Anatomy, Surgical and topographical -- Atlases; Surgery -- Atlases; Surgery, Operative -- Atlases
When a femoral hernia protrudes at the saphenous space L h, Pl. 28, the
dense falciform process, h, embraces its outer side, while the pubic
portion of the fascia, L, lies beneath it. The cord, K, is placed on the
inner side of the hernia; the cribriform fascia covers it; and the upper
end of the saphena vein, M, passes beneath its lower border. The upper
cornu, h, Pl. 29, of the falciform process would seem, by its situation,
to be one of the parts which constrict a crural hernia. An inguinal
hernia, which descends the cord, K, Pl. 28, provided it passes no
further than the point indicated at K, and a crural hernia turning
upwards from the saphenous interval over the cord at K, are very likely
to present some difficulty in distinctive diagnosis.
DESCRIPTION OF THE FIGURES OF PLATES 28 & 29.
PLATE 28.
A. The fleshy part of the external oblique muscle; a, its tendon
covering the rectus muscle.
B. The umbilicus.
C. The anterior superior spinous process of the ilium.
D. The spinous process of the os pubis.
E. The point where in this instance the fibres of the aponeurotic tendon
of the external oblique muscle begin to separate and form the pillars
of the external ring.
F G. See Plate 29.
H. The fascia lata--its iliac portion. The letter indicates the
situation of the common femoral artery; h, the falciform edge of the
saphenous opening.
I. The sartorius muscle covered by a process of the fascia lata.
K. The spermatic fascia derived from the external oblique tendon.
L. The pubic part of the fascia lata forming the inner and posterior
boundary of the saphenous opening.
M. The saphenous vein.
N. A tributary vein coming from the fore part of the thigh.
[Illustration: Abdomen and leg, showing blood vessels, muscles
and other internal organs.]
Plate 28
PLATE 29.
A. The muscular part of the external oblique; a, its tendon.
B. The umbilicus.
C. The anterior superior iliac spine.
D. The spine of the os pubis.
E. The cremasteric fibres, within the external ring, surrounding the
cord; e, the cremasteric fibres looping over the cord outside the ring.
F. The muscular part of the internal oblique giving off, E, the
cremaster; its tendon sheathing the rectus muscle.
G. The linea alba; f, g, the linea semilunaris.
H. The iliac part of the fascia lata; h, the upper cornu of its
falciform process.
I. The femoral vein.
K. The femoral artery.
L. The anterior crural nerve.
M. The sartorius muscle.
N. The sheath of the femoral vessels; n, its upper part.
O. The saphena vein.
P. The pubic part of the fascia lata.
[Illustration: Abdomen and leg, showing blood vessels, muscles
and other internal organs.]
Plate 29
COMMENTARY ON PLATES 30 & 31.
THE SURGICAL DISSECTION OF THE FIFTH, SIXTH, SEVENTH, AND EIGHTH
LAYERS OF THE INGUINAL REGION, AND THEIR CONNEXION WITH THOSE
OF THE THIGH.
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