1196 



THE SURGICAL ANATOMY OF HERNIA. 



whole of the space included between the crural arch and innominate bone is filled 

 in by the parts which descend from the abdomen into the thigh. The outer half 

 of the space is occupied by the Iliacus and Psoas muscles, together with the 

 external cutaneous and anterior crural nerves. The pubic half of the space is 

 occupied by the femoral vessels included in their sheath, a small oval-shaped 

 interval existing between the femoral vein and the inner wall of the sheath, 

 which is occupied merely by a little loose areolar tissue, a few lymphatic vessels, 



Crural 



Poupart s ligament. i mnc h Anterior crural, 

 of genito- 

 cniral. 



External 

 cutaneous nerve. 



Iliac portion of 

 fascia lata. 



Femoral vein. 

 Femoral ring. 



Gimbernat' s 

 ligament. 



Femoral artery. 

 FIG. 765. Structures which pass beneath the crural arch. 



and occasionally by a small lymphatic gland : this is the crural ring, through 

 which the gut descends in femoral hernia. 



Gimbernat's Ligament (Fig. 766) is that part of the aponeurosis of the External 

 oblique muscle which is reflected downward and outward from the spine of the 

 os pubis, to be inserted into the pectineal line. It is about half an inch in length, 

 larger in the male than in the female, almost horizontal in direction in the erect 

 posture, and of a triangular form, with the base directed outward. Its base., or 

 outer margin, is concave, thin, and sharp, and lies in contact with the crural sheath. 

 Its apex corresponds to the spine of the os pubis. Its posterior margin is attached 

 to the pectineal line, and is continuous with the pubic portion of the fascia lata. 

 Its anterior margin is continuous with Poupart's ligament. 



Crural Sheath. The femoral or crural sheath is a continuation downward of 

 the fasciae that line the abdomen, the transversalis fascia passing down in front of 

 the femoral vessels, and the iliac fascia descending behind them ; these fasciae 

 are directly continuous on the iliac side of the femoral artery, but a small space 

 exists between the femoral vein and the point where they are continuous on the 

 pubic side of that vessel, which constitutes the femoral or crural canal. The 



