Inguinal Canal

INTRODUCTION:
  • The inguinal canals are the two passages in the anterior abdominal wall which in men convey the spermatic cords and in women the round ligament of uterus. 
  • The inguinal canals are larger and more prominent in men. 
  • There is one inguinal canal on each side of the midline.
  • It is an Intermuscular canal
ANATOMY:
The position of inguinal canal

  • : In lower part of anterior abdominal wall, just above the medial half of inguinal ligament. It extends from deep to superficial inguinal ring.
  • Inguinal ligament :Ligamentous portion of external oblique aponeurosis, extends from anterior superior iliac spine to the pubic tubercle.Psoas major & Femoral vein passes 
  • behind inguinal ligament 
  • Deep ring (Internal ring) 'U' shaped defect in the fascia tranversalis which form the posterior wall of inguinal canal. It lies 1.25 cm above the midpoint of the inguinal
  • ligament. It transit spermatic cord in males and round ligament in females.
  • External ring (Superficial ring): Triangular defect in external oblique aponeurosis. It is bounded on lateral and medical crura formed by external oblique aponeurosis and the base is formed by pubic crest.Superficial inguinal ring is situated superior and lateral to pubic tubercles
  • Inguinal canal: It is 4 cm in length extending from the deep inguinal ring to the superficial Inguinal ring.
BOUNDARIES:
  • Anterior: Skin, superficial fascia, external oblique aponeurosis,fibers of internal oblique in lateral 1/3
  • Posterior: Fascia transversalis, extraperitoneal connective tissue, parietal peritoneum, conjoint tendon in medial 2/3, reflected part of inguinal ligament at medial end.
  • Roof: Medial crus of aponeurosis of external oblique Musculoaponeurotic arches of internal oblique and transverse abdominal
  • Floor: Union of inguinal ligament with fascia transversalis, Lacunar ligament at medial end.
STRUCTURE PASSING THROUGH INGUINAL CANAL:
  • Spermatic cord in males
  • Internal spermatic fascia
  • Round ligament of uterus in females
  • Ilioinguinal nerve in both sexes.
STRUCTURE PASSING THROUGH DEEP INGUINAL RING:
  • Same as above except ilioinguinal nerve, which enters between external and internal oblique muscles and passes out through superficial inguinal ring.
BOUNDARIES OF HASSELBACHS TRIANGLE:
  • Laterally: inferior epigastric artery
  • Medially: lateral border of rectus abdominis Inferiorly: medial half of inguinal ligament
  • It is divided into two unequal portions by obliterated umbilical artery.

Exam Question
  • Spermatic cord in males, round ligament of uterus in females & Internal spermatic fascia passes through deep inguinal ring
  • Posterior wall of inguinal canal formed by fascia transversalis, extraperitoneal connective tissue, parietal peritoneum, conjoint tendon in medial 2/3, reflected part of inguinal ligament at medial end
  • Psoas major & Femoral vein passes behind inguinal ligament 
  • Roof is formed by Medial crus of aponeurosis of external oblique Musculoaponeurotic arches of internal oblique and transverse abdominal
  • Floor is formed Union of inguinal ligament with fascia transversalis, Lacunar ligament at medial end
  • Anterior surface is formed by Skin, superficial fascia, external oblique aponeurosis,fibers of internal oblique in lateral 1/3
  • Superficial inguinal ring is situated superior and lateral to pubic tubercles
  • Inguinal canal is an Intermuscular canal
  • Round ligament of uterus, Ilioinguinal nerve passes through inguinal canal in females 
  • Spermatic cord in males, Internal spermatic fascia ,Round ligament of uterus in females, Ilioinguinal nerve in both sexes are the structures passing through inguinal canal

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