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.
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![External sper- matic fascia. External ring i; closed towards abdomen. proach the outer angle of the external ring, they assume the form of a fascial membrane; and this membrane interposed between the pillars of the ring, and joining them firmly together, is the intercolumnar fascia. When the superficial fascia is first raised, the borders of the external ring are not distinctly seen, in consequence of a process of fascia being continued from the pillars of the ring on to the surface of the spermatic cord, called the external spermatic fascia. This structure extends into the scrotum, where it is lost in the expansion of the cremaster. It is desirable to leave this fascia entire on one side of the subject, and to remove it on the other, in order to examine more carefully the form and relations of the external ring. Before the tendon of the external oblique is divided, it is very important to ascertain how the external ring is closed towards the abdominal cavity, or in other words how the direct protrusion of the viscera, is prevented. If the student endeavour to push his finger through the ring towards the cavity, he will find that it is obstructed by a firm ligamentous structure. This consists, 1. Of the fascia pyramidalis, a small portion of fascia, which is derived from the tendon of the opposite external oblique, and is inserted into the os pubis behind the external ring. 2. Of the united ten- don of the internal oblique and transversalis, which is attached to the linea-ilio-pectinea. It is also necessary to remark that behind this common tendon, there is the fascia transversalis ; so that the viscera are supported at the external ring—by ]. the common integuments, consisting of the skin and superficial fascia; 2. the external spermatic fascia; 3. the pyramidal fascia; 4. tendon of internal oblique and transversalis; 5. fascia transversalis. The next stage of the dissection consists in dividing the tendon of the external oblique in the same way as the integuments, taking care that the perpendicular incision is continued completely down to the symphysis pubis; this will allow the triangular flap to be sufficiently turned towards the groin to expose the parts be- neath.](https://iiif.wellcomecollection.org/image/b28525474_0668.jp2/full/800%2C/0/default.jpg)
