FEMORAL HERNIA. 89 



together with the muscle called abductor indicis; others, again, 

 enumerate four palmar and four dorsal. The principle of classifi- 

 cation should be with regard to their action. Whether they are 

 abductors or adductors, with reference to an axis passing through 

 the middle finger. If you split the first dorsal interosseous into two 

 muscles, and call that portion arising from the metacarpal bone of 

 the thumb, the abductor indicis; and enumerate the remaining por- 

 tion among the palmar interossei, you can reconcile the various 

 modes of counting these muscles. 



MUSCLES OF THE LOWER EXTREMITY. 



The lower extremity is covered by a dense fascia called fascia 

 lata^ which commences at the crest of the ilium, and extending over 

 the glutei muscles, reaches the foot. In the front of the thigh it is 

 termed iliac and pubic, with reference to its proximity to these bones. 

 At the knee, it forms a general covering, called the involucrum ; in 

 the leg it is termed the crural fascia ; in front of the ankle it con- 

 stitutes the annular ligament, which binds down the extensor ten- 

 dons ; under the sinuosity of the os calcis, it binds down the flexor 

 tendon in the form of the ligamentum laciniatum, or plaited liga- 

 ment ; finally, it terminates in ihe plantar fascia, that firm aponeu- 

 rosis upon the sole of the foot. From it are formed numerous 

 sheaths for muscles. 



ANATOMY OF FEMORAL HERNIA. 



This variety of hernia is a protrusion of intestine at an opening 

 near the passage of the large vessels to and from the thigh. We 

 shall at first describe the parts as they occur upon dissection, and 

 then the descent of the gut. 



Upon the removal of the skin from the upper portion of the thigh 

 the superficial fascia is brought into view. This fascia is a continua- 

 tion of the superficial fascia of the abdomen, and like it is capable 

 of being dissected in laminae. In the groin it contains numerous 

 lymphatic glands. It is traversed by the saphena vein, which en- 

 ters the femoral vein, through the saphenous opening about an inch 

 below Poupart's ligament. 



Having removed this fascia we bring into view X\\q fascia lata of 

 the thigh. This fascia is of a pearly white colour and very dense 

 structure. It consists of two portions, the sartorial and pectineal. 

 The sartorial portion* is upon the iliac side, and is connected at its 

 upper part with Poupart's ligament. It passes in front of the sheath 

 of the vessels and has a crescentic edge on its inner side, called the 

 falciform process. This process limits the saphenous opening on 

 its outer side ; and in order that this edge should be distinctly seen, 

 a layer of superficial fascia with which it is continuous must be care- 

 fully removed ; this portion of superficial fascia which fills up the 

 saphenous opening is often called cribriform fascia. (See Fig. 60.) 



8* 



