LISTON'S
Surgical Anatomy
OF THE
GROIN.
Price 7s. Boards.

$150-35
Xxxx
•6119
Lis
181
ARTES
LIBRARY
UNIVERSITY OF MICHIGAN
VERITAS
& PLURIBUS UNUN
THEBOR
SCIENTIA
OF THE
SI QUERIS PENINSULAM AMOENAM
CIRCUMSHICE
JGDAL
The
George E. Wantz
(UM Medicine 1946)
Collection
As
CEL.

ERMOIN
PICKERING & CHATTO LTD
LISTON, Robert. MEMOIR ON THE FORMATION AND CONNEXIONS OF THE
CRURAL ARCH, and other parts concerned in inguinal and femoral
hernia ... Edinburgh: printed for Peter Hill and Co. Edinburgh;
Baldwin, Cradock, and Joy, London; and Hodges and M'Arthur,
Dublin. 1819.
$150
FIRST EDITION, 4to, pp. 22 and 3 engraved plates, plates foxed;
uncut in the original printed boards, immitation morocco paper
spine, sligthtly worn.
An interesting and well preserved publishers binding. The title
printed directly onto the upper board within a decorative border
giving the appearance of the more usual lable, and the spine is
covered in blue paper embossed to immitate the morocco which
would have been used in a more expensive binding. This slim book
was nevertheless quite dear at 7s.
Wellcome III, p. 530.

but complete.
3 Plates (foxed)

MEMOIR
ON THE
FORMATION AND CONNEXIONS
OF THE
CRURAL ARCH,
AND
OTHER PARTS CONCERNED IN INGUINAL AND FEMORAL HERNIA.
BY ROBERT LISTON,
MEMBER OF THE ROYAL COLLEGES OF SURGEONS OF LONDON AND EDINBURGH;
LECTURER ON ANATOMY AND SURGERY, &c. &c. &c.
EDINBURGH:
PRINTED FOR PETER HILL AND CO. EDINBURGH; BALDWIN, CRADOCK, AND JOY,
LONDON; AND HODGES AND M'ARTHUR, DUBLIN.
1819.
EDIZBRECH
Oliver & Boyd, Printers, Edinburgh.
GES
TEGAOSED OF TATO Y
PERPESES OR THE FOAVE GOFFEGER OF EASGEONS OF TODOX VED EDITORCH
20
BA BOBEBL LOW
GBOBVT
CBDEVI VECH
FEET 50
LOBNVLIOZ VZD CONNEXIONE
MENOIE
.L54
543
QM
Book Room
Taubman/Rare


TO
HENRY JARDINE, ESQUIRE,
OF HARWOOD,
FELLOW OF THE ROYAL SOCIETY, AND VICE-PRESIDENT OF THE SOCIETY
OF SCOTTISH ANTIQUARIES, &c. &c.
THIS MEMOIR
IS RESPECTFULLY DEDICATED
BY
THE AUTHOR.

30
OF
Sauged 14ICIAL YIK
GOOVISNI TO
02 SET 20 PERCENTS-JOIN GEA 31000 JAYOT SET TO
231SATOITIA PETROS
10MM BIRT
ROHTUA THE

