THE ABDOMEN 643 



Upon the right side McBurney's point and Monro's point very 

 nearly coincide. Both of these points are now regarded as indicat- 

 ing approximately the situation of the ileo-caecaJ valve, and not 

 the base of the vermiform appendix. The guide to the base or 

 opening of the appendix is a point on an average rather more than 

 I inch below the ileo-caecal valve — that is to say, the base or open- 

 ing of the vermiform appendix is rather more than i inch below 

 McBurney's point.* 



Anterior Abdominal Fasciae. — ^The superficial fascia of the anterior 

 wall of the abdomen, from Poupart's ligament to a line drawn trans- 

 versely from the anterior superior iliac spine to the linea alba, 

 resembles the superficial fascia of the uro-genital division of the 

 perineum in being divisible into two layers. The layer immediately 

 beneath the skin is called the subcutaneous layer or fascia of 

 Camper, and the other layer is called the deep layer or fascia of 

 Scarpa. 



The subcutaneous layer or fascia of Camper is composed of 

 areolar tissue containing adipose tissue in its meshes. When 

 traced upwards it blends with the deep layer above the level of 

 the line connecting the anterior superior iliac spine with the linea 

 alba. \\Tien followed inwards it is continuous with the corre- 

 sponding layer of the opposite side. In a downward direction it 

 is freely continuous over Poupart's ligament with the subcutaneous 

 layer of the superficial fascia of the front of the thigh. When traced 

 downwards and inwards it passes along the spermatic cord into 

 the scrotal wall and over the penis, in which situations, more 

 especially the former, it contains involuntary muscular fibres, 

 which replace its adipose tissue, and so, with the deep layer which 

 it here joins, it forms the tunica dartos. In the female Camper's 

 fascia passes along the romid ligament of the uterus into the 

 labium majus. 



The deep layer or fascia of Scarpa is a strong membrane which 

 contains yellow elastic tissue. It is separated from Camper's 

 fascia by the superficial epigastric vessels, and, in the region of 

 Poupart's ligament, by the inguinal glands. Its deep aspect is 

 loosely connected by areolar tissue to the subjacent aponeurosis 

 of the external oblique muscle. Superiorl)', above the line con- 

 necting the anterior superior iliac spine with the linea alba, it 

 blends with Camper's fascia. At the middle line it is firmly bound 

 down by fibrous bands to the linea alba. Interiorly it blends with 

 the inner part of Poupart's ligament, but external to this it passes 

 over that ligament, to which it is bound by fibrous bands, and 

 immediately ' thereafter it becomes incorporated with the fascia 

 lata of the thigh. When traced downwards and inwards it 

 passes along the spermatic cord into the scrotal wall, and over 

 the penis. In the former situation it forms, along with the 

 subcutaneous layer, the tunica dartos. In the female Scarpa's 



* Sir Frederick Treves, based upon observations made by Dr. C. Addison 

 and Dr. Arthur Keith. 



