Anatomy, Surgical and topographical -- Atlases; Surgery -- Atlases; Surgery, Operative -- Atlases
The bloodvessels which pass in the neighbourhood of the femoral canal
are, 1st. the femoral vein, F, Fig. 1, Plate 43, which enclosed in its
proper sheath lies parallel with and close to the outer side of the
passage. 2nd, Within the inguinal canal above are the spermatic vessels,
resting on the upper surface of the femoral arch, which alone separates
them from the upper part or entrance of the femoral canal. 3rd, The
epigastric artery, F, Fig. 2, Plate 43, which passes close to the outer
and upper border of, H, the femoral ring. This vessel occasionally gives
off the obturator artery, which, when thus derived, will be found to
pass towards the obturator foramen, in close connexion with the ring;
that is, either descending by its outer border, G*, between this point
and the iliac vein, K; or arching the ring, G, so as to pass down close
to its inner or pubic border. In some instances, the vessel crosses the
ring; a vein generally accompanies the artery. These peculiarities in
the origin and course of the obturator artery, especially that of
passing on the pubic side of the ring, behind Gimbernat's ligament and
the conjoined tendon, E H, are fortunately very rare.
As the course to be taken by the bowel, when a femoral hernia is being
formed, is through the crural ring and canal, the structures which have
just now been enumerated as bounding this passage, will, of course, hold
the like relation to the hernia. The manner in which a femoral hernia is
formed, and the way in which it becomes invested in its descent, may be
briefly stated thus: The bowel first dilates the peritonaeum opposite
the femoral ring, H, Fig. 2, Plate 43, and pushes this membrane before
it into the canal. This covering is the hernial sac. The crural septum
has, at the same time, entered the canal as a second investment of the
bowel. The hernia is now enclosed by the sheath, G, Fig. 1, Plate 43, of
the canal itself. [Footnote 1] Its further progress through the
saphenous opening, B F, Fig. 1, Plate 44, must be made either by
rupturing the weak inner wall of the canal, or by dilating this part; in
one or other of these modes, the herniary sac emerges from the canal
through the saphenous opening. In general, it dilates the side of the
canal, and this becomes the fascia propria, B G. If it have ruptured the
canal, the hernial sac appears devoid of this covering. In either case,
the hernia, increasing in size, turns up over the margin of F, the
falciform process, [Footnote 2] and ultimately rests upon the iliac
fascia lata, below the pubic third of Poupart's ligament. Sometimes the
hernia rests upon this ligament, and simulates, to all outward
appearance, an oblique inguinal hernia. In this course, the femoral
hernia will have its three parts--neck, body, and fundus--forming nearly
right angles with each other: its neck [Footnote 3] descends the crural
canal, its body is directed to the pubis through the saphenous opening,
and its fundus is turned upwards to the femoral arch.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account