FEMORAL HERNIA. 455 



FEMORAL HERNIA. 



Femoral hernia is the protrusion of some of the ab- 

 dominal viscera through the femoral ring. The super- 

 ficial fascia over Scarpa's triangle consists of two layers : 

 the superficial layer is thick and loaded with fat; be- 

 neath it are some of the superficial arteries, veins, nerves, 

 and lymphatics. The long saphenous vein is the most 

 important structure ; it passes through the saphenous 

 opening of the fascia lata, and opens into the femoral 

 vein. That portion of the deep layer of the superficial 

 fascia, attached to the margins of the saphenous opening, 

 is called the cribriform fascia ; it is perforated for the 

 passage of numerous veins and small arteries. Clustered 

 about the long saphenous vein are a number of lymphatic 

 glands arranged in a double chain ; the upper set com- 

 municate with the lymphatics of the external genitalia, 

 the lower with the lymphatics of the thigh and leg. The 

 deep fascia, or fascia lata, is aponeurotic, and presents 

 at the upper part of Scarpa's triangle the saphenous 

 opening ; to its margins the cribriform fascia is attached 

 and must be removed before the aperture can be plainly 

 seen. It is oval in outline, about one inch in its longest 

 diameter, and presents a well-marked, sharply-defined, 

 outer border, known as the falciform process or Key's 

 ligament. It passes over the femoral vessels, and is at- 

 tached to Poupart's ligament and continued through 

 Gimbernat's ligament to the pubes. Inferiorly it forms 

 a sharply-defined loop ; the inner border is less defined 

 than the outer; it passes beneath the femoral vessels 

 and becomes continuous with the femoral sheath. The 

 sheath for the femoral vessels is formed in front by a 

 continuation of the transverse fascia beneath Poupart's 

 ligament ; the iliac fascia completes it behind. The 

 femoral vein and artery enter the sheath and pass down 



