INGUINAL HERNIA SUPERFICIAL DISSECTION. 823 



perforates the aponeurosis of the external oblique, above and to the outer side 

 of the external ring. 



The deep layer of superficial fascia should be divided across in the same 

 direction as the external incisions, separated from the aponeurosis of the Ex- 

 ternal Oblique, to which it is connected by delicate areolar tissue, and reflected 

 downwards and outwards. It is thin, aponeurotio in structure, and of consider- 

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

 and below, to the whole length of Poupart's ligament and the 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 may be 

 traced into the perineum, where they are continuous with the deep layer of the 

 superficial fascia in that region, which is attached, behind, to the triangular 

 ligament, and on each side, to the ramus of the pubes and ischium. The con- 

 nections of this fascia serve to explain the course taken by the urine in extra- 

 vasation of that fluid from rupture of the urethra ; passing forwards from the 

 perineum into the scrotum, it ascends on to the abdomen, but is prevented ex- 

 tending 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, and is pre- 

 vented from passing on to the buttock by the posterior connections of the 

 periueal fascia. 



Fig. 446. 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 



