. Abdominal hernia : its diagnosis and treatment. thigh and abdomen. edge of Gimbernats ligament. Below the sheath is thepectineus, and at the outer side the psoas muscle. To theouter side of the femoral sheath close to Pouparts ligament isthe crural branch of the genito-crural nerve. Femoral protrusions leave the abdominal cax-it)- by escap-ing beneath Pouparts ligament, and passing to the inner sideof the femoral vessels (fig. 165). Gimbernats ligament iscrowded towards the median line. Tt is this thin tendon whichordinarily produces the knife-edge cutting of the bowel that is FEMORAL HERNL\
. Abdominal hernia : its diagnosis and treatment. thigh and abdomen. edge of Gimbernats ligament. Below the sheath is thepectineus, and at the outer side the psoas muscle. To theouter side of the femoral sheath close to Pouparts ligament isthe crural branch of the genito-crural nerve. Femoral protrusions leave the abdominal cax-it)- by escap-ing beneath Pouparts ligament, and passing to the inner sideof the femoral vessels (fig. 165). Gimbernats ligament iscrowded towards the median line. Tt is this thin tendon whichordinarily produces the knife-edge cutting of the bowel that is FEMORAL HERNL\. 303 so destructive in strangulated hernia of this type. These pro-trusions escape from beneath the fascia lata at the saphenousopening, penetrating or carrying before them the cribriformfascia, and form a tumor on the anterior and inner aspect of thethigh three-quarters of an inch to the outer side of, and thesame distance below, the spine of the pubes. The long diameterof the femoral opening, after hernia has distended it, is trans- FlG. side viezt. Front view. Reducible femoral hernia of enormous size. This hernia was reducible and could be retained by a truss. verse, or parallel with the ramus of the pubes, and is triangularin shape, the term Ring being a misnomer. Considering the parts from within, we have first, the peri-toneum ; second, the extra-peritoneal fat; third, the transver-salis fascia, which forms the sheath of the femoral vessels;fourth, subcutaneous tissue; and fifth, skin. The vessels of theregion are important and should be clearly fixed in mind, buttheir proximity need cause no timidity on the part of the 304 ABDOMINAL HERXL\. careful operator. The saphenous vein passes over tlie falci-form edge of the fascia lata to join the femoral vein, and herealso are given off from the femoral artery the external pubic,the external epigastric and the circumflex iliac arteries. Formation.—Femoral hernia usually develops by a slowprocess, frequently attended b
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