9o8 A MANUAL OF ANATOMY ■ 



or vulva is to be carefully inspected. The guide already given to the 

 dissection of the ischio-rectal or anal division of the I male perineum is 

 equally applicable to that of the female. An effort should be made to show the 

 perineal body, which is peculiar to the female. The guide to it is the central 

 tendinous point, of which it may be regarded as a deep expansion. In 

 connection with the vaginal orifice the following structures are to be dis- 

 sected : the bulbo-cavernosus or sphincter vaginae ; the bulbi vestibuli, one 

 on either side of the orifice, and the pars intermedia of Kobelt, which is situated 

 in front of the bulbi vestibuli ; and the glands of Bartholin, which are also 

 situated on either side of the vaginal orifice, just posterior to the bulbi vestibuli. 

 If these glands should be displayed, an effort should be made to dissect their 

 ducts, each of which is about three-quarters of an inch in length. The 

 muscles requiring special attention are the following : the bulbo-cavernosus 

 or sphincter vaginae already dissected ; and the ischio-cavernosus, or erector 

 clitoridis. The other muscles are practically similar in both sexes. The 

 internal pudic artery takes a similar course in the female to what it does in 

 the male. The pudic nerve is practically the same in both sexes. 



Antero-lateral Abdominal Wall. 



The first duty of the dissector is to make himself familiar with the surface- 

 markings of the anterior wall of the abdomen. The abdomen is to be inflated 

 with air, by introducing a blow-pipe through the umbilicus. On withdrawing 

 the blow-pipe, the opening is to be secured by a ligature, a circular cut through 

 the skin, around and close to the umbilicus, having been previously made in 

 order to give the string a hold. The skin is to be removed by making the 

 following incisions : a median incision extending from the ensiform process 

 of the sternum to the upper border of the symphysis pubis ; an incision along 

 the line of Poupart's ligament from the anterior superior iliac spine to the 

 lower end of the median incision ; a transverse incision from the ensiform 

 process to a point as far outwards as the position of the body will allow ; 

 and another transverse incision from the anterior superior iliac spine inwards 

 as far as the median line. The skin having been removed, the arrangement 

 of the superficial fascia over the lower part of the anterior abdominal wall 

 is to be studied. The region referred to extends from the level of Poupart's 

 ligament upwards to the level of a line extending horizontally inwards from 

 the anterior superior iliac spine to the linea alba. 



A dissection of this region will show that the superficial fascia is divisible into 

 a subcutaneous fatty layer, called Camper's fascia, and a deep membranous 

 and elastic layer, known as Scarpa's fascia. This arrangement of the superficial 

 fascia will at once recall to the dissector a similar arrangement of the super- 

 ficial fascia of the anterior division of the perineum, the deep layer being there 

 known as the fascia of CoUes. A good guide to the separation between Camper's 

 fascia and Scarpa's fascia is the superficial epigastric vessels (especially the 

 vein). Camper's fascia being superficial to them and Scarpa's fascia underneath 

 them. The difference in the naked-eye appearance of the two fasciae is 

 usually a sufficient indication of the existence of two layers. Camper's fascia 

 being fatty, and Scarpa's fascia membranous. Along the line of the groin 

 the separation is quite distinct, being here effected not only by the super- 

 ficial epigastric vessels, but also by the inguinal glands (superior or oblique 

 superficial inguinal glands). The dispositions of Camper's fascia and Scarpa's 

 fascia are to be very carefully studied, especially the disposition of Scarpa's 

 fascia, beneath which extravasated urine ultimately comes to lie in cases 

 of rupture of the bulb of the urethra in the perineum. A careful incision is 

 to be made through Camper's fascia transversely inwards from the anterior 

 superior iliac spine. Before dividing it along the linea alba its continuity 

 with the corresponding fascia of the opposite side is to be noted, and, in 

 turning it downwards to the front of the thigh, this should be done in 

 concert with the dissector of the lower limb. A similar transverse incision 

 is next to be made through Scarpa's fascia as deep as the external oblique 

 aponeurosis, and another vertical incision along the linea alba. The fascia 



