HERNIA 



423 



distend the inguinal canal and force the abdominal contents further and 

 further along it until they eventually protrude through the subcutaneous 

 inguinal ring. The coverings of such a hernia will naturally be the con- 

 stituent parts of the abdominal wall in the inguinal region that is from 

 within outwards, (i) peritoneum, (2) extra-peritoneal fat, (3) infundibuli- 

 form portion of transversalis fascia, (4) cremasteric fascia, (5) intercrural 

 fascia, (6) superficial fascia, and (7) skin. A hernia which travels obliquely 

 through the abdominal wall, along the line of the inguinal canal, is called an 

 oblique inguinal hernia, and as the neck of the hernial sac lies to the lateral 



_ Gut 



Cavity of ._/._./ 

 processus vaginali 



Cavity of 

 processus vaginal is 



Cavity of 

 Tunica vaginalis 



Ductus deferens 



Cavity ot 

 processus vaginalis 



Cavity of tunica vag. 

 Testicle 



_Gut 



Cavity of 

 processus vaginalis 



Cavity of tunica vag. 

 Ductus deferens 

 Testicle 



3 4 



FIG. 159. Diagram illustrating different forms of scrotal herniae. 



side of the inferior epigastric it is called a lateral inguinal hernia. If the 

 cavity of the persisting processus vaginalis, into which the hernia has passed, 

 is still continuous with the cavity of the tunica vaginalis the herniated 

 viscus or peritoneal fold will enter the tunica vaginalis of the testicle, but 

 if the cavity of the upper part of the processus vaginalis has been separated 

 from that of the lower part, by the formation of an oblique or transverse 

 septum, the upper part of the processus, with its contained hernia, may be 

 forced downwards either anterior or posterior to the lower part, or the lower 

 end of the upper parr, may invaginate the upper end of the lower part. 

 Herniae differentiated from each other by the relationship which the upper 

 part of the processus, containing the herniated viscus, bears to the lower part, 

 the tunica vaginalis, are described by surgeons under special names which 

 the student will find fully explained in manuals of surgery. There are, 



