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Home  »  Anatomy of the Human Body  »  pages 418

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

pages 418

  If the thorax be fixed, the muscles, acting together, draw the pelvis upward, as in climbing; or, acting singly, they draw the pelvis upward, and bend the vertebral column to one side or the other. The Recti, acting from below, depress the thorax, and consequently flex the vertebral column; when acting from above, they flex the pelvis upon the vertebral column. The Pyramidales are tensors of the linea alba.

The Transversalis Fascia.—The transversalis fascia is a thin aponeurotic membrane which lies between the inner surface of the Transversus and the extraperitoneal fat. It forms part of the general layer of fascia lining the abdominal parietes, and is directly continuous with the iliac and pelvic fasciæ. In the inguinal region, the transversalis fascia is thick and dense in structure and is joined by fibers from the aponeurosis of the Transversus, but it becomes thin as it ascends to the diaphragm, and blends with the fascia covering the under surface of this muscle. Behind, it is lost in the fat which covers the posterior surfaces of the kidneys. Below, it has the following attachments: posteriorly, to the whole length of the iliac crest, between the attachments of the Transversus and Iliacus; between the anterior superior iliac spine and the femoral vessels it is connected to the posterior margin of the inguinal ligament, and is there continuous with the iliac fascia. Medial to the femoral vessels it is thin and attached to the pubis and pectineal line, behind the inguinal aponeurotic falx, with which it is united; it descends in front of the femoral vessels to form the anterior wall of the femoral sheath. Beneath the inguinal ligament it is strengthened by a band of fibrous tissue, which is only loosely connected to the ligament, and is specialized as the deep crural arch. The spermatic cord in the male and the round ligament of the uterus in the female pass through the transversalis fascia at a spot called the abdominal inguinal ring. This opening is not visible externally, since the transversalis fascia is prolonged on these structures as the infundibuliform fascia.

The Abdominal Inguinal Ring (annulus inguinalis abdominis; internal or deep abdominal ring).—The abdominal inguinal ring is situated in the transversalis fascia, midway between the anterior superior iliac spine and the symphysis pubis, and about 1.25 cm. above the inguinal ligament (Fig. 401). It is of an oval form, the long axis of the oval being vertical; it varies in size in different subjects, and is much larger in the male than in the female. It is bounded, above and laterally, by the arched lower margin of the Transversus; below and medially, by the inferior epigastric vessels. It transmits the spermatic cord in the male and the round ligament of the uterus in the female. From its circumference a thin funnel-shaped membrane, the infundibuliform fascia, is continued around the cord and testis, enclosing them in a distinct covering.

The Inguinal Canal (canalis inguinalis; spermatic canal).—The inguinal canal contains the spermatic cord and the ilioinguinal nerve in the male, and the round ligament of the uterus and the ilioinguinal nerve in the female. It is an oblique canal about 4 cm. long, slanting downward and medialward, and placed parallel with and a little above the inguinal ligament; it extends from the abdominal inguinal ring to the subcutaneous inguinal ring. It is bounded, in front, by the integument and superficial fascia, by the aponeurosis of the Obliquus externus throughout its whole length, and by the Obliquus internus in its lateral third; behind, by the reflected inguinal ligament, the inguinal aponeurotic falx, the transversalis fascia, the extraperitoneal connective tissue and the peritoneum; above, by the arched fibers of Obliquus internus and Transversus abdominis; below, by the union of the transversalis fascia with the inguinal ligament, and at its medial end by the lacunar ligament.

Extraperitoneal Connective Tissue.—Between the inner surface of the general layer of the fascia which lines the interior of the abdominal and pelvic cavities, and the peritoneum, there is a considerable amount of connective tissue, termed the extraperitoneal or subperitoneal connective tissue.