THE ABDOMINAL RINGS 



11 15 



The ring, and especially its outer pillar, can easily be felt by invaginatin<r the 

 scrotal skin with a linger, and pusliing upwards and outwards. In a female 

 patient, if the thigh be abducted, the tense tendon of the adductor longus will 

 lead up to the site of the ring. The internal ring is situated about half an inch 

 above the centre of Poupart's ligament; oval in shape, and nearly vertical in 

 direction, it has the arching fibres of the transversalis abovy it, and to its inner 

 side the deep epigastric artery. The canal runs obli(piely downwards and for- 

 wards between the two rings. In the adult it is aixuit an inch and a half long, but 

 in early life, and in adults with a large hernia dragging upon the i>arts, the two 

 rings are much nearer, and may be one behind the other. If the external ring lie 

 exposed, and the finger thrust carefully up tlu^ canal, the following structures will 

 be noted: — After the finger has carefully dilated the canal, its tij) will l»e prevented 

 from entering the abdomen l)y the infundilndiform fascia. If it be pressed down- 

 wards, it will feel Poupart's ligament, which, with the meeting of the fascia trans- 

 versalis, forms the floor; above, it will be arrested by the arching fibres of the 



Fk;. «h.'). — oiu.K^ius ExTEKXus Axi) Fascia Lata. 



Intercolumnar 

 flbrea 



Aponeurosis — 

 of obliquus 

 externuB 

 SPERMATIC 

 CORO 

 Origin of 

 eremaster 

 Triangular 

 fascia 



Insertion of 

 eremaster 



External 

 abdominal 

 ring 



Saphenous 

 opening 



internal oblique and transversalis, coming down to the })ectineal line to form the 

 conjoined tendon. Towards the abdominal wall the finger will feel the aponeurosis 

 of the external oblicjue stretcliing over the wliole anterior as})ect of the canal; if 

 turned tow^ards the belly cavity, the finger would feel less resistant layers, viz. 

 extra-peritoneal fat and peritoneum, and, liehind the external ring, the conjoined 

 tendon. The finger would, of course, also take notice of the spermatic cord in the 

 male and the round ligament in the female, and investigate any alteration in the 

 former, and isolate the vas deferens. 



Vessels in the abdominal wall. — The three superficial branches of the 

 connnoii femoral, the external pudic (superior and inferior), epigastric and circum- 

 flex iliac, supply the lower part of the abdominal wall and the atljacent groin and 

 genitals. The only others that have to l)e remembered are the deep epigastrics and 

 epigastric branch of the internal mammary, the deep circumflex iliacs, the last two 

 intercostals, and the abdominal 1 tranches of the lumbar arteries. Of these, the dee]» 

 epigastric is the most ini]»ortant; its course will be marked out l»y a line drawn 

 from a jtoint just internal to the centre of Poupart's ligament, uitwards and 



