INGUINAL CANAL

INGUINAL CANAL 

• 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.

• Inguinal canal: It is 4 cm in length extending from the deep inguinal ring to the superficial Inguinal ring.

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. 

• Inferior epigastric vessels run upwards & medially along the medial margin of deep inguinal ring.

• Indirect inguinal hernia enters inguinal canal through it.

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.

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.

INGUINAL TRIANGLE OF HASSELBACHS

• Peritoneal triangle in the posterior wall of the inguinal canal.

• Boundaries are:

– 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.

• Direct inguinal hernia enters the inguinal canal through this triangle.

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