ABDOMEN. 



reflected backwards, outwards, and a little 

 upwards, they are likewise inserted into the 

 linea ilio-pectinea, which commences at the 

 spine of the pubis. The lower margin of the 

 tendon is thus folded back a little as it arches 

 over the excavation between the pubis and 

 ilium, so as to present towards the abdomen a 

 slight channel-like excavation, which affords 

 origin to the muscular fibres of the internal 

 oblique as well as to those of the transver- 

 salis, whilst it has the appearance of a rounded 

 ligamentous cord towards the thigh. In this 

 manner is formed Poupart's ligament, which, 

 contrary to what its usual name denotes, is 

 not a distinct ligamentous cord, but the in- 

 ferior margin of the external oblique stretched 

 from pubis to ilium, and folded a little upon 

 itself. By its superior margin it is continuous 

 with the fibres of the tendon of the external 

 oblique, which fall obliquely upon it ; by its in- 

 ferior margin it is intimately connected with the 

 fascia lata of the thigh ; externally it is inserted 

 into the anterior superior spine of the ilium ; and 

 by its pubic extremity it has three attachments, 

 1. to the body of the pubis; 2. to the spine 

 of the same; and 3. to the linea ilio-pectinea, 

 constituting what has been called Gimbernufs 

 ligament, which has a sharp slightly crescentic 

 margin directed backwards and outwards to- 

 wards the femoral vessels.* (See GROIN, 

 REGION OF THE.) 



The external abdominal ring is a triangular 

 opening, situated obliquely ; the superior angle 

 being directed upwards and outwards, and its 

 base, represented by a line uniting the pubic 

 insertions of the two pillars, resting upon the 

 pubis. The superior angle is formed evidently 

 by the separation of the fibres of the aponeu- 

 rosis, the primitive direction of which is the same 

 as that of a perpendicular from the apex to the 

 base of the triangle, viz. downwards and in- 

 wards, (sacrad and pubad.) This separation, 

 however, is strengthened, and the angle round- 

 ed by some tendinous fibres which inter- 

 sect the oblique ones nearly at a right angle, 

 arising as a cord of variable thickness from 

 Poupart's ligament, and passing upwards and 

 inwards over the apex of the ring, gradually 

 separating into several tendinous fibres. These 

 fibres are sometimes very strong, at other 

 times very feeble and scarcely perceptible ; 

 but it rarely, if ever, happens that they are 

 completely absent ; they have been termed 

 intercolumnal bands. I have seen them so 

 strong that they could be distinctly dissected 

 off the external oblique aponeurosis, like a 

 separate tendinous expansion; but most fre- 

 quently they are so united to the aponeurosis 

 as to render it impossible to remove them 

 without injury to it. These fibres are evi- 

 dently intended, as Scarpa expresses it, " to 

 fix the limits of the inguinal ring, and to 

 oppose the further divergence of the tendi- 

 nous pillars towards the side." They are 



* The terms crural arch, and ligament of Fallophis, 

 are also used synonymously with Poupart's liga- 

 ment. Velpeau calls it bandelette ilio-piibienne du 

 grand oblique. 



equally met with, although not nearly so much 

 developed, in women and children as in men ; 

 and Mr. Lawrence asserts that in old hernias 

 they are particularly strong. I cannot confirm 

 this remark from my own observation, as in 

 my dissections of old hernise, I have not 

 found them particularly developed; nor is it con- 

 sistent with the general result of pressure from 

 within on tendinous fibres to believe that such 

 pressure would produce an increase of deve- 

 lopment in them. 



The size of the external abdominal ring is 

 greatest in the male subject, but here it varies 

 considerably, sometimes closely embracing 

 the cord as it passes through it, and at others 

 appearing much too large for it. In the male 

 the parts which pass through it are the sper- 

 matic cord, enveloped in its proper tunic, and 

 in one of condensed cellular membrane pro- 

 longed from the fascia transversalis, a branch 

 of the genito-crural nerve, the cremaster mus- 

 cle, the cremasteric artery, and the spermaticus 

 superficialis nerve. In the female, we find 

 the round ligament of the uterus, covered and 

 accompanied by similar parts, excepting the 

 cremaster. From the margin of the external 

 abdominal ring, a cellular expansion or fascia 

 is carried over the cord or round ligament, 

 and has been denominated fascia spermatica. 

 This fascia consequently forms a covering of 

 any hernia that may be protruded through the 

 external ring; and, accordingly, in old hernia; 

 we find it greatly thickened. Its formation 

 is simply in accordance with what we find oc- 

 curring in all parts of the body, viz. that when 

 any part passes through an opening in a fibrous 

 membrane, it carries with it a cellular expan- 

 sion from the margin of that opening. This 

 we observe in the passage of the vena cava 

 through the diaphragm, of the urethra through 

 the triangular ligament or deep perineal fascia. 

 This view confirms the opinion of Sir A. 

 Cooper, that this fascia is a production from 

 the margin of the ring itself. 



The external oblique muscle is covered in 

 all its extent by the superficial fascia; its costal 

 margin is related to the serratus magnus, and to 

 the latissimus dorsi, with which muscle it is also 

 in close relation by its posterior margin, being 

 sometimes slightly overlapped by the anterior 

 margin of the latissimus, but at others separated 

 from that muscle by a triangular interval 

 through which the fibres of the obliquus inter- 

 nus appear : interiorly the fascia lata of the 

 thigh is related to the margin of the external 

 oblique muscle, both as it covers the glutaei, and 

 as it lies in front of the thigh. Along the 

 middle line the aponeuroses of opposite sides 

 meet at the linea alba, and superiorly the mus- 

 cular fibres are related to and sometimes con- 

 nected by a fleshy slip with those of the pecto- 

 ralis major, and the aponeurosis is continuous 

 with that of the same muscle.* When the ex- 



* " By its position, the direction of its fibres, and 

 the short distance to which its fleshy portion extends 

 forwards, the external oblique corresponds so much 

 to the external intercostals, that one is led to say 

 that it represents them in the abdomen." Merk<-l. 



