1056 



THE SURGICAL ANATOMY OF HERNIA. 



saphenous opening. It is attached externally to the crest of the ilium and its 

 anterior superior spine ; to the whole length of Poupart's ligament ; and to the 

 pectineal line in conjunction with Gimbernat's ligament. From the spine of the 

 os pubis it is reflected downward and outward, forming an arched margin, the outer 

 boundary or falciform process or superior cornu of the saphenous opening. This 

 margin overlies and is adherent to the anterior layer of the sheath of the femoral 

 vessels ; to its edge is attached the cribriform fascia, and below it is continuous 

 with the pubic portion of the fascia lata. 



The pubic portion of the fascia lata is situated at the inner side of the saphenous 

 opening : at the lower margin of this aperture it is continuous with the iliac 

 portion : traced upward, 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 attached above to the ilio-pectineal line, where it becomes 

 continuous with the fascia covering the Iliacus muscle. From this description it 

 may be observed that the iliac portion of the fascia lata passes in front of the 

 femoral vessels and the pubic portion behind them, so that an apparent aperture 



FIG. 586. Femoral hernia, showing fascia lata and saphenous opening. 



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 front of the thigh, below Poupart's ligament, and is directed 

 obliquely downward and outward. 



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 



