244 



THE INFERIOR EXTREMITY 



occurrence in cases of femoral hernia. The sharp tense base of the lacunar 

 ligament and the superior cornu of the margin of the fossa ovalis are 

 especially apt to bring about that condition. 



Abnormal Obturator Artery. The account of the surgical anatomy 

 of femoral hernia cannot be complete without mention of the relation 

 which the obturator artery frequently bears to the femoral ring. In 

 two out of every five subjects the obturator artery, on one or on both sides, 

 takes origin from the inferior epigastric artery. In those cases it passes 

 posterior to the pubic bone to gain the obturator sulcus in the upper part 



Profuncla femoris artery 



Lateral circumflex 

 artery 



Intermediate cuta- 

 neous nerve (O.T. 

 middle cutaneous) 



Lateral cutaneous nerve 



Inguinal ligament 



Superficial circumflex iliac artery 

 ,*' Femoral nerve 



| Superficial epigastric and 

 superficial pudendal arteries 



Deep external 

 pudendal artery 



Adductor brevis 

 Femoral vein 



aphenous 



Femoral artery 



FIG. 112 Dissection of the Femoral Triangle of the right side 



of the obturator foramen, and according to the point at which it arises 

 from the epigastric trunk, it presents different relations to the femoral 

 ring. In the majority ot cases it lies in close contact with the external iliac 

 vein and on the lateral side of the femoral ring. In that position it is in 

 no danger of being wounded in operations undertaken for the relief of a 

 strictured femoral hernia. In about thirty-seven per cent. , however, of the 

 cases in which it exists, the artery is placed less favourably. In those it 

 either passes medially, across the septum femorale which closes the 

 opening into the femoral canal, or it arches over it and turns posteriorly, 

 on the medial side of the ring, upon the deep aspect of the base of the 

 lacunar ligament. In the latter situation it is in a position of great danger, 



