INGUINAL HEENIA. ANATOMY OF THE GROIN. 1019 



with Poupart's ligament and the upper end of the fascia lata ; and, after 

 descending over the spermatic cord into the scrotum, it becomes continuous 

 with the membrane of the same kind which covers the perinseum. Its 

 thickness varies much in different persons, on account of the different quan- 

 tity of fat contained within its meshes ; but in the scrotum the fascia is 

 devoid of fat ; as it also is elsewhere towards the internal surface, where 

 its density is at the same time augmented. From the varying thickness of 

 this structure on the abdomen and the scrotum, as well as in different 

 persons, it will be inferred that the depth of incision required to divide it 

 in an operation must vary considerably. 



The superficial vessels of the groin are encased by the fascia, and are held 

 to separate it into two layers. The vessels which ramify over the inguinal 

 canal and the scrotum are the external pudic and epigastric arteries and 

 veins (p. 437 and 475). The veins, especially the epigastric, are consider- 

 ably larger than the arteries they accompany. Some of these vessels are 

 wounded in operations performed for the relief of strangulated hernia ; but 

 the bleeding from them is small in quantity and rarely requires the applica- 

 tion of a ligature or other means to arrest it. The lymphatic glands of the 

 groin (p. 489) admit of being arranged in two sets one being placed over 

 Poupart's ligament and parallel with that structure ; while the other series 

 is upon the upper part of the thigh at its middle, about the saphenous 

 opening in the fascia lata. 



When the superficial fascia is removed, the aponeurosis of the external 

 oblique muscle (p. 249) is in view, together with, in the male body, the 

 spermatic cord, in the female body the round ligament of the uterus, which 

 emerge from an opening close to the outer side of the pubic spine. The 

 lowest fibres of the aponeurosis, as they approach the pubes, become sepa- 

 rated into two bundles which leave an interval between them for the passage 

 of the cord or round ligament. One of the bands, the upper one and the 

 smaller of the two, is fixed in front of the symphysis of the pubes ; and the 

 lower band, which forms the lower margin of the apoueurosis, being stretched 

 between the anterior superior iliac spine and the pubes, is named Poupart's 

 ligament, or the femoral arch. This latter tendinous band has considerable 

 breadth. It is fixed at the inner end to the spine of the pubes, and, for 

 some space outside that process of the bone, to the pectin eal ridge. In 

 conseqiience of the position of the pectiueal ridge at the back part of the 

 bone, the ligament is tucked backwards ; and its upper surface affords space 

 for the attachment of the other broad muscles, at the same time that it 

 supports the spermatic cord. Poupart's ligament does not He in a straight 

 line between its two fixed points ; it curves downwards, and with the curved 

 border the fascia lata is connected. It is owing to the last-mentioned fact 

 that the so-named ligament, together with the rest of the aponeurosis of the 

 external oblique, is influenced by the position of the thigh, being relaxed 

 when the limb is bent, and the converse. Moreover, the change of the 

 position of the limb exercises a corresponding influence on the state of the 

 other structures connected with Poupart's ligament. 



The interval left by the separation of the fibres of the aponeurosis above 

 referred to, is named the external abdominal ring) and the two bands by 

 which it is bounded are known as its pillars or columns. The space is 

 triangular in shape, its base being the crest of the pubes, while the apex is 

 at the point of separation of the two columns. The size of the ring varies 

 considerably in different bodies ; in one case its sides will be found closely 

 applied to the spermatic cord ; while, in another, on the contrary, the space 



