ANATOMY OF FEMORAL HERNIA. 143 



inwards. This edge is named from its shape the falciform margin of 



the saphenous opening (falciform process of Burns) ; it is superficial 



to the femoral vessels, and is connected by fibrous bands to the 



crural sheath, and to the cribriform fascia. Traced upwards, the which joins 



outer edge blends with the base of Gimbernat's ligament (part of {^"memf * 



Poupart's ligament) : and the upper end of this border, where it is and fornis 



internal to the subjacent femoral vein, has been named the femoral femoral 



ligament ; 

 ligament. 



The rigidity of the margin of the opening is much influenced by tenseness ot 

 tlie position of the liml > : for with the finger beneath the upper part varies? 1 ^ 

 of the falciform border, while the thigh is moved in different 

 directions, this band will be perceived to be most unyielding when 

 the limb is extended and rotated outwards, and most relaxed when 

 the thigh is bent and turned in the opposite direction. 



Through the lower cornu of the opening the saphenous vein is Parts 

 transmitted ; and through the upper part, close to the falciform 

 edge, a femoral hernia projects. Lymphatics and one or two super- opening, 

 ficial arteries also pass through it. 



PARTS CONCERNED IN FEMORAL HERNIA. 



To understand the anatomy of a heniial protrusion in the thigh, Anatomy 

 the dissector has to study the undermentioned parts, viz., the crural hern" 

 arch and Gimbernat's ligament, the crural sheath with its crural 

 canal and ring, together with a partition (septum crurale) between 

 the thigh and the abdomen. 



Dissection (fig. 56). To examine Poupart's ligament and the Dissection 

 membranous sheath round the femoral vessels, the piece of the 

 fascia lata outside the saphenous opening is to be reflected inwards 

 by the following incisions : One cut is to be begun near the upper 

 end of the falciform border, and to be carried outwards for one inch 

 and a half, parallel with and close to Poupart's ligament. Another 

 is to be directed obliquely downwards and inwards from the termina- 

 tion of the first, to a little below the inferior cornu of the opening. 

 When the triangular piece of fascia marked out by those incisions 

 has been raised and turned inwards, and the fat removed, the tube 

 on the vessels (crural sheath) will be brought into view as it 

 descends beneath Poupart's ligament. 



With the handle of the scalpel the craral sheath is to be separated 

 carefully from Poupart's ligament in front, and from Gimbernat's 

 ligament oil the inner side. 



Poupart's ligament or the crural arch (fig. 56, c) is the firm band Crural arch: 

 of the aponeurosis of the external oblique muscle of the abdomen, attach- 

 which stretches from the front of the iliac crest to the pubis. 

 When viewed on the surface the arch is curved downwards towards 

 the liinb, so long as the fascia lata remains on the thigh. The 

 outer half is oblique. But the inner half is almost horizontal, 

 and widens as it approaches the pubis, where it is inserted into 

 the pubic spine and pectineal line of the hip-bone, forming Gim- 

 bernat's ligament (fig. 97, p. 263). 



