QS Study

The inguinal region of the body, also known as the groin, is located on the lower portion of the anterior abdominal wall, with the thigh inferiorly, the pubic tubercle medially, and the anterior superior iliac spine (ASIS) superolaterally.

Inguinal canal

The inguinal canal is a passage in the anterior abdominal wall that transmits structures from the pelvis to the perineum formed by the fetal migration of the gonad from the abdomen into the labioscrotal folds. It is a musculoaponeurotic tunnel about 4cm. in length and extends from the deep inguinal ring to superficial inguinal ring. Because of the weakness, the inguinal canal creates in the abdominal wall, it is the most frequent site for a hernia.

  • Length – 4 cm long.
  • Direction: Downwards, forwards and medially.
  • Extension – From deep inguinal ring to the superficial inguinal ring.

Boundaries

(A) Anterior wall: aponeurosis of the external oblique, reinforced by the internal oblique muscle laterally.

(i) In its whole extent –

  1. Skin;
  2. Superficial fascia;
  3. External oblique aponeurosis.

(ii) In its lateral 1/3 – Fleshy fibers of the internal oblique muscle.

(B) Posterior wall: transversalis fascia.

(i) In its whole extent –

  1. Fascia transversal;
  2. Extraperitoneal tissue;
  3. Parietal peritoneum.

(ii) In its medial 2/3 – Conjoint tendon.

(iii) At its medial end – Reflected part of the inguinal ligament.

(iv) In its lateral 1/3 – Interfoveolar ligament.

(C) Roof: Formed by the arched fibers of the internal oblique and transversus abdominis. (Transversalis fascia, internal oblique, and transversus abdominis)

(D) Floor: Formed by the grooved upper surface of the inguinal ligament, and at the medial end by a lacunar ligament.

Fig: Spermatic cord Inguinal canal

Contents

In male – (1) Spermatic cord, and (2) Ilioinguinal nerve.

In female – (1) Round ligament of uterus (2) Ilioinguinal nerve.

Clinical importance

The presence of the inguinal canal is a cause of weakness in the lower part of an anterion abdominal wall. So, abnormal protrusion of abdominal contents such as greater omentum and intestine may come into the canal or through the canal due to the rise of intra abdominal pressure, chronic cough, heavy weight lifting, labor etc., results in an inguinal hernia. A hernia that exits the abdominal cavity directly through the deep layers of the abdominal wall, thereby bypassing the inguinal canal, is known as a direct inguinal hernia.