THE INGUINAL REGION. . 173 



SUEGICAL ANATOMY OF THE INGUINAL KEGION. 



Surface Markings. This region may be indicated by 

 a line drawn from the anterior superior spine of the 

 ilium to the mesial line of the body superiorly, the 

 mesial line itself, internally, and Poupart's ligament, 

 below. Between the bony prominences, the anterior 

 superior spine externally, and the crest of the pubes in- 

 ternally, is a curved furrow, with its convexity down- 

 wards, indicating the fold of the groin, and the position 

 of Poupart's ligament. Just above the pubes can be 

 felt the external abdominal ring, and the structures 

 forming the cord are readily recognizable. 



Before commencing the dissection, the finger should 

 be passed up into the external ring without using any 

 force, by tucking up the scrotal tissue upwards along 

 the cord, in order to ascertain under what conditions of 

 the position of the leg the examination of the canal 

 could be most readily made, and the exact relations of 

 the structures composing it felt. 



Dissection. In order to arrive at a correct idea of 

 the parts concerned in inguinal hernia, it is advisable 

 to endeavor to obtain a simultaneous view of both sur- 

 faces of the abdominal parietes in this region, and for 

 this purpose a flap containing the entire thickness of 

 the walls should be made (including the umbilicus), so 

 that in prosecuting the dissection the actual relation 

 of the structures both at the commencement and termi- 

 nation of the course taken by a hernia may be examined 

 with facility. 



On reflecting the skin, the superficial fascia is readily 

 divisible into two layers, between which lie the cutane- 

 ous vessels and lymphatics, the deep layer being closely 



15 



