The principles and practice of surgery : founded on the most extensive hospital and private practice, during a period of nearly fifty years; with numerous plates, illustrative both of healthy and diseased structure / by Astley Cooper ; edited by Alexander Lee.
- Cooper, Astley, Sir, 1768-1841.
- Date:
- 1836-1837
Licence: Public Domain Mark
Credit: The principles and practice of surgery : founded on the most extensive hospital and private practice, during a period of nearly fifty years; with numerous plates, illustrative both of healthy and diseased structure / by Astley Cooper ; edited by Alexander Lee. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
650/1190
![Contents of the sheath. Femoral aper- ture. is much looser in its texture than the portion investing the artery and vein, which is firm and unyielding. tt If the sheath be opened, the contents will be found separated by i two membranous septa, one passing between the artery and vein, o and a second, equally distinct, between the vein and the ab- n sorbents; the septum is formed by a process from the fascia ai transversalis passing backward, to attach itself to the fascia iliaca. n The contents of the sheath differ in their attachment to the bag ; j le the artery and vein are seen completely filling up the space in the h sheath which is allotted to them ; while the absorbents are loosely m connected by means of cellular membrane and fat, which, not j t] affording sufficient resistance to the pressure of the abdominal | tl viscera, occasionally allows the descent of a hernia. Fig. 9. j tl Plate II. It is this opening in the inner part of the sheath, occu- ai pied by the absorbent vessels and cellular membrane, to which the fe term femoral aperture, as allowing the descent of a hernia, should be strictly applied. This aperture is situated between the lunated if edge of Gimbernat’s ligament and the inner side of the femoral pt vein. When viewed from the abdomen, after the peritoneum is 1 removed, it appears filled with cellular texture, which, being , tl elastic, readily allows the finger to pass for an inch below the crural arch. If the finger be pressed forwards against the arch, 1 the posterior edge of the latter may be distinctly felt; and even when 11 Poupart’s ligament is cut away, a tendinous unyielding band will be felt on the fore part of the sheath, where the latter is united to !l Poupart’s ligament. The opening which allows the passage of the * iliac vessels under Poupart’s ligament is necessarily large, and can only be seen by removing the whole of the vessels, together with * their sheath. The opening then appears to be of an irregularly oval shape, extending from the outer edge of Gimhernat’s ligament 1 to the junction of the fascia iliaca with the crural arch, and is > bounded behind by the os pubis and its ligament, and before by s the posterior edge of the crural arch. Its figure and boundaries I will be seen delineated in Plate II.](https://iiif.wellcomecollection.org/image/b28525474_0662.jp2/full/800%2C/0/default.jpg)
