THE SURGICAL ANATOMY OF HERNIA. 



usually much larger than the arteries ; they terminate in the internal saphenous 

 vein. 



The superficial inguinal lymphatic glands are placed immediately beneath the 

 integument, are of large size, and vary from eight to ten in number. They are 

 divisible into two groups : an upper, disposed irregularly along Poupart's liga- 

 ment, which receive the lymphatic vessels from the integument of the scrotum, 

 penis, parietes of the abdomen, perineal and gluteal regions, and the mucous 

 membrane of the urethra ; and an inferior group, which surround the saphenous 

 opening in the fascia lata, a few being sometimes continued along the saphenous 



Superficial 

 circumflex 

 iliac vein. 



External abdominal 

 ring. 



FIG. 579. Inguinal hernia. Superficial dissection. 



vein to a variable extent. This latter group receive the superficial lymphatic 

 vessels from the lower extremity. 



The deep layer of the superficial fascia (fascia of Scarpa) is thinner and more 

 membranous in character than the superficial layer. In the middle line it is 

 intimately adherent to the linea alba ; above, it is continuous with the superficial 

 fascia over the rest of the trunk ; below, it blends with the fascia lata of the thigh 

 a little below Poupart's ligament ; below and internally, in the male, it is continued 

 over the penis and over the outer surface of the cord to the scrotum, where it helps 

 to form the dartos. From the scrotum it may be traced backward to be continuous 

 with the base of the triangular ligament of the urethra. In the female it is con- 

 tinuous with the labia majora. 



The scrotum is a cutaneous pouch which contains the testes and part of the 

 spermatic cords, and into which an inguinal hernia frequently descends (see page 

 1014). 



The Aponeurosis of the External Oblique Muscle. This is a thin but strong 



