumboinguinal branch of the genitofemoral nerve.
The medial cutaneous nerve (ramus cutaneus anterior; internal cutaneous nerve) passes obliquely across the upper part of the sheath of the femoral artery, and divides in front, or at the medial side of that vessel, into two branches, an anterior and a posterior. The anterior branch runs downward on the Sartorius, perforates the fascia lata at the lower third of the thigh, and divides into two branches: one supplies the integument as low down as the medial side of the knee; the other crosses to the lateral side of the patella, communicating in its course with the infrapatellar branch of the saphenous nerve. The posterior branch descends along the medial border of the Sartorius muscle to the knee, where it pierces the fascia lata, communicates with the saphenous nerve, and gives off several cutaneous branches. It then passes down to supply the integument of the medial side of the leg. Beneath the fascia lata, at the lower border of the Adductor longus, it joins to form a plexiform