832 



SURGICAL ANATOMY OF FEMORAL HERNIA. 



exist naturally, but is the result of dissection. Mr. Callender, however, speaks 

 of cases in which, probably as the result of pressure from enlarged inguinal 

 glands, the fascia has become atrophied, and a saphenous opening exists inde- 

 pendent of dissection. 1 A femoral hernia, in passing through the saphenous 

 opening, receives the cribriform fascia as one of its, coverings. 



The deep layer of superficial fascia, together with the cribriform fascia, hav- 

 ing been removed, the fascia lata is exposed. 



Fig. 450. Femoral Hernia, showing Fascia Lata and Saphenous Opening. 



The Fascia Lata, already described, is a dense, fibrous aponeurosis, which 

 forms a uniform investment for the whole of this region of the limb. At the 

 upper and inner part of the thigh, a large oval-shaped aperture is observed 

 in it ; it transmits the internal saphenous vein and other small vessels, and is 

 called the saphenous opening. In order the more correctly to consider the mode 

 of formation of this aperture, the fascia lata in this part of the thigh is described 

 as consisting of two portions, an iliac portion and a pubic portion. 



The iliac portion of the fascia lata is situated on the outer side of the saphe- 

 nous opening, covering the outer surface of the Sartorius, the Rectus, and the 

 Psoas and Iliacus muscles. It is attached externally to the crest of the ilium 

 and its anterior superior spine, to the whole length of Poupart's ligament as 

 far internally as the spine of the pubes, and to the pectineal line in conjunction 

 with Gimbernat's ligament, where it becomes continuous with the pubic por- 

 tion. From the spine of the pubes, it is reflected downwards and outwards, 

 forming an arched margin, the outer boundary (superior cornu) of the saphe- 

 nous opening. This is sometimes called the falciform process of the fascia lata 



1 Anatomy of Femoral Rupture, note on p. 18. 



