182 SURGICAL ANATOMY OF 



The parts divided in an operation for strangulated in- 

 guinal hernia, would be those between the outer ring 

 and the gut, and the sac, if so indicated by the nature 

 of the case, and when reached, the constriction itself; 

 although in actual practice, the condition of these struc- 

 tures is often so altered that this arrangement must be 

 merely regarded as anatomical. 



Structures to be Avoided. The deep epigastric vessels 

 and the cord. 



The position of the deep epigastric artery with regard 

 to the abdominal parietes is pretty much that of the su- 

 perficial epigastric vessels seen beneath the integuments, 

 and its course is indicated by a line drawn from a point 

 a little internal to the centre of Poupart's ligament to 

 about the middle of the space between the umbilicus and 

 pubes. 



SUKGICAL ANATOMY OF THE CKUKAL KEGION. 



In works on Descriptive Anatomy, this region is 

 generally described and dissected as belonging to the 

 lower limb ; but as its surgical relations essentially con- 

 cern those of the contents of the abdomen, and as it has 

 so many points in common with it, besides forming, by 

 its deep aspect, part of the abdominal parietes, it has 

 been thought advisable to introduce it here, and to refer 

 back to it again when describing the superior femoral 

 region. 



The boundaries of this region are, above, the crural 

 arch; externally, a line passing from the anterior iliac 

 spine to the trochanter major ; internally, the prominence 

 of the adductor longus ; and below, a line drawn through 

 the point of meeting of the sartorius and adductors. 



