THE THIGH 185 



Dissection. The femoral sheath should be opened, in order that the 

 arrangement of parts inside may be displayed. Make three vertical and 

 parallel incisions through the anterior wall one over the femoral artery 

 which occupies the lateral part of the sheath, another over the femoral vein, 

 and the third about half an inch medial to the second. The first two 

 should begin at the level of the inguinal ligament, and should extend 

 distally for an inch and a half. The most medial of the three incisions 

 should commence at the same point, but should only be carried distally for 

 half an inch or less. 



Interior of the Femoral Sheath. A little dissection will 

 show that the sheath is subdivided by two vertical partitions 

 into three compartments. The femoral artery and lumbo- 

 inguinal nerve occupy the most lateral compartment'., the 

 femoral vein fills up the intermediate compartment', whilst in 

 the most medial compartment is lodged a little loose areolar 

 tissue, a small lymph gland, and some lymph vessels. This 

 last compartment, from its relation to femoral hernia, has the 

 special name of canalis femoralis applied to it. 



Canalis Femoralis (Femoral Canal). The boundaries and 

 extent of this canal must be very thoroughly studied. 

 The best way to do this is to introduce the little finger 

 into the canal and push it gently upwards. The length 

 of the canal is not nearly so great as that of the other 

 two compartments. Indeed it is not more than half 

 an inch long. Inferiorly it is closed, and it rapidly 

 diminishes in width from above downwards. Its proximal 

 aperture lies on the lateral side of the base of the lacunar 

 ligament, and is called the annulus femoralis. It is closed 

 by the closely applied extra- peritoneal fatty tissue of the 

 abdominal wall. The parts which immediately surround this 

 opening can be readily detected with the finger : laterally 

 the femoral vein, medially the sharp crescentic base of the 

 lacunar ligament, anteriorly the inguinal ligament, and pos- 

 teriorly the pubic bone covered by the pectineus muscle. The 

 portion of the extra-peritoneal fatty tissue which closes the 

 ring is called the septum femorale. On the abdominal 

 surface of the septum femorale is the peritoneal lining of 

 the abdominal cavity, and when examined from above both 

 are seen to be slightly depressed into the opening so as to 

 produce the appearance of a dimple. 



Femoral Hernia. Femoral hernia is the name applied to a pathological 

 condition which consists in the protrusion of some of the contents of the 

 abdominal cavity into the region of the thigh. In their descent they 



