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Henry Gray (1825–1861). Anatomy of the Human Body. 1918.

pages 412

medial half gradually widens at its attachment to the pubis, is more horizontal in direction, and lies beneath the spermatic cord.

The Lacunar Ligament (ligamentum lacunare [Gimbernati]; Gimbernat’s ligament) (Fig. 394).—The lacunar ligament is that part of the aponeurosis of the Obliquus externus which is reflected backward and lateralward, and is attached to the pectineal line. It is about 1.25 cm. long, larger in the male than in the female, almost horizontal in direction in the erect posture, and of a triangular form with the base directed lateralward. Its base is concave, thin, and sharp, and forms the medial boundary of the femoral ring. Its apex corresponds to the pubic tubercle. Its posterior margin is attached to the pectineal line, and is continuous with the pectineal fascia. Its anterior margin is attached to the inguinal ligament. Its surfaces are directed upward and downward.


FIG. 394– The inguinal and lacunar ligaments. (See enlarged image)

The Reflected Inguinal Ligament (ligamentum inguinale reflexum [Collesi]; triangular fascia).—The reflected inguinal ligament is a layer of tendinous fibers of a triangular shape, formed by an expansion from the lacunar ligament and the inferior crus of the subcutaneous inguinal ring. It passes medialward behind the spermatic cord, and expands into a somewhat fan-shaped band, lying behind the superior crus of the subcutaneous inguinal ring, and in front of the inguinal aponeurotic falx, and interlaces with the ligament of the other side of the linea alba (Fig. 396).

Ligament of Cooper.—This is a strong fibrous band, which was first described by Sir Astley Cooper. It extends lateralward from the base of the lacunar ligament (Fig. 394) along the pectineal line, to which it is attached. It is strengthened by the pectineal fascia, and by a lateral expansion from the lower attachment of the linea alba (adminiculum lineæ albæ).

Variations.—The Obliquus externus may show decrease or doubling of its attachments to the ribs; addition slips from lumbar aponeurosis; doubling between lower ribs and ilium or inguinal ligament. Rarely tendinous inscriptions occur.
  The Obliquus internus abdominis (Internal or ascending oblique muscle) (Fig. 395), thinner and smaller than the Obliquus externus, beneath which it lies, is of