Soustene si fosze booter.ban alig var tale contentenon
brood bed rods exolod fotba
car has colzano
Santeroban oven Bluse 3rd rods doporo
MEMOIR, &c.
-Coo al motoriz
voy ded: bastirohib team or to 300 an
-orriz ere to rebi tani, vas mich anodal doum juodi
edi no jdeü yas words
Sue sun a printedle to calcinotto of His to Soome to dosidua
Janai is soivrez e ob lada Idi to ogbelwome 2003
es grotoned)
THE Anatomy of the parts concerned in Hernia has, of late
years, engaged the attention of the most eminent Surgeons
and Anatomists in this as well as in other countries. Much
light has, of course, been thrown on the subject, and many use-
ful practical inferences drawn from a more accurate knowledge
of the structure: still great variety exists in the descriptions of
different authors, and, consequently, much difficulty is thrown
in the way of the Student anxious to make himself master of
the subject. Many parts have a variety of names affixed to
them, and many again are divided and subdivided, each of
their separate parts receiving distinct appellations.
no retro of em not 718225
ond How zi di
7d barabta
vet
Several years ago, far from being satisfied with the demon-
stration of the parts concerned in Femoral Hernia, as given by
the most eminent Anatomists, and finding, on more accurate
investigation made on a number of subjects, that their descrip-
tions did not correspond with the structure of the parts, I
continued to inquire into the matter, and last year demonstrated
to my Class of Anatomy the views which I had been led to take
of the formation of the Crural Arch, and parts connected with
it. I then began to perceive, from the simplicity of the de-
B

6
monstration, that my pupils understood exactly the appearance,
connexion, and uses of parts, which before they had heard
enough about, but could never understand.
It is well known, that the anatomy of this situation is con-
sidered by Students one of the most difficult; and that very
few can, without much labour, form any just idea of the struc-
ture. I therefore conceive, that if I can throw any light on the
subject, or smooth at all the difficulties of attaining a true and
accurate knowledge of it, I shall do a service, at least, to the
younger members of the profession. If so, I shall completely
attain my object. In order to make the description more
easily understood, and that no ambiguity with regard to terms
may exist, I have added three plates of the anatomy from very
beautiful and accurate sketches, for which I am indebted to my
friend, Staff Surgeon SCHETKY, who unites to the freedom of a
master in the use of the pencil, the truth and accuracy of a
skilful anatomist. The drawings were made from my own dis-
sections for the purpose, and not before a very great number
of similar ones had been examined. rises user bas modes
in gaivies after oturages rieds
It must appear quite unnecessary for me to enter on a de-
scription of the abdominal muscles; these are well known,
and their situation and connexions accurately enough laid
down in the common manuals of anatomy. It is chiefly that
part known under the name of the ligament of Poupart that I
have to notice. This part, though named a ligament, and cer-
tainly composed partly of parallel fibres, running from the an-
terior superior spinous process of the ilium, to the tuberosity of
the pubis, cannot be separated from the tendon of the external
oblique muscle of the abdomen, of which it forms the lower
MiU

7
boundary. It has been described by all anatomists and sur-
geons as reflected upon itself, forming a round thick edge ex-
ternally; and internally again presenting a kind of sharp
grooved appearance.* It is also said to send a process to be at-
tached to the spine or crest of the pubis, forming a lunated
edge, generally known under the name of the ligament of
Gimbernat. It is this lunated edge that very frequently
forms the stricture in Femoral Hernia, and which requires to
be divided in the operation. It has been proposed also to di-
vide the ligament of Poupart, in order to remove the strangu-
lation of this species of rupture; but what effect this would
have in relieving it, will immediately be seen by an examination
of the anatomical structure. to slow simile asce
efs komen
of mi notoiberines e
rose estamo
It is one of my objects, in this paper, to shew that the liga-
ment of Gimbernat is totally unconnected with that of Pou-
part; that this part, or, what is the same thing, the inferior
pillar of the external ring, instead of being turned down from
its attachment to the tuberosity of the pubis, to be fixed to its
crest, frequently sends fibres, in a curved direction upwards, to
strengthen the conjoined tendon of the internal oblique and
transversalis. The ligament of Poupart has also been named
the Crural Arch; and the different fasciæ, in this situation,
have been described by some as attached to its upper or lower
* This reflection is but very slight, and that only close to the tuberosity, and is pro-
duced by the insertion of the more descending fibres into the straight and parallel
ones.
+ The insertion of the parallel fibres under the descending ones into the tuberosity
of the pubis, is named, by some Surgeons, the ligament of Gimbernat; but the whole
lunated attachment to the spine of that bone, is, by all writers with whom I am ac-
quainted, so denominated.

