. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. MuscularbranchesCutaneous branches, ?iliohypogastric Ilio-inguinal-nerve Internal obliquemuscleA nterior cutaneousbranches, twelftkintercostal \~ Inguinal ring Fig. 81.—Course and distribution of llic intercostal nerves. (After Spaltcholz.) Theintercostal and oblicjue abdominal muscles arc removed. (From liraun.) HERNIA 3^3 to the subcutaneous tissue in this r
. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. MuscularbranchesCutaneous branches, ?iliohypogastric Ilio-inguinal-nerve Internal obliquemuscleA nterior cutaneousbranches, twelftkintercostal \~ Inguinal ring Fig. 81.—Course and distribution of llic intercostal nerves. (After Spaltcholz.) Theintercostal and oblicjue abdominal muscles arc removed. (From liraun.) HERNIA 3^3 to the subcutaneous tissue in this region. Other fibers, which followthe cord through the ring, are supplied to the upper portion and sideof the scrotum and thigh. This nerve is not constant, and occa-sionally is found joined to the genital branch of the genitocrural toform the external spermatic nerve, or it may form a common trunkwith the iliohypogastric. pudic. anterior CLLtan:s(^llolor aateriorcutarfsoF ^(ilio-hypog.) r Intern, ring 1 Ext. ring / Lateral 12. cL— Infer, pudendal \ of small Sciatic 1-2 5 \ ^^,v,y Fig. 82.—Sites for local anesthesia in the inguinal region. (After Gushing.) The genitocrural nerve, its genital branch, appears at the internalring and passes down the back part of the spermatic cord into thescrotum, where it suppKes the cremaster muscle, testicle, and othercontents of the scrotum. The skin of the scrotum receives fibersfrom the inferior pudendal branch of the small sciatic and from the 364 LOCAL ANESTHESIA superficial perineal branch of the pudic, in addition to the ilio-in-guinal nerve already mentioned. It will be seen from a study of the above that after the skin ispassed all nerves entering the field emerge at or near the internal ring,and it is consequently here that we inject most of our solutions. Preparation for the Operation.^—Preliminary h^-podermic pan-topon or
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