ABDOMEN AND PELVIS 451 



ANTERIOR ABDOMINAL WALL. 



Inflate the abdominal cavity (cavum abdominis) by means of 

 an aspirating needle and bicycle pump, and make the following 

 incisions through the skin only (vide Fig. 7) : 



(1) Along the anterior median line from the level of the tip of the 



xiphoid process to the mons pubis; carry the knife around the 

 umbilicus, leaving it intact. 



(2) From the upper limit of the first, transversely around the body, as 



far back as possible. 



(3) From the lower limit of the first to the tuberculum pubicum, thence 



over the ligamentum inguinale to the spina iliaca anterior superior 

 and along the iliac crest as far back as possible. 



Reflect the flaps so formed, taking no fat with the skin, but 

 leaving intact the layer beneath (fascia superficialis) and the 

 vessels and nerves which ramify in it. 



Superficial Fascia (Fascia superficialis). 



Observe the distribution of fat, especially in the hypogastric 

 region; the dense white band of tissue (linea alba) in the ante- 

 rior median line; the arrangement of the superficial fascia in 

 two layers, especially in the hypogastric region; superficially 

 the fascia of Camper, and more deeply the fascia of Scarpa. 

 Dissect out the structures in the superficial fascia, preserving 

 them carefully : 



Arteries. (Vide Fig. 9.) 



(a) Superficial circumflex artery of ilium (A. circumflexa ilium super- 



ficialis) (O. T. superficial circumflex iliac artery). 



(b) Superficial epigastric artery (A. epigastrica superficialis). 



(c) External pudendal arteries (Aa. pudendae externae) (0. T. exter- 



nal pudic arteries). 

 Veins. 



(a) Parumbilical vein (V. parumbilicalis) . 



(b) Thoraco-epigastric vein (V. thoraco-epigastrica) . 



(c) Superficial epigastric vein (V. epigastrica superficialis). 



(d) External pudendal veins (Vv. pudendae externae). 



(e) Superficial circumflex vein of ilium (V. circumflexa ilium super- 



ficialis ) . 

 Nerves. 1 (Vide Fig. 8.) 



(a) Anterior cutaneous rami of intercostal nerves (rami cutanei ante- 

 rior es). 



1 Regarding the variations in the nerves of the abdominal wall, see the 

 paper by Professor Bardeen in the American Journal of Anatomy, vol. i., No. 2, 

 p. 203. 