8
00
edge; by others, as arising from it. It will, however, appear,
that the Crural Arch is formed by a union of the fasciæ, un-
der the ligament of Poupart; and this we shall proceed to
shew. o a
88900
orga brez et hice ople at JI 9008 eggs bevoorg
Seteral e quinol gidug ed3 10 or so enigz edi of bedes
o In the dissection of the parts in the groin, the first fascia
which presents itself, is that strong expansion covering the
lower part of the tendon of the external oblique, and extending
down along the spermatic chord in the male.* This fascia is
described as attached to the edge of Poupart's ligament, and
afterwards continued over the fore and upper part of the thigh
containing the glands of the groin; and, in this situation,
named the loose Cellular Fascia of the thigh. The very name
carries a contradiction in the face of it. In the healthy state
of the parts, there is, in this situation, nothing but a loose cel-
lular substance, containing a quantity of adipose matter, envel-
oping the glands. In cases, again, where Hernia has existed
for some time, there is formed a very firm and dense covering,
then, to be sure, deserving the name of fascia.† The Superficial
Sure
mi asadit abuse ylineupert
*This fascia, in Inguinal Hernia, forms a layer above the tendon of the cremaster.
In ventro-inguinal Hernia, it is of course the only proper covering under the common
integuments. In a case of this kind, it formed so dense a layer, as at first to be mis-
taken for the Hernial Sac, covering a quantity of fat doughy substance, resembling
omentum. On examination, this fat was perceived to be deposited on the true
Hernial Sac, which was thus rendered three-fourths of an inch thick.
corcomb
noites
+ It is from this part being described as a fascia, that the opposers of the new doc-
trines, with regard to the anatomy of this situation, draw their arguments, and say,
that the cellular substance and fat may be sliced, like a cucumber, into as many layers
as the dissector pleases. That some anatomists have carried the rage for the discovery
of fascia too far, is no reason why those parts which are distinct, and which evidently
alter and modify the appearances of hernial tumors, should be described, as formed by
the knife, and not existing in nature. The translator of Scarpa's splendid work on

9
Abdominal Fascia is totally unconnected with this fatty layer on
the fore part of the thigh; neither is it attached to Poupart's
ligament; but, on the outer or iliac side, it is firmly united to
the combined fascia at this part, and forms one continuous
expansion with the external layer of the falciform process of
the fascia lata of the thigh. On the inner or pubal side, it
has a slight union with that part of this fascia which covers the
pectineus and adductor longus, and is, as mentioned before,.
continued over the spermatic chord, or round ligament.
ffy Joniset teom
The Fascia Lata of the thigh, at its upper part, has been most
accurately described as separating into two portions, thus form-
ing an opening for the passage of the vena saphena, and indeed
of the blood vessels, nerves, and absorbents, passing out of, or en-
tering the abdomen. The inner or pubal portion, that which
covers the pectineus and head of the adductor longus, passes
under the vessels, over the brim of the pelvis, and forms one
continuous expansion with the fascia iliaca. The outer or iliac
portion, with its falciform process,* lying on the anterior part of
Hernia has made a very bold assertion regarding the fascia of the groin, and has
brought in the names of two celebrated anatomists to corroborate his opinions. "They
❝ have repeatedly complained," says he, " that they had less trouble in demonstrating
"the natural structure of these parts in the manner of Scarpa, than in manufacturing
"new forms with the knife, to explain to their pupils what is meant by these fascia."
Notwithstanding the high authority with which this opinion is supported, no doubt can
exist in the mind of any person, who will carefully examine the parts for himself,
after the method to be described.
* This part was first described by the late Mr A. Burns under this name, who
also called the edge of what is generally considered as Gimbernat's ligament, the cres-
centic portion. These names, as being more accurate, I propose to retain, omitting alto-
gether the name of Gimbernat's ligament, as, by different authors, it is attached to very
different parts. Some anatomists have confounded the two names of falciform
pro-
cess and crescentic edge, and used them indiscriminately. This must of course be.
guarded against.
C

