378 



APPLIED ANATOMY. 



cremaster muscle usually arises from Poupart's ligament, beneath the spermatic cord, 

 from the lower edge of the internal oblique to near the spine of the pubes, thus 

 obliterating the space usually shown to the under side of the cord, between it and 

 Poupart's ligament. The fibres of the cremaster hang in loops on the cord, and are 

 attached by their distal extremity to the pubic bone in the neighborhood of the spine. 

 The transversalis muscle arises from the six lower ribs, through the lumbar 

 fascia from the transverse processes of the five lumbar vertebrae, and from the ante- 

 rior two-thirds of the iliac crest and outer third of Poupart's ligament. It inserts 

 through the sheath of the rectus in the linea alba and crest of the pubis, and 

 through the conjoined tendon into the spine of the pubis and iliopectineal line for 

 about 4 cm. (i l A in. ) The transversalis does not come down so low as the internal 



Latissimus dorsi~t 



Cut edge of internal oblique 

 Transversalis 



Transversalis fascia 



Internal abdominal ring 



Cremaster muscle 



Poupart's ligament 



Spermatic cord 



External oblique cut and 

 turned back 



Internal oblique turned back 



Conjoined tendon of internal 

 /oblique and transversalis 



Rectus 



Pyramidalis 

 Spine of pubis 

 Attachment of cremaster 



FIG. 390. Transversalis muscle. 



oblique, because it arises from the outer third of Poupart's ligament instead of the 

 outer half, as does the internal oblique. As already stated, the blended tendons of 

 the external and internal oblique and transversalis muscles all pass in front of the 

 rectus in its lower fourth. As the umbilicus is below the middle of the linea alba, 

 this point, where the fold of Douglas is formed, is nearer to the umbilicus than it is 

 to the symphysis (Fig. 390). 



VESSELS OF THE ABDOMINAL WALLS. 



The vessels of the abdominal walls comprise arteries, veins, and lymphatics. 

 The arteries are superficial and deep ; of these the deep are the more important. 

 The arterial twigs in the subcutaneous tissue are small. The superficial epigas- 

 tric runs in a line from the femoral artery toward the umbilicus. The superficial 

 circumflex iliac runs to its outer side toward the iliac spine, mostly below Poupart's 

 ligament. Branches of these vessels may require the temporary application of a 

 haemostatic forceps in the operations for hernia or appendicitis. 



The deep arteries are important : they are the superior epigastric, deep epi- 

 gastric, and deep circumflex iliac (Fig. 391). 



