SURGICAL ANATOMY. 383 



Posterior wall iliac fascia and pubic portion of the fascia 

 lata; 



External wall fibrous septum of the femoral vein; 



Internal wall Gimbernat's ligament, deep crural arch, and 

 the junction of the iliac and transversalis fascia. 



The septum crurale is a layer of dense areolar tissue, sup- 

 porting small lymphatic glands and closing in the femoral ring. 

 It is perforated by numerous lymphatic vessels, and forms a bar- 

 rier to the escape of hernia at this point. 



The crural or femoral sheath is a prolongation downward of 

 the fascia lining the abdomen (transversalis fascia in front, iliac 

 fascia behind the vessels), closely adhering to the femoral vessels 

 to about an inch below the saphenous opening. Its upper part 

 is funnel-shaped and its lower part continuous with the sheath 

 of the vessel. It is divided by septa into three compartments; 

 in the outer is lodged the femoral artery; the middle is occu- 

 pied by the femoral vein ; and the innermost, the femoral canal, 

 is empty, or occupied by a lymphatic gland. Its outer border is 

 pierced by the genito-crural nerve, its inner by the internal 

 saphenous vein. 



The deep femoral arch is a fibrous thickening of the trans- 

 versalis fascia which forms the anterior wall of the femoral 

 sheath. 



The saphenous opening is an oval aperture of half an inch 

 in width, an inch and a half in length in the upper and inner 

 part of the fascia lata, between its two divisions, the iliac and 

 pubic portions. It is bounded externally by the falsiform 

 process of Burns, internally by the pubic portion of the fascia 

 lata, which curves upward behind the saphenous vein. The open- 

 ing is covered externally by the cribriform fascia and the skin. 



The coverings of femoral hernia are : 



1. Skin; 



2. Superficial fascia; 



3. Cribriform fascia; 



4. Femoral sheath, or fascia propria; 



5. Septum crurale; 

 G. Peritoneal sac. 



ISCHIO-RECTAL REGION AND PERINEUM. 



The outlet of the pelvis is a lozenge-shaped space divided 

 by an imaginary line drawn in front of the anus, transversally 

 between the front part of the tuber ischii, into two parts, the 

 ischio-rectal region behind and the perineum in front. 



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