10
the vessels, is divided into two layers. In many subjects this
division is quite distinct without much dissection; on all it can
easily be demonstrated. Many anatomists describe the falci-
form edge as altogether artificial, and, in a great measure, form-
ed by the knife of the dissector; and before I completely un-
derstood the connexion of these fasciæ, I was, I confess, some-
what of this opinion. If the integuments of the abdomen, along
with the superficial fascia, be reflected over the thigh, the chance
is, that the external layer of the falciform process, which is
most distinct, will be dissected off, leaving only its internal layer.
This I have often seen happen; and then the question may be
put, where is the falciform process? The want of it does not
arise from any imperfect formation, but rather from the awk-
wardness with which the dissection has been conducted. The
attachment of the superficial fascia to the external layer of
the fascia lata, ought not to be divided, and then, on re-
moving the fat and glands at the upper part of the thigh, the
falciform process will easily be brought into view. The falci-
form process of the fascia lata is twisted at its inner part, un-
der the ligament of Poupart, and this twisted portion is, by Mr
Hey, named the femoral ligament. It turns in thus to form
the anterior layer* of the crescentic part of the Crural Arch.
On removing the superficial abdominal fascia, and the external
layer of the falciform process along with it, the internal layer
* The division of this part of the Crural Arch into distinct layers, I first observed and
demonstrated in 1815, at which time I filled the situation of House Surgeon to the
Royal Infirmary in Edinburgh, and in which capacity I embraced eagerly the great
opportunities which it afforded of examining both the sound and diseased appearances.
I find that Clocquet, a late French writer on Hernia, has noticed the division of what
he calls the ligament of Gimbernat into two layers, but still he considers it as a part of
the ligament of Poupart, or the reflection of the tendon of the external oblique upon
the crest of the pubis.

11
of that process will be found to be continuous with the fascia
transversalis.
This Fascia Transversalis, first described by Mr Cooper, is ge-
nerally considered as attached to the inner edge of Poupart's
ligament, along the crest of the ilium, firmly united with the
fascia iliaca; and it is this connexion (which is easily seen even
to the middle space, between the spinous process of the ilium
and tuberosity of the pubis), which prevents the protrusion
of the bowels betwixt the ligament of Poupart and the psoas
and iliacus muscles. The fascia iliaca, after leaving the mus-
cles, passes under the vessels, as said before, to meet with the
pubal portion of the fascia lata. A kind of oval space is thus
left for the vessels, &c. bounded behind by the bone covered
by the fascia, on the inner side by the crescentic portion of
the Crural Arch, before by the Crural Arch, and on the outer
side by the meeting of the iliac and transversalis fascia. This
space is by many Surgeons named the Crural Ring. The fascia
transversalis then passes upwards under the muscle of that name,
gradually getting thinner as it ascends. Its extent and strength
varies in different subjects; but it can at all times be easily de-
monstrated, forming an opening for the passage of the sper-
matic chord, or round ligament of the uterus, with a superior
semilunar edge, and provided with distinct pillars. The inferior
pillar, where it joins with the fascia iliaca, and inner layer of the
iliac portion of the fascia lata, is by much the strongest, and is
composed of distinct fibres running in the direction of those of
the ligament of Poupart. I have little doubt that this has by
many been considered as the folding in of the lower border of
the external oblique upon itself. The internal or superior
pillar is chiefly formed of the tendon of the transversalis,

