Inguinal Ligament

Inguinal Ligament / Poupart’s ligament Lower border of aponeurosis of Ext. Oblique Extends from anterior superior iliac spine to pubic tubercle From pubic tubercle it is reflected to form lacunar ligament Continuous with fascia lata

Subcutaneous Inguinal Ring / External abdominal ring Triangled shaped opening in aponeurosis of Obliquus externus Above & lateral to pubic crest Gives passage to spermatic cord and ilioinguinal n. in male, and to round ligament of the uterus and ilioinguinal n. in female

The Lacunar Ligament / Gimbernat’s ligament Part of aponeurosis of Obliquus externus Forms medial boundary of femoral ring Apex corresponds to pubic tubercle Posterior margin is attached to pectineal line Anterior margin is attached to inguinal ligament

Ligament of Cooper Fibrous band Extends from the base of lacunar ligament along pectineal line Strengthened by Pectineal fascia Lower attachment of the linea alba (adminiculum lineæ albæ)

Conjoint tendon This tendon is the combine insertion of transversus abdominis and internal oblique muscles in to pubic crest and pectineal line. Medial posterior wall of inguinal canal is formed by conjoint tendon

Boundaries roof Medial crus of aponeurosis of external oblique�� Musculoaponeurotic arches of internal oblique and transverse abdominal��Transversalis fascia (conjoint tendon) floor inguinal lig. Lacunar lig.(medial third of canal only) iliopubic tract (lateral third of canal only)

posterior wall: Conjoint tendon transversalis fascia reflected part of inguinal ligament, medial third of canal only) Deep ing. ring(lateral third of canal only) anterior wall: aponurosis of ext.Ob. fleshy part of internal oblique (lateral third of canal only) Superficial inguinal ring(medial third of canal only)

Hesselbach’s Triangle Boundaries Medial half of inguinal ligament Linea semilunaris (lateral border of rectus abdominis) Inferior epigastric artery Surgical importance Not reinforced by conjoint tendon Potentially weak area Direct Inguinal hernias protrude through it

Mid Inguinal point Mid point of inguinal ligament

Hernia Direct Indirect