THE ABDOMEN. 



3*5 



Hydroccle of the Canal of Nuck. The inguinal canal in the female transmits 

 the round ligament, and sometimes a finger-like extension of the peritoneum resemb- 

 ling the vaginal process in the male. Accumulation of fluid may occur in this in 

 the same manner as hydrocele of the cord is formed in the male. It is then called 

 hydrocele of the canal of Nuck. 



Acquired Inguinal Hernia. Acquired inguinal herniae may be either of the 

 indirect or direct kind. To understand them one must know the construction of 

 the inguinal canal and spermatic cord. 



The Spermatic Cord. As the testicle descends it leaves in its wake the vas 

 deferens, the essential part of the spermatic cord. It carries with it the spermatic 

 artery, from the aorta, the pampiniform plexus of veins, and the artery of the vas 

 from the superior vesical. * The vas deferens with its artery lies posteriorly and the 

 spermatic artery and pampiniform plexus are anterior. The cremasteric branch of 



Internal abdominal 

 ring 



Shelving edge of 

 Poupart's ligament 



Cremaster muscle 



covering the 



spermatic cord 



Sheath of rectus 



Aponeurosis of exter- 

 nal oblique 



Arching fibres of inter- 

 nal oblique 



Conjoined tendon of 

 internal oblique and 

 transversalis 

 Attachment of cremas- 

 ter to pubis 



Spine of pubis 



FIG. 396. Parts concerned in inguinal hernia; the inguinal canal exposed. 



the deep epigastric supplies the cremaster muscle. The cord also contains sym- 

 pathetic nerves, lymphatics, some fibrous remains of the vaginal process, and a few 

 muscular fibres. These structures are imbedded in fatty tissue continuous with the 

 subperitoneal fat and are covered by a fibrous sheath formed by a continuation of the 

 structures of the abdominal walls, viz., the intercolumnar fascia from the external 

 oblique, the cremasteric fascia from the internal oblique, and the transversalis fascia. 

 Inguinal Canal (Canalis Ingiiinalis*) . This runs from the external to the 

 internal abdominal ring and is about 4 cm. ( i ^ in. ) in length. The external ring 

 (annuhis inguinalis subcutaneus*) (Fig. 395) barely admits the tip of the finger ; it lies 

 immediately to the outside and above the spine of the pubis. It is formed by a split- 

 ting of the fibres of the external oblique aponeurosis into two columns or pillars. The 

 external column (crzts inferius) blends with Poupart's ligament, passes beneath the 

 cord, and inserts into the spine of the pubis. The internal column (crus superius} 

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