12
which passes down to be inserted into the crest of the
pubis. From the opening for the passage of the chord
through the fascia transversalis, a production of this mem-
brane is continued under the cremaster muscle, forming
that layer in Inguinal Hernia which is next the Sac. Thus
the opening is not truly a ring, but merely the mouth of a
funnel; and it is only after this covering of the chord is re-
moved, that any thing like a defined edge is presented. This,
as far as I know, was first described by Clocquet, and is very dis-
tinctly expressed in Plate II. That the fascia are unconnect-
ed with Poupart's ligament, and that they are all conjoined
under it, can easily be demonstrated. If, after dissecting off
the superficial abdominal fascia from the external oblique, leav-
ing it attached to the falciform process, and raising the exter-
nal and internal oblique muscles, so as to expose the lower
border of the transversalis, and the passage of the chord through
the fascia transversalis, - an incision be cautiously made through
the tendon of the external oblique, and through its inferior
border, or Poupart's ligament, at its middle part, it will be
found very easy to separate the fibres, merely with the forceps,
towards the attachments of the ligament to the ilium and pubis.
This may be done without any laceration of the fibres; and
thus the true connexion of the fascia underneath, totally un-
connected with this ligament, will be immediately perceived.
It will then also be found, that some of the fibres of Poupart's
ligament, are, after being attached to the tuberosity of the pu-
bis, reflected under the chord upon that part of the tendon
of the internal oblique and transversalis, which is opposite the
external ring; thus forming a security against the occurrence
of ventro-inguinal Hernia. Not a single fibre goes to be in-.
serted into the crest of the pubis, which is situated at least:

13
half an inch above the attachment of this ligament to the tu-
berosity of that bone. It thus appears, that the lower border
of the external oblique lies in the angle of union of the super-
ficial fascia with the fascia lata and transversalis, and is con-
nected to them only by cellular substance. Ditor od 9radt
década leurs ad
Although the ligament of Poupart is removed, still the Cru-
ral Arch remains not much weakened. That part of the arch
attached to the spine of the pubis, which I have all along
named its crescentic part, is also left; and, on examination, will
be found to be divided into three layers, between which the han-
dle of the knife can be introduced down to the bone, and felt by
the finger passed under the arch. The anterior or external layer
of this ligament, I said before, will be found to be formed by
the twisting in of the falciform process; the internal layer,
again, by the dipping down and attachment of that part of the
fascia transversalis, which forms the inferior pillar of the inter-
nal ring, to the ligamentous substance covering the bone.
The middle layer is formed by the attachment of the lower
part of the combined tendon of the internal oblique and
transversalis, to the crest of the pubis and the descending
fibres, strengthened by a strong cross slip from the attach-
ment of the rectus abdominis of the opposite side. The in-
ner layer, formed by the fascia transversalis, is also thus ren-
dered stronger. When the external and internal layer of the
crescentic part of the arch are removed, the internal layer will
be observed to form an acute angle with the ligament of Pou-
part, and the lunated appearance is produced by the filling up
of the angle by the junction of the other two layers. emos deuord
mited qand
alduch edi o
BUCH
We may, in short, consider the fascia lata, at its upper part,
D

