FEMORAL HERNIA 



1399 



of the rest of the body. (6) Deep layer of superficial fascia. — Thin and mem- 

 branous, onh' met "wdth over the lower third of the abdominal wall and to the 

 medial side of the groin. 



It is continuous through the scrotum with the deep layer of the superficial fascia of the 

 perineum. Just below the inguinal Hgament it is joined to the fascia lata. From these two 

 facts it results that in rupture or giving way of the urethra the extravasated urine may come 

 forward by way of the genitals (p. 1385) and from the continuity of the fascia make its waj' on 

 to the abdomen, but not down on to the thigh. 



Between the two layers of superficial fascia lie the superficial nodes of the groin, the super- 

 ficial branches of the common femoral artery, one or two cutaneous nerves, and some veins 

 descending to the fossa ovalis to join the great saphenous vein. 



(2) Inguinal (Poupart's) ligament. — This is also known as the crural arch, a 

 misnomer, as 'crus' means leg. A description of its shape and attachments is 

 given on p. 1371. Owing to the connection of the fascia lata to its lower border, 

 the fossa ovalis (saphenous opening), which is situated in the fascia lata, and has 

 its upper cornu blending with the inguinal ligament, wall be affected by movements 

 of the thigh, much as is the subcutaneous inguinal (external abdominal) ring, 

 being tightened and stretched when the limb is extended and abducted, relaxed 

 when it is adducted and flexed. 



Fig. 1122. — The Lacunae beneath the Inguinal Ligament. (Lockwood.) 



Inguinal ligament 

 Muscular lacuna 



Ilio-pectineal ligament' 

 Ilio-pectineal eminence 



Vascular lacuna 



Cooper's ligament 



Lacunar ligament 



— Spermatic cord 



The parts beneath the ligament which block up the gap between it and the 

 innominate bone are of the utmost importance in preventing the escape of a 

 femoral hernia (fig. 1122). 



The different structures are arranged in three compartments (fig. 1122), 

 named latero-mediall}" — A. lateral, iliac, or muscular; B. central, or vascular; 

 and C. medial, or pectineal. Of these, the first is the largest; the second or 

 intermediate one lies slight^ nearer to the inguinal ligament than the other two ; 

 while the medial compartment differs from the other two by not communicating 

 with the pelvis, being closed above {vide infra). 



(A) The lateral, or iliac, compartment is bounded in front by the inguinal ligament and the 

 iliac fascia, which is here blending with it, behind by the ilium, laterally by this bone and the 

 sartorius, and medially by the ilio-pectineal septum, which, descending from the blending 

 of the iliac fascia and the inguinal ligament above, passes down to the iho-pectineal eminence, 

 and thence to the medial aspect of the front of the capsule of the hip-joint. This compartment 

 transmits the ilio-psoas and femoral (anterior crural) and lateral cutaneous nerves. (B) The 

 vascular compartment is bounded, in front, by the inguinal hgament and the transversalis 

 fascia, which here blends with it, forming the so-called deep crural arch, and at the same time 



