ABDOMINAL WALL 401 



the inguinal region it plays an important part as a constituent 

 of the abdominal wall. 



In the present state of the dissection (on the right side of 

 the body), a small gap or interval is seen to exist between 

 the lower arched border of the transverse muscle and 

 the inguinal ligament. The membrane which fills up this 

 interval is the transversalis fascia. At no part of the 

 abdominal wall is the fascia stronger than here, and this 

 accession of strength is obviously for the purpose of com- 

 pensating for the deficiency in the transverse muscle, which, 

 at this point, does not descend so low as the inguinal liga- 

 ment. In this interval the transversalis fascia has an im- 

 portant relation to the spermatic cord. It, the fascia, is 

 pierced by the cord, but as yet no opening is visible. Take 

 hold of the cord and draw it downwards and medially. The 

 margins of the aperture through which it passes will be 

 observed to be prolonged downwards upon the cord in a 

 funnel-shaped manner, so as to invest it upon all sides with 

 a tube of fascia. This investment, which is thus seen to come 

 directly from the fascia transversalis, is called the infundibuli- 

 form or internal spermatic fascia. 



Dissection. It must now become the object of the dissector to 

 demonstrate the more important attachments of this fascia. He must, 

 therefore, divide the fibres of the transverse muscle along the lateral part 

 of the inguinal ligament and along the crest of the ilium, and, raising the 

 muscle from the subjacent fascia, throw it upwards. It is not necessary to 

 reflect the entire muscle. 



Attachments of the Fascia Transversalis. When the fascia 

 is cleaned, with the handle of the scalpel, it will be seen to be 

 attached laterally to the medial lip of the iliac crest. Along 

 the line of this attachment, which is by no means firm, it 

 becomes continuous with the fascia iliaca that portion of the 

 same fascial stratum which covers the iliacus and psoas 

 muscles in the iliac fossa. Close to the crest of the ilium the 

 fascia transversalis is pierced first by the ascending branch and 

 then by the terminal branches of the deep circumflex iliac 

 artery. Anteriorly, in the inguinal region, its connections are 

 more complicated, and must be studied at three different points 

 (i) between the anterior superior iliac spine and the femoral 

 artery, where it will be seen to be attached to the inguinal 

 ligament ; along this line also it becomes continuous with the 

 fascia iliaca; (2) opposite the femoral vessels, where it is 



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