The surgical anatomy of inguinal herniæ, the testis and its coverings / by Thomas Morton.

  • Morton, Thomas, 1813-1849.
Date:
1841
Catalogue details

Licence: Public Domain Mark

Credit: The surgical anatomy of inguinal herniæ, the testis and its coverings / by Thomas Morton. Source: Wellcome Collection.

    14/134 page 216
    216* any portion of tlie canal wliicli may be anterior to tlie deep peri- nseal fascia or triangular ligament.* 1 he aponeurosis of the external oblique muscle.—The tendon of the external oblique muscle, which has been exposed by the dis- section of the skin and superficial fascia, may next be examined. It will be observed, that, in the hypogastric and iliac regions, the external oblique musele is altogether tendinous; but it does not present a perfectly continuous and unbroken surface throughout its entire extent, as, at several points, there are formed nume- rous apertures in it which serve for the transmission of the smaller branehes of the deep epigastrie artery which anastomose with the ramifications of the superficial vessels; several filaments of the lower dorsal and upper lumbar nerves also issue through these openings, in their course to be distributed to the cutaneous coverings of the lower part of the belly. The distribution of these nerves sufficiently explains the sensation of being ^’■tightly girded''’ which is so commonly complained of by those patients who labour under disease and curvature of the middle portions of the vertebral column. The apertures in the tendinous aponeurosis of the external oblique muscle, are sometimes found to be very much enlarged in their dimensions, and to be filled with a small mass of adi- pose substance which is frequently connected with the outer surface of the peritonaeum, which is itself now and then pro- truded in the form of a small pouch or sacculus. When any of the contents of the abdominal cavity escape by these openings, the name of ventral hernia is given to the disorder. The external oblique muscle arises, on each side, from the outer surface of the eight inferior ribs by as many fleshy pro- cesses, which correspond with, and indigitate with some of the costal attachments of the serratus magnus and latissimus dorsi muscles : — the posterior fibres of the muscle, which arc fleshy in their structure, descend, in nearly a perpendicular direction, from the false ribs, and are inserted into the anterior half of the outer labium of the crest of the ilium, while the fibres from the superior ribs incline downwards and inwards, towards the mesial line, and terminate at the outer edge of the rectus mus- * Vide The Surgical Anatomy of the Perina?um, p. 12 and p. 69.
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