14
as divided into two portions; the one the pubal portion covering
the heads of the adductors of the thigh, and becoming continu-
ous with the mesial part of the fascia iliaca; the other, the iliac
portion, covering the vessels. The cellular substance, connecting
these two portions with the vessels, on the anterior and posterior
part, forms what has been named the crural sheath, or sheath
of the vessels.* The iliac portion, forming the falciform pro-
cess, is again divided into two layers; the one passing anterior-
ly to the abdominal muscles, and named the superficial abdom-
inal fascia; the other, again, lining their inner surface, and pass-
ing betwixt the transversalis muscle and peritoneum, forming
the fascia transversalis. The lower part of the abdominal mus-
cles and Poupart's ligament thus lie in the angle of splitting,
or union of all these fasciæ, and the Crural Arch is formed by
this junction.
ginou 643 rd a 28
From this view of the parts, it will immediately be under-
stood how the Crural Arch can be relaxed, and the reduction
of Femoral Hernia, either before or during the operation, fa-
COD red
Deed benid
benidmoo od do
veten ed
Lo
* The vessels in all parts of the body receive a strong sheath of cellular substance,
which binds them together; but here they have been described as having two sheaths:
this, however, is not the case. It has been disputed, whether or not the tumor of
Crural Hernia passes in the sheath of the vessels, by which is meant that cellular con-
nexion, anteriorly with the Crural Arch, posteriorly with the pubis and pubal portion
of the fascia lata; as no force could possibly cause the insinuation of the sac into the
true sheath. The Crural Hernia passes, on the inner side of the vein, generally
through some of the foramina in that tough cellular substance, filling up that space
which serves for the passage of the lymphatics. Part of the tumor is sometimes forced
through some of the openings in the iliac portion of the fascia lata, through which the
lymphatics perforate, and the indentations caused by the elongation of the membra-
nous slips, which often cross these foramina, produce the appearance of the double Fe
moral Hernia.
Toda a vem sy
100

15
cilitated, by the bending and rotation of the thigh inwards, or the
carrying of the one limb across the other. This relaxation of
the arch will account for the frequent occurrence of Femoral
Hernia, in people falling under great weights; in which case
the knees are commonly forced together. The ligament of
Poupart cannot possibly be at all affected by the motions of
the inferior extremity, as extending betwixt two immoveable
points of bone. Whereas the tension of the Crural Arch, form-
ed as has been described, is changed in every position. It will
clearly appear, also, that the division of the ligament of Pou-
part alone, though it may slightly weaken the Crural Arch,
cannot be trusted to as a means of relieving strangulation.
The division of the falciform process, on the other hand, or its
continuation, the femoral ligament, must immediately relax
both the arch and its crescentic portion, and by attention to the
position of the limb, it will seldom be found necessary to
carry the edge of the knife against either of the two last-men-
tioned parts.

21
od) to abrwyl dybt ad to moltetor basyallied ads
ebrewyi
vd hotgifis
to nortexsler afifTeto edizzoros dmil er end to endereJ
Isromo I to serremoto desuport or not darees lltw de
caro doidw si ;atrolow loare robar quillet oloog ni si
goed aad en be
geggs virsalo
els
enamed en redtegel Desset ylcommos ex teen ers
to anotom sa vd hotosba lle da od idizzog Jomaro Jusquo i
ed
eidasvommi owl izivled naibretro vaimethe whstar edi
dor A TETUTO or to moienes art esered W sued to aiming
lliw I maniacq yiovs ai bogando at bodige
-204 to tremavil odt to motivib ed) Jedi
don A Isurro edit redsey vinigile vam ti dopadli enols dzery
meltelugastie quiveller to casem s as of betema ed tommes
xi to bred radio era o gessor motiolatedt to solzivih edт
xelst vleisthommi jane dhemspil istomet odt noitaumitres
and of normalde yd bae noftrog stine2019 aji
done od drod
at pussssson barot ed mobles lliy di dunil eds to melthog
from deaf out on to rectie tenisus stiml aid to sche ont vusə
18 banoj


A
Drawn by John Alex: Schetley Esq
www
a
PLATE I.
F
b
The in
D
Edinburgh, Published by P.Hill & Co 1819.
unw
B
Engraved by W&D. Lizars

