380 ABDOMEN 



fascia differs somewhat from the same fascia in other parts of 

 the body. It is more elastic, and this elasticity is due to the 

 presence of elastic fibres in its deeper membranous part. 

 Over the lower part of the linea alba the elastic tissue is 

 generally seen collected in the form of a distinct band which, 

 in the region of the symphysis pubis, becomes connected with 

 the penis and its suspensory ligament. A reference to com- 

 parative anatomy gives interest to this fact. In the human 

 subject this elastic band is the rudimentary representative of 

 a continuous and distinct layer of yellow elastic tissue (the 

 abdominal tunic\ which is present in the horse and other 

 quadrupeds in which the weight of the viscera is chiefly 

 sustained by the abdominal wall. 



When the two layers of the superficial fascia are followed 

 downwards, from the front of the abdomen, the fatty layer of 

 Camper passes over the inguinal ligament and becomes 

 directly continuous with the fatty superficial fascia on the 

 front of the thigh. The relations of the fascia of Scarpa are 

 very different. In the region of the pubes it is carried con- 

 tinuously downwards over the spermatic cords, the penis and 

 scrotum, into the perineum, where it becomes continuous 

 with the fascia of Colles. On the lateral side of the spermatic 

 cord, in the region of the groin, it proceeds downwards, 

 and ends immediately distal to the inguinal ligament by 

 blending with the fascia lata of the thigh. 



These connections of the fascia of Scarpa are so important that it is 

 necessary to undertake a special dissection, in order that they may be 

 demonstrated. As this encroaches somewhat upon the region of the thigh, 

 it must be done in conjunction with the dissector of the lower extremity. A 

 transverse incision should be made through the entire thickness of the 

 superficial fascia on the front of the abdomen from the anterior superior 

 spine of the ilium to the middle line of the abdomen. On raising the lower 

 edge of the divided fascia the two layers can be easily distinguished. 

 Insinuate the fingers between the fascia of Scarpa and the subjacent pearly- 

 looking tendon of the external oblique muscle. Little resistance will be 

 met, as the fascia of Scarpa is only bound down by some lax areolar tissue. 

 As the superficial fascia is thus raised from the aponeurosis of the external 

 oblique, the anterior cutaneous branch of the ilio-hypogastric nerve will 

 be seen piercing the aponeurosis and entering the deep surface of the 

 superficial fascia a little way above the subcutaneous inguinal ring. The 

 fingers can be readily passed downwards behind the fascia of Scarpa 

 as far as the inguinal ligament. Here it will be found that they can force 

 their way no farther. The passage of the hand into the thigh is barred by 

 the blending of the fascia of Scarpa with the fascia lata of the thigh. At this 

 level it ceases to exist ; it loses its identity by becoming fused with the deep 

 fascia of the thigh along the line of, and immediately distal to, the inguinal 

 ligament. 



