INGUINAL HERNIA SUPERFICIAL DISSECTION. 759 



direction as the external incisions, separated from the aponeurosis of the External 

 oblique, to which it is connected by delicate areolar tissue, and reflected down- 

 wards and outwards. It is thin, aponeurotic in structure, and of considerable 

 strength. It is intimately adherent, in the middle line, to the linea alba, and, 

 below, to the whole length of Poupart's ligament and upper part of the fascia 

 lata. It forms a thin tubular prolongation round the outer surface of the cord, 

 which blends with the superficial layer, and is continuous with the dartos of the 

 scrotum. From the back of the scrotum, the conjoined layers maybe traced into 

 the perineum, where they are continuous with the deep layer of the superficial 

 fascia in this region, which is attached, behind, to the triangular ligament, and, on 

 each side, to the ramus of the pubes and ischium. The connections of this fascia 

 serve to explain the course taken by the urine in extravasation of this fluid from 

 rupture of the urethra ; passing forwards from the perineum into the scrotum, 

 it ascends on to the abdomen, but is prevented extending into the thighs by the 

 attachment of the fascia to the ramus of the pubes and ischium, on each side, and 

 to Poupart's ligament in front. 



Fig. 380. Inguinal Hernia. Superficial Dissection. 



The aponeurosis of the External oblique muscle is exposed on the removal of this 

 fascia. It is a thin, strong, membranous aponeurosis, the fibres of which are 

 directed obliquely downwards and inwards. It is attached to the anterior superior 

 spinous process of the ilium, the spine of the pubes, the pectineal line, front of the 

 pubes, and linea alba. That portion of the aponeurosis which extends from the 



