FEMOBAL HEENIA. 395 



fascia. The canal itself contains the lymphatic vessels passing 

 from the superficial femoral lymphatic glands to the deep external 

 iliac lymphatic nodes, and sometimes a lymphatic gland itself 

 is actually placed in the canal. The boundaries of the canal 

 are, anteriorly, the fascia transversalis, posteriorly, the fascia 

 iliaca, externally, the septum separating the space from that for 

 the vein, and, internally, the meeting of the fascia transversalis 

 with the fascia iliaca. 



Superficial to the femoral canal, and in a sense forming its 

 lower aperture or exit, is found the so-called saphenous opening 

 a term which is wholly a misnomer, for there is no true 

 opening, and it is not, therefore, an obvious one. The pseudo- 

 opening lies at the upper and inner part of the thigh, a couple 

 of fingers' breadth below and external to the spine of the 

 os pubis. It is formed between two layers of the fascia lata 

 of the thigh, known as the iliac, or anterior, and the pubic, 

 or posterior, portions. It gives passage to the internal saphenous 

 vein. The upper edge of the opening has its upper extremity 

 attached to the anterior aspect of Gimbernat's ligament and the 

 lower border of Poupart's ligament, and is fairly defined and 

 somewhat sharp. 



Again, as in the case of an inguinal hernia, the actual 

 coverings of a femoral hernia are not of much moment. They 

 may be mentioned here as the skin, superficial fascia, cribriform 

 fascia (probably the deeper layer of the superficial fascia), fascia 

 transversalis, extraperitoneal tissue, followed by the sac itself. 



Whilst the sac of a femoral protrusion is traversing the 

 femoral canal, it necessarily takes a vertical direction, and lies 

 to the inner side of the femoral vein, and its neck is external 

 to the spine of the os pubis. In the male, the spermatic cord is 

 above, that is on a higher level than the femoral ring, the deep 

 epigastric artery is on the outer side and above. The pubic 

 branch of this vessel passes downwards and backwards on the 

 outer side of the femoral ring to anastomose on the upper 

 surface of Gimbernat's ligament with a similar branch derived 

 from the obturator artery. In about two cases out of every 



