FASCIA LATA SAPHENOUS OPENING. ?69 



nat's ligament, where it becomes continuous with the pubic portion. From the 

 spine of the pubes, it is reflected downwards and outwards, forming an arched 

 margin, the outer boundary (superior cornu) of the saphenous opening. This is 

 sometimes called the falciform process of the fascia lata or femoral ligament of 

 Hey ; it overlies, and is adherent to the sheath of the femoral vessels beneath ; 

 to its edge is attached the cribriform fascia, and it is continuous below with th,e 

 pubic portion of the fascia lata by a well-defined curved margin. 



The jJubic portion of the fascia lata is situated at the inner side of the saphe- 

 nous opening; at the lower margin of this aperture, it is continuous with the iliac 

 portion ; traced upwards, it covers the surface of the Pectineus, Adductor longus, 

 and Gracilis muscles; and passing behind the sheath of the femoral vessels, to 

 which it is closely united, is continuous with the sheath of the Psoas and Iliacus 

 muscles, and is finally lost in the fibrous capsule of the hip-joint. This fascia is 

 attached above to the pectineal line, and internally to the margin of the pubic 

 arch. It may be observed from this description, that the iliac portion of the 

 fascia lata passes in front of the femoral vessels, the pubic portion behind them ; 

 an apparent aperture consequently exists between the two, through which the 

 internal saphenous joins the femoral vein. 



The Saphenous Opening is an oval-shaped aperture, measuring about an inch 

 and a half in length, and half an inch in width. It is situated at the upper and 

 inner part of the thigh, below Poupart's ligament, on the pubic side of its centre, 

 and is directed obliquely downwards and outwards. 



Its outer margin is of a semilunar form, thin, strong, sharply defined, and lies 

 on a plane considerably anterior to the inner margin. If this edge is traced 

 upwards, it will be seen to form a curved elongated process or cornu, the superior 

 cornu or falciform process of Burns, which ascends in front of the femoral vessels, 

 and curving inwards is attached to Poupart's ligament and to the spine of the 

 pubis and pectineal line, where it is continuous with the pubic portion. If traced 

 downwards, it is found continuous with another curved margin, the concavity of 

 which is directed upwards and inwards ; this is the inferior cornu of the saphenous 

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

 Pectineus muscle. 



The inner doundary of the opening is on a plane posterior to the outer margin, 

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

 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 outwards, and to be relaxed on flexing the limb 

 and inverting it : hence the necessity of 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, together with its falciform process, should now be removed, 

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

 subjacent structures, and turning it aside, when the sheath of the femoral vessels is exposed 

 descending beneath Poupart's ligament (fig. 385). 



The Crural Arch or Pouparfs Ligament is the lower border of the aponeurosis 

 of the External oblique muscle, which stretches across between the anterior supe- 

 rior spine of the ilium to the spine of the os pubis and pectineal line ; the portion 

 corresponding to the latter insertion is called Gimbernafs ligament. Its direction 

 is curved downwards towards the thigh ; its outer half being oblique, its inner half 

 nearly horizontal. Nearly the whole of the space included between the crural 

 arch and innominate bone is filled in by the parts which descend from the abdo- 

 men into the thigh. The outer half of this space is occupied by the Iliacus and 

 Psoas muscles, together with the external cutaneous and anterior crural nerves. 

 The pubic side of the space is occupied by the femoral vessels included in their 

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