i eredu Josipall Isromet od barnen
og ofane ID 543
romet od: Former reithog betatud eft
eval lauratze eis much of ni amry
8701
Istenen ni lliw
How don! Isun edt to nott
EXPLANATION OF THE PLATES.
Jusquo I to trompiledt & bonowed aired Intou
de lcioltoque odt to anitoom ons devordi palaide nece zi
mtoffelst end 20 royal lammetze edt diliw sinest leniwob
8299016
PLATE 1. je ansadga 2057 941 5
I. SEE encodque ensy e
erewol er de misy Isromet
adi gaistme se bo
22000xg protiofal art to
not gairmoso bueuport as hedirseeb eeainego szort to ono
Exhibits a Superficial View of the Parts in the Groin, upon the re-
moval of the Common Integuments and Adipose Substance.
ountinos vinebive sisest lamimonde leidinesque on??
digidi odi to stal clozi adi to royal lameize ed
coll
Frodo ods 1970 pil
A, The symphysis pubis, with the attachment of the suspensory
ligament of the penis to it.
B, The anterior and superior spinous process of the left ilium.
C, The body of the penis, the integuments being reflected
from it.
D, The iliac portion of the fascia lata of the thigh.
E, The pubal portion.
F, The abdominal muscles; the superficial fascia being dis-
sected from them, along with the integuments, and again
separated both from them, and from the interposed cel-
lular substance.
aa, The cellular substance, containing a quantity of adipose
matter, along with the lymphatic glands of the groin, re-
flected down over the thigh.
b, The falciform process of the fascia lata, the division of
which, or of,
E

18
c, its twisted portion, named the femoral ligament, where it
turns in to form the external layer of the crescentic por-
tion of the Crural Arch, will in general remove the tension
of the whole arch, and thus facilitate the reduction of fe-
moral hernia. Between c and B, the ligament of Poupart
is seen shining through the meeting of the superficial ab-
dominal fascia, with the external layer of the falciform
process.
d, The vena saphæna major, passing up and seen entering the
femoral vein at the lower part of the falciform process.
e, One of those openings described, as frequently occurring, for
the passage of lymphatics, and now and then admitting
the hernial tumor.
9
ff, The superficial abdominal fascia, evidently continuous with
the external layer of the fascia lata of the thigh.
g, That part of the superficial fascia which lies over the chord,
concealing the cremaster muscle.
eineg odi lo Juengli
Asili stofort to azesorg aronige motregue Las roistre ed
Codboller gated ctrosuryetri oli aineg ent to bed od
a
9
digit sili to nisl albest ork
ons to molto osili odr
nofrog fedua ed
21b galed coat offerre et colocnm lentmonds
nings Sm alromagedni
romagojni od; iiy grole mods meil betsee
so bozorrotul on mor bas med most od boterores
coundedua tahu
somsledne vinilos SAT
ear of del yacis room
noids eds revo nwob batech
off to assocs anticla ed J
So so dolde
erapins to piesop's gainistros
eriors ofs to abrufy


P
Vint
B
MU
PLATE II.
K
Vo
AMC
C
FORM

19
To Jing offce9205
Selenicdames 5% Aleppey sifa
east odo lo morton'sdl J
PLATE II.
rowded gristilge of
dore oft
Represents a deeper view taken from the same subject. The differ-
ent Layers of Muscles are reflected so as to shew the Connexion
of the Fascice, and the Formation of the Arch and its Append-
ages, independently of Poupart's Ligament, which is divided and
separated towards its attachments, from the cellular substance
connecting it to the Arch.
all dig slo
Mood Inriarch fo
to/1oys!
A. The symphysis pubis.
Co
B, The anterior and superior spinous process of the right ilium.
C, The crest of the left.
D, the integuments divided a little below the umbilicus.
E, The penis.
F, The linea alba.
aaa, The superficial abdominal fascia reflected over the thigh,
with a perforation cut in it, in order to shew the situation
of
360
b, The falciform process of the fascia lata.
cc, Part of the lower portion of the tendon of the external ob-
lique, with the spermatic chord passing through it.
dd, The reflected portions of Poupart's ligament.
e, Part of the internal oblique, with the cremaster muscle cov-
ering the chord.
f, The lower border of the transversalis turned a little up.
g, The cut edge of the internal oblique.
h, The fascia transversalis, giving the covering
i, To the chord under the cremaster muscle. It is here slit up,
shewing

