THE INGUINAL REGION. 175 



strangulated hernia, when, owing to this laxity, by 

 pinching up a fold of integument and transfixing it, he 

 obtains a linear incision, which does not include either 

 sac or gut. It is, moreover, of great value for the in- 

 troduction of the needles in Wood's operation for the 

 radical cure. Between these layers of fascia are the lym- 

 phatics, transmitting the ducts from the external genitals, 

 the termination of ilio-hypogastric and ilio-inguinal 

 nerves, and three superficial branches of the common 

 femoral artery viz., the superficial epigastric, superfi- 

 cial circumflex iliac, and superficial external pudic, with 

 their accompanying veins. In plastic operations for the 

 relief of extroversion of the bladder, the superficial epigas- 

 tric should be carefully preserved to nourish the flaps. 

 Beneath the deep layer of the superficial fascia is the apo- 

 neurosis of the external oblique ; its lower portion, by its 

 union with the fascia lata and deep fascia, forms the crural 

 arch, which extends from the anterior superior spine of the 

 ilium to the spine of the pubes, having also an attachment 

 to the ilio-pectineal line (Gimbernat's ligament). The at- 

 tachment to the ilio-pectineal line is strengthened by a 

 triangular band of fibres passing upwards and inwards 

 towards the linea alba, behind the inner pillar of the exter- 

 nal ring. It will be noticed that extension and abduction 

 of the leg renders the crural arch tense, so that in the ex- 

 amination of the parts or in the application of the taxis, 

 the external abdominal ring must be relaxed by flexion 

 and abduction. The two pillars of the external ring are 

 bound together by a set of aponeurotic fibres, which in- 

 terlace, more or less, over the whole of the inner part of 

 this region, constituting the intercolumnar bands, from 

 which a fascia is derived, forming a covering to the 

 emerging cord the intercolumnar or external spermatic 



