Anatomy, Surgical and topographical -- Atlases; Surgery -- Atlases; Surgery, Operative -- Atlases
there that feels anxiety concerning the origin or the distinctiveness of
the "spermatic fascia?" Or, knowing it to be present, who concerns
himself about the better propriety of naming it "tunica vaginalis
communis," "tunique fibreuse du cordon spermatique," "fascia
cremasterica," or "tunica aponeurotica?"]
The close relations which the cord, D F, bears to the saphenous opening,
E, of the fascia lata, should be closely considered, forasmuch as when
an oblique inguinal hernia descends from D to F, it approaches the
situation of the saphenous opening, E, which is the seat of the femoral
or crural hernia, and both varieties of hernia may hence be confounded.
But with a moderate degree of judgment, based upon the habit of
referring the anatomy to the surface, such error may always be avoided.
This important subject shall be more fully treated of further on.
The superficial bloodvessels of the inguino-femoral region are, e e,
the saphenous vein, which, ascending from the inner side of the leg and
thigh, pierces the saphenous opening, E, to unite with the femoral vein.
The saphenous vein, previously to entering the saphenous opening,
receives the epigastric vein, i, the external circumflex ilii vein, h,
and another venous branch, d, coming from the fore part of the thigh. In
the living body the course of the distended saphenous vein may be traced
beneath the skin, and easily avoided in surgical operations upon the
parts contained in this region. Small branches of the femoral artery
pierce the fascia lata, and accompany these superficial veins. Both
these orders of vessels are generally divided in the operation required
for the reduction of either the inguinal or the femoral strangulated
hernia; but they are, for the most part, unimportant in size. Some
branches of nerves, such as, k, the external cutaneous, which is given
off from the lumbar nerves, and, f, the middle cutaneous, which is
derived from the crural nerve, pierce the fascia lata, and appear upon
the external side and middle of the thigh.
Numerous lymphatic glands occupy the inguino-femoral region; these can
be felt, lying subcutaneous, even in the undissected state of the parts.
These glands form two principal groups, one of which, c, lies along the
middle of the inguinal fold, C B; the other, G g, lies scattered in the
neighbourhood of the saphenous opening. The former group receive the
lymphatic vessels of the generative organs; and the glands of which it
is composed are those which suppurate in, syphilitic or other affections
of these parts.
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