20
k, The vessels, &c. composing the chord.
1, The junction of the fascia forming the Crural Arch.
m, The splitting between the layers of the crescentic part of
the arch.
nn, The cut ends of Poupart's ligament on the right side.
o, The internal oblique turned back.
p, The transversalis muscle raised, so as to shew the fascia trans-
versalis passing up under it. 01 plinabesqobni sego
q, The continuity of the fascia transversalis, with the internal
layer of the falciform process of the fascia lata, shewn by
the removal of the superficial abdominal fascia, with its
external layer.
r, The opening in the fascia transversalis for the passage of the
chord, which opening is named the internal ring.
The appearance is only presented after the removal of the
production from the fascia, immediately covering the
chord.
ess
s, The inferior pillar of the internal ring, formed by the fascia
transversalis.oofer cless fonimobor
t, Its superior or internal pillar, principally composed of the
tendinous fibres of the transversalis and internal oblique
muscles.
off to casoory motivist odT
do ferredze ar to nobret erk to noftrog zewol edt to the o
3f diguous gnizes brodo sitsmaga edt diiv supil
dre med atreguo 1, to erotron betalter edt 55
Too elemor estarmers als duty sunildo lazatni er to the T
brodo art gaire
grabil a Semmi allsere vemend and to rebrod revol ed? 3
erpildo larredut est to epho aro edT
gutterco est gaivly allserverest coast od T
im
ed rebar bor edi oT s
eatwada
on dife crail of teammateso


H
G
PLATE III.
J
k
I
d
19

21
Les offresser to betenni eT
lado os
PLATE III.
gently stea
nload of t
Gives an Internal View of a Female Pelvis, and the Formation of
the Crescentic Portion of the Arch in three Lamine.
70 300 2235 aleger
god speil sto
dru nounitass
A, The symphysis pubis.
B, The crest of the left ilium.
C, The crest of the right.
D, The bodies of the lumbar vertebræ..
E, The sigmoid flexure of the colon.
F, The bladder sunk into the pelvis.
G, The right thigh.
H, The left thigh.
a, The anterior superior spinous process of the right ilium.
The Crural Arch.
c, A thread, holding up the lower part of the combined ten-
don of the transversalis and internal oblique muscles,.
which is inserted into the spine or crest of the pubis, and
forms the middle layer of the crescentic part of the arch;
it is seen shining through the internal layer, making, with
the Crural Arch, an acute angle.
d, The external layer, formed by the turning in of the falci-
form process of the fascia lata.
e, The internal layer of the crescentic part of the arch, com-
posed of the lower part of the fascia transversalis, which
forms the inferior pillar of the internal ring.
ff, Threads supporting the cut edges of the recti muscles.
g, The crossing of their tendinous insertions; the fibres of
the left side passing over to strengthen the middle and
internal layers of the crescentic part of the arch of the
right side,
F

22
h, The lunated or crescentic edge, formed by the meeting of
the external and internal layers.
ii, The fascia iliaca, covering the iliacus internus and psoas
muscles, and joined with the fascia transversalis, and iliac
portion of the fascia lata, to the place where
k, The vessels pass out over the brim of the pelvis. The fas-
cia iliaca then passes under the vessels, and becomes
continuous with the pubal portion of the fascia lata of
the thigh.
zivleg oris est alive 56eld of
22500g erroride ofreque
Seng sowol ads on well fed boerde
Oliver and Boyd, Printers, Edinburgh.
dis guidin cawl fomented Squonks vaini
foc
advd ferrot goyel Inmetze er? 5
abbated So Ar
meer af di
8 lo zepão tro
malar oda
020
Tot
erk Sabrorque absord
To arsyet formed
18



UNIVERSITY OF MICHIGAN
LIBRARY
∞ CONSERVATION UNIT ∞
Examination and treatment records
are on file.
Call #
Job #
QM 543.154
Date
2020.016
Kyle Clark
кук
2/26/2020
Work by
80924