244 THE ABDOMEN AND PELVIS 



glands (p. 400). Above the umbilicus, those from the anterior ab- 

 dominal wall join the pectoral glands,, while those from the pos- 

 terior abdominal wall terminate in the subscapular group (p. 35). 



Lymph vessels from the liver descend along the ligamentum 

 teres to the umbilicus, where they establish communications 

 with the lymphatics of the anterior abdominal wall. Cancer of 

 the umbilicus may occur secondarily to cancer of the liver, and 

 the infection may spread to the lymph-glands in the groin. 



Lateral and Anterior Muscles of the Abdominal 

 Wall. The external oblique muscle arises from the lower 

 eight ribs, and its fibres are mainly directed downwards, forwards, 

 and medially. Above, it interdigitates with the serratus anterior 

 (serr. magnus), and the deep fascia which covers both muscles 

 forms a continuous sheet (p. 31). The lowermost (or posterior) 

 fibres run vertically downwards, and are inserted into the 

 anterior half of the iliac crest, so that between the last rib and 

 the crest the external oblique has a free posterior border, which 

 forms the lateral boundary of the lumbar triangle (of Petit). 

 The remaining fibres become aponeurotic near the linea semi- 

 lunaris, and pass in front of the rectus abdominis to reach 

 the xiphoid process, linea alba, pubic symphysis, and crest. 

 No muscular fibres are found below a line joining the anterior 

 superior spine of the ilium to the umbilicus. 



The lower border of the aponeurosis of the external oblique 

 forms the inguinal ligament (of Poupart), which extends from 

 the anterior superior spine to the pubic tubercle (spine). It is 

 bent upwards and backwards on itself so that the upper surface 

 of the ligament is grooved. The lacunar ligament (of Gimbernat) 

 is the medial part of the folded-back margin of the inguinal 

 ligament. It is attached to the pecten pubis (ilio-pectineal line) 

 and possesses a free, crescentic, lateral margin, which is intimately 

 related to the femoral (crural) ring (p. 403). 



Just above the medial end of the inguinal ligament the 

 spermatic cord pierces the aponeurosis of the external oblique, 

 and the opening through which it passes is known as the 

 subcutaneous inguinal (ext. abdom.) ring (pp. 239 and 254). 



The Internal Oblique lies under cover of the preceding 

 muscle. It arises from the lumbo- dorsal fascia (p. 269), 

 through which it gains attachment to the lumbar spines, so that 

 it possesses no free posterior border the iliac crest, and the 

 lateral two -thirds of the inguinal ligament. The general 

 direction of the fibres is upwards, forwards, and medially. 



