456 PRACTICAL ANATOMY. 



the thigh. To the inner side of the vein there exists an 

 interval called the femoral ring, but filled with cellular 

 tissue. Of all the parts below the femoral arch (formed 

 by Poupart's ligament) this space is the point of least 

 resistance ; hence, in femoral hernia the protrusion en- 

 gages almost uniformly at this point at the inner side of 

 the vein. The coverings for femoral hernia, it will be 

 seen, are, from within outward, the peritoneal sac, the 

 cellular tissue (septum crurale) to the inner side of the 

 vein, the sheath of the vessels, the cribriform fascia, 

 superficial fascia, and skin. 



INGUINAL HERNIA. 



Inguinal hernia may be indirect or direct. The skin 

 at the lower part of the abdomen is thin and loosely 

 attached to the subcutaneous tissues, in which ramify the 

 superficial arteries, veins, and lymphatics. The deep 

 fascia is very thin, and is adherent to the linea alba. 

 Beneath the deep fascia is the aponeurotic tendon of the 

 external oblique muscle ; its lower border is much thick- 

 ened and cord-like ; it is attached to the anterior superior 

 spine of the ilium and the spine of the pubes, and is 

 called Poupart's ligament. The direction of the fibres 

 of the tendon of the external oblique is downward and 

 inward, and that portion inserted upon the pubes is split, 

 forming a long triangular separation of the fibres of the 

 tendon, called the external inguinal ring. The base of 

 this opening is at the pubes ; the inner edge is called 

 the inner column; the outer is called the outer column. 

 Between the two columns the deep fascia is slightly 

 thickened and attached to the margins of the ring, form- 

 ing the intercolumnar fascia. When this is removed, 

 the finger can be placed directly against the conjoined 



