Illustrations of the anatomy of the pelvis / By Alexander Monro.

  • Alexander Monro
Date:
1827
Catalogue details

Licence: Public Domain Mark

Credit: Illustrations of the anatomy of the pelvis / By Alexander Monro. Source: Wellcome Collection.

    29/44 page 21
    THIS Plate is a copy of one of Scarpa’s celebrated Engravings illustrative of Hernia. It exhibits, in a very distinct manner, the anatomy, not only of the parts concerned in the operations for Inguinal and Crural Her- niz, but also, that of the parts operated upon for Femoral and Popliteal Aneurisms. No. 1, 1, 1, point out the thin Membrane which lies under the skin of the abdomen, and which has been turned down in order to shew the tendinous expansion that is connected with the external oblique muscle of the ab- domen. Upon removing, with care, the skin of the belly, a thin Fascia, No. 1, 1, 1, or rather membrane, presents itself, which has been said by some to take its rise only from the inferior part of the tendon of the external oblique mus- cle, and has been described by CAMPER. It rarely exhibits a fibrous appearance in the adult, but the fibres, when distinct, pass in a transverse direc- tion with respect to the abdomen. These fibres do not resemble tendinous fibres, being neither to the eye glisten- ing, nor communicating to the touch the same dense feeling as tendon. This membrane is proportionally thicker in the foetus. This fascia, which has always appeared to me to consist of condensed cellular substance, covers the spermatic cord and round ligament of the uterus, and also some of the inguinal glands of the upper and under cluster; and may, in some subjects, at the upper part of the thigh, be divided into layers, between which some small lymphatic glands are placed. In a few cases, it may be readily traced for six or eight inches down the thigh. This membrane, in some cases of scrotal hernia, attains a very considerable thickness; in others, it adheres so intimately to the hernial sac, that it is impossible to separate the one from the other. | No. 2. and 2. point out the Tendinous Expansion of the external oblique muscle ; and No. 3. the separation of those Tendinous Columns which form the under abdominal aperture. The under part of the tendon of the external oblique muscle, stretched between the anterior superior spinous process of the Os Ilium, No. 5, and the Symphysis Pubis, No. 4, is thicker and stronger than any other part of it, and somewhat rounded, especially towards the ossa pubis, and has been described under the name of Pourart’s Ligament: and, more lately, it has been called by anatomists Crural Arch. It is marked No. 7, 7, as it extends over the flexor muscles, great bloodvessels, and. nerves of the thigh. This under part of the tendon was formerly supposed to be attached only to the anterior superior spinous pro- cess of the ilium, and the ligament of the symphysis pubis. Mr GimBernatT has, however, shewn, that the tendon is doubled inwards, and forms a canal for the sperma- tic cord in the male, and for the round ligament of the female uterus. | Poupart’s Ligament, or the Crural Arch, is sometimes dowble. I have seen two such ligaments on each side. When that is the case, the one ligament is generally fixed about a line above the tubercle of the pubes, and the other is found in its usual situation. About an inch or a little more from the symphysis pubis, the tendon of the external oblique muscle is gene- rally divided into an upper and under column ; but, in some instances, the division takes place at a greater dis- tance from the symphysis pubis. Between the tendinous columns, which are connected at the upper part by a few transverse tendinous fibres, a space intervenes somewhat of an oval figure, which has been commonly called the Spermatic Ring; but this term conveys an inaccurate idea of the form of this aperture, and it should be called Inguinal or Abdominal Aperture, with the addition of the word Under, to distinguish it from the Up- per Inguinal or Abdominal Aperture. . Through the under abdominal aperture, the spermatic cord passes; and, in the female, the round ligament. of the uterus. There is no direct opening into the abdomen, the passage being shut up by the internal oblique, and transverse muscles, and by the fascia transversalis. The under abdominal aperture in the male, is somewhat curved above, angular below, and directed obliquely downwards and inwards, and the sides of it are thicker than its upper or under part, being formed of the straight fibres of the tendon ; whereas the thinner tendinous substance, which connects the thicker fibres of the tendon, form the upper part of the aperture. In the male, the under inguinal aperture is about an inch in Jeneth, but in the female it is rather longer, and also narrower. No. 5. is placed upon the anterior and superior Spinous Process of the Os Ilium, and No. 4. upon the Sym- physis Pubis. KF
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