3.3.

11
The inguinal canal
(3:55)

Now well move on to look at the inguinal region. An important feature that well see is a structure that
passes obliquely through the abdominal wall, just above the inguinal ligament. In the female the structure
is the round ligament of the uterus; in the male its the spermatic cord, the lifeline of the testis. The
passage that this structure passes through is called the inguinal canal. Well start by taking a more detailed
look at the inguinal ligament.

In this dissection, the body has been divided in the midline. Heres the anterior superior iliac spine, heres
the pubic symphysis. Heres the inguinal ligament. Its the lowest part of the external oblique aponeurosis.
Laterally, the ligament is attached to the anterior superior iliac spine. Medially, its attached to the pubic
tubercle. The cut edge here was created by dividing the external oblique aponeurosis along this line.

The edge of the inguinal ligament cant be seen from the outside because the fascia lata, the investing
deep fascia of the thigh, is attached to the ligament along here.

To see the edge of the ligament well go round to the inside. Heres the edge of the ligament. The ilo-
psoas fascia, which has been removed in this dissection, comes down over the iliopsoas, and is attached to
the ligament along here.

The lowest fibers of the inguinal ligament curl around to form this triangular extension, the lacunar
ligament. The lacunar ligament runs backwards and a little upwards, to insert on the sharp upper edge of
the superior pubic ramus, the pecten.

Heres transversus. Its lowest fibers arise from a thickening of theunderlying ilio-psoas fascia.. Now well
add the internal oblique to the picture.

Here it is. The lowest fibers of the internal oblique arise from the same thickening of the ilio-psoas fascia.
The tendinous fibers of these two muscles arch over and unite, to form this flat tendon, the conjoint
tendon. The conjoint tendon is attached to the pubic crest, and also behind, to the pecten.

Now well bring this lowest part of the external oblique aponeurosis up to its natural position, and add the
rest of the aponeurosis to the picture. Here it is. Theres an opening in the external oblique aponeurosis,
the superficial inguinal ring. Through this the spermatic cord (or the round ligament) passes as well see
shortly.

The fibers below and above the opening are called the inferior crus and the superior crus of the superficial
inguinal ring. Theyre attached to the pubic tubercle, and the pubic crest respectively.

The inguinal canal passes through the superficial inguinal ring, then beneath the free borders of the
internal oblique muscle, and the transversus abdominis muscle.

To see where the inguinal canal begins, we'll go tround to the inside. It begins at this arch beneath the
lower border of transversus, which is called the deep inguinal ring.