The surgical anatomy of inguinal herniæ, the testis and its coverings / by Thomas Morton.
- Morton, Thomas, 1813-1849.
- Date:
- 1841
Licence: Public Domain Mark
Credit: The surgical anatomy of inguinal herniæ, the testis and its coverings / by Thomas Morton. Source: Wellcome Collection.
Provider: This material has been provided by Kings College London. The original may be consulted at Kings College London.
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![It is with the view of producing a similar relaxation of the pillars of the external abdominal ring, and of the several struc- tures which enter into the composition of the parietes of the inguinal canal, that surgeons are in the constant habit, pre- viously to endeavouring to reduce the contents of a strangulated inguinal hernia by the taxis, of first taking the precaution of placing the lower limbs in such a position as shall most com- pletely relax this portion of the abdominal walls. The dissection of the inguinal canal.—The lower part of the tendinous aponeurosis of the external oblii]^ue muscle may now be raised, in order that the external abdominal ring may be examined from its inner surface, as well as the subjacent structures which are connected wdth the anatomy of the inguinal canal. For this purpose let an incision be made through the fleshy fibres of the external oblique muscle, about one inch be- yond the anterior superior spinous process of the ilium, so as to expose the cellular interspace which separates its fibres from those of the internal oblique muscle; this incision should be prolonged in an oblique direction as far as the linea alba, and thence dowmwards to the symphysis of the pubes; observ- ing, at the same time, to render the subjacent muscles tense, by drawing the linea alba towards the opposite side, and the cord and testicle downwards and across the right thigh. (See Plate II.) The tendinous and fleshy flap, thus marked out, is to be carefully dissected from the fleshy fibres of the internal oblique and cremaster muscles, and the sheath of the rectus. Near the umbilicus it will be found rather difficult to separate the tendon of the external oblique from the sheath of the rectus muscle; but, as we approach the crista of the os pubis, the con- nexion between these structures becomes much less intimate, in consequence of the presence of some loose cellular tissue which is interposed between them. The internal and superior pillar of the external abdominal ring should not yet be cut across, but may be allowed to remain entire in its attachments to the body and symphysis of the ossa pubis. Oil raising the tendinous aponeurosis of the external oblique muscle, two nerves will be noticed lying between it and the fleshy fibres of the internal oblique (the musculo-cutaneotis and ilio-scrotal branches of the lumbar plexus) ; they descend, after having successively traversed the transvcrsalis and internal O V Q 2](https://iiif.wellcomecollection.org/image/b21307283_0029.jp2/full/800%2C/0/default.jpg)
