46o A MANUAL OF ANATOMY 



femoral vein, which has been called the falciform process of Burns 

 (John),* or the femoral ligament of Hey. The importance of this 

 process or ligament is that it impresses upon a femoral hernia its 

 final change in direction, inasmuch as it causes the protrusion to 

 turn upwards over Poupart's ligament upon the anterior abdominal 

 wall, or upwards and outwards towards the anterior superior iliac 

 spine. 



The saphenous opening is covered by the cribriform fascia, which 

 is more intimately attached to the outer border than elsewhere. 



Parts concerned in Femoral Hernia. 



Poupart's Ligament or the Superficial Femoral Arch. — This is the 

 thickened lower border of the aponeurosis of the external oblique 

 muscle. It is folded upon itself in a backward direction, and is 

 attached externally to the anterior superior iliac spine and internally 

 to the pubic spine. 



Gimbernat's Ligament. — This is the reflection of Poupart's 

 ligament from the pubic spine along the ilio-pectineal line for i inch. 

 It is triangular, and presents a free base which is sharp, wiry, and 

 concave, and is situated immediately to the inner side of the crural 

 or femoral ring. 



Deep Femoral Arch. — ^This is a thickening of the fascia trans- 

 versalis, due to an accession of fibres as it is prolonged downwards 

 beneath Poupart's ligament. It extends from the centre of that 

 ligament on its deep aspect to the pectineal portion of the ilio- 

 pectineal line, where it is attached behind Gimbernat's ligament 

 near its base. 



Falciform Process of Burns. — ^This has just been described in 

 connection with the superior comu of the saphenous opening. 



Femoral Slieath. — ^This sheath extends from Poupart's ligamicnt 

 to a point about i| inches below it, where it blends with the 

 special sheath of the femoral vessels. The outer wall is straight, 

 but the inner is oblique, being sloped downwards and outwards. 

 In shape the sheath resembles a funnel, from "which circumstance 

 the term infundibuliform has been applied to it. The anterior wall 

 is formed by the fascia transversalis, and the posterior wall by the 

 fascia iliaca, both of which fasciae are prolonged downwards beneath 

 Poupart's ligament. The outer wall is formed by the union of these 

 two fasciae close to the outer side of the femoral artery. The 

 imier wall is formed by their union at a point ^ inch to the inner 

 side of the femoral vein. 



Within the sheath there are two septa, external and internal, both 

 of which extend from the anterior to the posterior wall, the external 

 septum being close to the outer side of the femoral vein, and the 

 internal septum close to its inner side. By means of these two septa 

 the interior of the sheath is divided into three distinct compart- 



* Edinburgh Medical and Surgical Journal, July i, 1806, p. 269. 



