FEMORAL HERNIA. 



1195 



opening, and is blended with the pubic portion of the fascia lata covering the 

 Pectineus muscle. 



The inner ln\rn<l<inj "f tlie opening is on a plane posterior to the outer margin 

 and behind the level of the femoral vessels ; it is much less prominent and defined 

 than the outer, from being stretched over the subjacent Pectineus muscle. It is 

 through the saphenous opening that a femoral hernia passes after descending along 

 the crural canal. 



If the finger is introduced into the saphenous opening while the limb is moved 

 in different directions, the aperture will be found to be greatly constricted on 

 extending the limb or rotating it outward, and to be relaxed on flexing the limb 



FIG. 7&1. Femoral hernia. Iliac portion of fascia lata removed, and sheath of femoral. Vessels and femoral 

 canal exposed. 



and inverting it : hence the necessity for placing the limb in the latter position in 

 employing the taxis for the reduction of a femoral hernia. 



The iliac portion of the fascia lata. but not its falciform process, should now be removed by 

 detaching it from the lower margin of Poupart's ligament, carefully dissecting it from the sub- 

 jacent structures, and turning it inward, when the sheath of the femoral vessels is exposed, 

 descending beneath Poupart's ligament (Fig. 764). 



Poupart's Ligament, or the Crural Arch, is the lower border of the aponeurosis 

 of the External oblique muscle, which extends from the anterior superior spine of 

 the ilium to the spine of the os pubis. From this latter point it is reflected outward, 

 to be attached to the pectineal line for about half an inch, forming Gimbernat's 

 ligament. Its general direction is curved downward toward the thigh, where it 

 is continuous with the fascia lata. Its outer half is rounded and oblique in 

 direction. Its inner half gradually widens at its attachment to the os pubis, is 

 more horizontal in direction, and lies beneath the spermatic cord. Nearly the 



