THE TRUNK. 449 



(the decussating fibres), being carefully divided. Examine next the free 

 muscular edge of the internal oblique and transversalis muscles, and their con- 

 joined tendons, as well as the fibres of the cremaster muscle in the male. From 

 the junction of the outer with the middle third of Poupart's ligament carry 

 an incision vertically upwards, parallel with the linea alba, dividing and re- 

 flecting inwards in succession, and outwards, the muscular fibres of internal 

 oblique and transversalis muscles. The muscular fibres must be detached 

 from the outer third of Poupart's ligament. From the commencement of the 

 vertical incision the fibres may be separated in the direction of their fasciculi, 

 namely, towards linea semilunaris. The fascia transversalis will now be 

 exposed, the spermatic cord (or round ligament) resting upon it s pubic portion, 

 and lost in the internal abdominal ring, the external or iliac portion attached 

 to Poupart's ligament. The fascia spermatica interna is to be examined, 

 and then removed, to display more clearly the margins of the ring. Next 

 push upwards and backwards the peritoneum, and observe the course of the 

 spermatic vessels, the vas deferens, and the relations of the external iliac and 

 internal epigastric arteries. The/asa'a iliaca and its attachments may like- 

 wise be studied. 



Below Poupart's ligament. 1. Make an incision from the anterior and 

 superior spinous process of the ilium to the centre of the thigh, the direction 

 being inwards ; in fact, parallel with the course of the fibres of the Sartorius 

 muscle. 



2. An incision from the spine of the pubes, downwards, to the termination 

 of the last. Reflect the skin, only, upwards. Fat and fibre-cellular tissue 

 forming more or less a superficial fascia, which encloses small arteries and 

 veins, lymphatics, and their glands above, and the saphena vein below, may 

 be reflected upwards. The fascia lata will be exposed, and immediately 

 below the point at which the saphena vein is lost to view, by entering the 

 sheath of the femoral vessels, it divides into an internal pubic and an external 

 iliac portion. The handle of the scalpel may be passed under the falciform 

 process of the latter, and upon raising it, the sheath of the femoral vessels is 

 seen. The lymphatic vessels may be seen passing under Poupart's, and close 

 to the outer border of Gimbernat's ligament, on the inside of the femoral 

 vein, to the outer side of which is the femoral artery, each enclosed in sepa- 

 rate fascial canals, the most internal being called the crural ring. To demon- 

 strate this, make a small longitudinal incision through the anterior surface of 

 the sheath, parallel to and over the centre of each vessel; then, with the 

 handle of the scalpel passed along the sides of vessels, raise them from their 

 fibrous canals. A considerable quantity of adipose tissue will be found sur- 

 rounding the lymphatics below and at their entrance into the crural ring. 

 Dividing carefully across, or detaching the posterior surface of Poupart's liga- 

 ment from the anterior of the sheath of the femoral vessels (septum crurale), 

 the connexion bet ween this sheath and the pubic portion of fascia transversalis 

 will be displayed. TRANS.] 



29 



