1396 



CLINICAL AND TOPOGRAPHICAL ANATOMY 



peritoneal sac shorter and more direct. Direction. — From the abdominal to the 

 subcutaneous ring, downward, forward, and medially. 



Boundaries. — For convenience sake, certain limits (largely artificial) have 

 been named: — 



(1) Floor. — This is best marked near the outlet, where the cord rests on the 

 grooved upper margin of the inguinal (Poupart's) and the lacunar (Gimbernat's) 

 ligament. The meeting of the transversalis fascia with this ligament forms the 

 floor. (2) Roof. — The apposition of the muscles and the arched border of the 

 internal oblique and transversus. (3) Anterior wall. — Skin, superficial fascia, 

 external oblique for all the way. Internal oblique, i. e., that part arising from 

 Poupart's ligament, for the lateral third or so. To a slight extent, the trans- 

 versus and the cremaster. (4) Posterior ivall. — For the whole extent, transversalis 

 fascia, extraperitoneal tissue, and peritoneum. For the medial two-thirds, con- 

 joined tendon of internal oblique and transversus, and the lateral edge of the 

 reflected inguinal ligament, when developed. 



Fig. 1120. — Dissection of Inguinal Canal. (Wood.) 



External oblique 



(turned down) 



Rectus abdominis (with 

 sheath opened) 



The transversalis fascia is thicker and better marked at its attachments below; these are — 

 (a) laterally, to medial lip of iliac crest; {b) to the inguinal ligament between the anterior- 

 superior spine and the femoral vessels, where it joins the fascia iliaca; (c) opposite the femoral 

 vessels it also joins the fascia iliaca, and forms with it a funnel-shaped sheath; {d) medial to the 

 femoral vessels the fascia transvorsalis is attached to the terminal (ilio-pcctineal) line, behind 

 the conjoined tendon, with which it blends. The/ate inguinalis {conjoined tendon) needs special 

 reference. It is formed Ijy the lower fil)res of the internal oblique and transversus (arciform 

 fibres; arching downward over the cord to be inserted into the crest and spine and the terminal 

 (ilio-pectineal) line. The fibres of the internal oblique become increasingly tendinous as they 

 descend, and thi.s, with the fact that below they give off the cremaster, may cause some difficulty 

 in their identification when it is desired to unite- them to the upper surface of Poupart's liga- 

 ment in the operation of radical cure. 



The abdominal inguinal (internal abdominal) ring. — It has already been said 

 that the term 'ring' is hero misapplied except in an artificial sense, as when an 

 opening is made by a scalpel; or in al)normal conditions when a hernial sac is 

 present. The abdominal ring is not a ring in the least, but merely a funnel- 

 shaped expansion of the transversalis fascia, which the cord carries on with it as 

 it escapes from the abdomen. 



