834 SURGICAL ANATOMY OF FEMORAL HERNIA. 



superior spine of the ilium, to the spine of the os pubis and pectineal line : the 

 portion corresponding to the latter insertion is called GimbernaCs ligament. 

 The direction of Poupart's ligament is curved downwards towards the thigh; 

 its outer half being oblique, its inner half nearly horizontal. Nearly the whole 



Fig. 451. Femoral Hernia. Iliac Portion of Fascia Lata removed, and Sheath of Femoral 

 Vessels and Femoral Canal exposed. 



of the space included between the crural arch and innominate bone is filled by 

 the parts which descend from the abdomen into the thigh. The outer half of 

 the 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 sheath, a small oval-shaped 

 interval existing between the femoral vein and the inner wall of the sheath, 

 which is occupied merely by a little loose areolar tissue, and occasionally by a 

 small lymphatic gland; this is the -crural canal, along which the gut descends 

 in femoral hernia. 



Oimbernafs Ligament'(Fig. 452) is that part of the aponeurosis of the Ex- 

 ternal Oblique muscle which is reflected downwards and outwards, to be inserted 

 into the pectineal line of the os pubis. It is about an inch in length, larger in 

 the male than in the female, almost horizontal in direction in the erect posture, 

 and of a triangular form, the base directed outwards. Itsbase, or outer margin, 

 is concave, thin and sharp, lies in contact with the crural sheath, and is blended 

 with the pubic portion of the fascia lata. Its apex corresponds to the spine of 

 the pubes. Its posterior margin is attached to the pectineal line. Its anterior 

 margin is continuous with Poupart's ligament. 



Crnral Sheath. If Poupart's ligament is divided, the femoral or crural sheath 

 may be demonstrated as a continuation downwards of the fasciae that line the 



