VESSELS OF THE ANTERIOR ABDOMINAL WALL. 283 



Dissection of the abdominal wall renewed. The dissection of Dissection^ 

 the anterior abdominal wall will now be resumed. By raising the 

 stump of the spermatic cord from over the pubis towards the internal 

 abdominal ring, a fibrous band below Poupart's ligament, the deep 

 crural arch, will appear : it passes inwards to the pubis, and is to 

 be defined with some care. 



The remaining vessels of the abdominal wall, viz., the deep epi- and of the 

 gastric and circumflex iliac, and the ending of the internal mammary the^waii'of 

 artery, are to be next dissected. The epigastric and mammary abdomen, 

 arteries will be found on raising the outer edge of the rectus, one 

 at the upper end, and the other at the lower. 



The epigastric, with its earliest branches, may be traced by 

 removing the transversalis fascia from it near Poupart's ligament. 

 The circumflex iliac artery lies behind the outer half of Poupart's 

 ligament, and should be pursued along the iliac crest to its ending. % 



Deep crural arch (fig. 97, p. 263). Below the level of Poupart's Deep crural 

 ligament is a thin band of transverse fibres over the femoral vessels, arch ' 

 which has received the name deep crural arch from its position and 

 resemblance to the superficial crural arch (Poupart's ligament), attach- 

 This fasciculus of fibres, beginning about the centre of the ligament, ments - 



prolonged inwards to the pubis, where it is widened, and is 

 inserted into the pectineal line at the deep aspect of the conjoined 

 tendon of the broad muscles of the abdomen. It is closely connected 

 with the front of the crural sheath.* 



VESSELS IN THE WALL OF THE ABDOMEN. On the side of the Vessels in 

 abdomen are some of the intercostal and lumbar arteries with the wall, 

 nerves. In the sheath of the rectus lie the deep epigastric and 

 internal mammary vessels. And running along the crest of the ilium 

 is the circumflex iliac branch. 



The INTERCOSTAL ARTERIES of the lowest two Spaces issue Intercostal 



between the corresponding ribs, and enter the abdominal wall 

 between the transversalis and internal oblique muscles : they extend 

 forwards with the nerves, supplying the contiguous muscles, and 

 forming anastomoses with the internal mammary, epigastric and 

 lumbar arteries. 



LUMBAR ARTERIES. The anterior branches of the lumbar arteries Lumbar 

 supply the muscles in the hinder part of the abdominal wall, and 

 anastomose with the foregoing arteries above, with the circumflex 

 iliac and ilio-lumbar arteries below. The highest artery accom- 

 panies the last dorsal nerve below the twelfth rib, and is distributed 

 with the nerve. From the lowest lumbar artery a branch passes to 

 the integuments with the iliac part of the ilio-hypogastric nerve. 



INTERNAL MAMMARY ARTERY. The abdominal branch of this Superior 

 vessel is called the superior epigastric, and enters the wall 



* Sometimes this structure is a firm distinct band, which is joined by some 

 of the lower fibres of the aponeurosis of the external oblique. At other times, 

 and this is the most common arrangement, it is only a thickening of the 

 transversal is fascia, with fibres added from the tendon of the transversalis 

 muscle. 



