FEMORAL HERNIA. 



1057 



upward, it will be seen to form a curved elongated process, the falciform process 

 or superior coma, which ascends in front of the femoral vessels, and, curving 

 inward, is attached to Poupart's ligament and to the spine of the os pubis and 

 pectineal line, where it is continuous with the pubic portion. If traced down- 

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

 is directed upward and inward : this is the inferior cornu of the saphenoua 

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

 Pectineus muscle. 



The inner boundary 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 defined 

 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 outward, and to be relaxed on flexing the limb 



Fro. 587. Femoral hernia. Iliac portion of fascia lata removed, and sheath of femoral vessels and femoral 

 canal exposed. 



and inverting it : hence the necessity for 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, but not its falciform process, should now be removed by 

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

 jacent structures, and turning it inward, when the sheath of the femoral vessels is exposed, 

 descending beneath Poupart's ligament (Fig. 587). 



Poupart's Ligament, or the Crural Arch, is the lower border of the aponeurosis 

 of the External oblique muscle, which extends from the anterior superior spine of 



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