Landmarks, medical and surgical / by Luther Holden.

  • Luther Holden
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Landmarks, medical and surgical / by Luther Holden. Source: Wellcome Collection.

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    in the diagnosis of inguinal and femoral hernise. If the bulk of the tumour be above the line, the hernia is probably in- guinal ; if below it, femoral. The line is not a straight one drawn from the spine of the ilium to the spine of the pubes, but slightly curved, with the convexity downwards, owing to its close connection with the fascia lata of the thigh. In many persons it can be distinctly felt ; in nearly all its precise course is indicated by a slight furrow in the skin. For the points about the spine of the pubes, refer to para- graph 85. 112. Furrow at the bend of the thigh,—When the thigh is even slightly bent, there appears a second furrow in the skin below that at the crural arch. This second furrow begins at the angle between the scrotum and the thigh, passes out- wards, and is gradually lost between the top of the trochanter and the anterior superior spine of the ilium. It runs right across the front of the capsule of the hip-joint. For this reason it is a valuable landmark in amputation at the hip- joint. The point of the knife should be introduced externally where the furrow begins, should run precisely along the line of it, and come out where it ends ; so that the capsule of the joint may be opened with the first thrust. In suspected disease of the hip pressure made in this line, just below the spine of the ilium, will tell us if the joint be tender. Effusion into the joint obliterates all trace of the furrow, and makes a fulness when contrasted with the opposite groin. 113. Saphenous opening*.—In most persons there is a natural depression over the saphenous opening in the fascia lata, where the saphena vein joins the femoral. The position of this opening is just below the inner third of Poupart's liga- ment, and about an inch and a half external to the spine of the pubes. This is the place where the swelling of a femoral hernia first appears : therefore it ought to be carefully exa- mined in cases of doubt. 114. Femoral ring*.—The position of the femoral ring, through which the deep lymphatics of the thigh pass into the pelvis, and through which a femoral hernia escapes from the abdomen, is, on a deeper plane, about half an inch higher than