ANATOMY OF

INGUINAL CANAL
Dr Vishnu Mohan
29/11/2014
Inguinal Canal
This is an oblique
intermuscular passage in the
lower part of the anterior
abdominal wall ,
Situated just above the
medial half of the inguinal
ligament
Inguinal Canal

Location
Inferior part of
the anterolateral
abdominal wall
 Length & direction

It is about 4cm(1.5 inches) long,

and is directed downwards,
forwards and medially
The inguinal canal extends from
the deep inguinal ring to the
superficial inguinal ring
 A Box?

Roof Poster
ior wall
Anteri
o r wa l
l

Lateral

Floor

Imagine the right side inguinal canal viewed from the

Medial
front as a box with anterior & posterior walls, a roof &
floor. The arrow indicates that structures can run
through it from lateral to medial e.g. in males it
transmits the spermatic cord, and in females, the round
ligament of the uterus.
Deep inguinal ring

An oval opening in the fascia

transversalis situated 1.2 cm
above the midinguinal point, and
immediately lateral to the stem
of the inferior epigastric artery
 Inguinal canal
Deep inguinal ring

Medial

Here are the posterior wall, which has the DEEP Floor
inguinal ring situated laterally, and the floor. (Roof
and anterior wall removed).
 Superficial inguinal ring

Is a triangular gap in the external oblique

aponeurosis . It is shaped like an obtuse
angled triangle . The base of the triangle is
formed by the pubic crest, the two sides of the
triangle from the lateral or lower and the
medial or upper margins of the opening. It is
2.5 cm long and 1.2 cm broad at the base
these margins are referred as crura. At
and beyond the apex of the triangle 2 crura
are united by intercrural fibers
 Inguinal canal

Roo
f

Anteri
or wall

Medial

Superficial inguinal ring Floor

Here are the anterior wall (which has the

SUPERFICIAL inguinal ring situated medially), and the
roof.
BOUNDARIES OF INGUINAL
CANAL
THE ANTERIOR WALL
1.In its whole extent
a. Skin
b. Superficial fascia
c. External oblique aponeurosis
2.In its lateral one-third
The fleshy fibres of the internal
oblique muscle.
 Inguinal canal
The anterior wall is made up of the
external oblique muscle throughout,
and is reinforced by the
internal oblique m. laterally.
The transversus abdominus m. lies
even more laterally as part of the
anterior abdominal wall.

Superficial inguinal ring

13
 THE POSTERIOR
WALL
1.In its whole extent
a. The fascia transversalis
b. The extra peritoneal tissue
c. The parietal peritoneum.
2.In its medial two-thirds
a. The conjoint tendon
b. At its medial end by the reflected
part of the inguinal ligament.
Posterior wall of the inguinal canal
Posterior wall
Deep inguinal ring Conjoint tendon medially

The posterior wall is formed by transversalis fascia

(orange) throughout and the conjoint tendon (red)
medially. The wall is particularly weak over the
deep inguinal ring 15
Inguinal canal The conjoint tendon
attaches to the pubic crest,
reinforces the posterior
Conjoint tendon canal wall medially and
also forms the ROOF of the
canal

Poste
rior w
all

The transversus abdominis and

internal oblique mm. combine Floor
to form the CONJOINT tendon
that arches over the contents of
Spermatic cord
the inguinal canal 16
ROOF OF THE INGUINAL CANAL

It is formed by the arched

fibres of the internal oblique
and transverse abdominis
muscles.
Roof and anterior wall of the
inguinal canal
Roof
is
tendo formed b
n y the
anter and the c
io r a n meet onjoint
the c d pos in
anal terior g of the
wa ll s
of Superficial inguinal ring
Anteri
or wal
l

The anterior wall of the canal is formed by external oblique

muscle (orange) throughout and by internal oblique
muscles (red/black/white) laterally. This wall is weak
medially because of the hole in the external oblique
18
muscle (= superficial inguinal ring).
 FLOOR
It is formed by the grooved
upper surface of the inguinal
ligament; and at the medial
end by the lacunae ligament
Floor of the inguinal
canal

The floor is formed by an incurving of the inguinal Floor

ligament, which is part of the external oblique
muscle, forming a gutter. (Medially it forms the
lacunar ligament which is not illustrated). 20
 SEX DIFFERENCE

The inguinal canal is

larger in males than in
females.
 STRUCTURES PASSING
THROUGH THE CANAL
1.The spermatic cord in males, or the
round ligament of the uterus in
females, enters the inguinal canal
through the deep inguinal ring and
passes out through the superficial
inguinal ring.
2.The ilioinguinal nerve enters the
canal through the interval between
the external and internal oblique
muscles and passes out through the
superficial inguinal ring.
 Inguinal canal
Spermatic cord enters
Deep inguinal ring the inguinal canal
through the deep
inguinal ring

Poste
rior w
a ll

Medial

Superficial inguinal ring

Spermatic Floor
cord exits
through the
superficial
inguinal ring
 Inguinal canals why
have them?
Allow contents of the scrotum to
communicate with intra-abdominal
contents
Prevent mobile intra-abdominal
contents (e.g. intestine) from
entering the scrotum and possibly
becoming damaged, while at the
same time permitting blood vessels,
nerves, lymphatics, vas deferens etc.
 MECHANISM OF
INGUINAL CANAL
The presence of the inguinal
canal is the cause of weakness
in the lower part of the
anterior abdominal wall. This
weakness is compensated by
the following factors
 Obliquity of the
inguinal canal

The two inguinal rings do not lie

opposite to each other. Therefore,
when the intra-abdominal pressure
rises the anterior and posterior walls
of the canal are approximated, thus
obliterating the passage. This is
known as the flap valve
mechanism.
The superficial inguinal ring
is guarded from behind by the
conjoint tendon and by the
reflected part of the inguinal
canal.
The deep inguinal ring is
guarded from the front by the
fleshy fibres of the internal
oblique.
 Shutter mechanism of
the internal oblique
This muscle has a triple relation to
the inguinal canal. It forms the
anterior wall, the roof, and the
posterior wall of the canal. When it
contracts the roof is approximated
to the floor, like a shutter.
 Ball valve mechanism

Contraction of the cremaster

helps the spermatic cord to
plug the superficial inguinal
ring
 Slit valve
mechanism
Contraction of the external
oblique results in approximation
of the two crura of the superficial
inguinal ring . The integrity of the
superficial inguinal ring is greatly
increased by the intercrural fibres.
 Hormones
may play a role in maintaining
the tone of the inguinal
musculature
Whenever, there is a rise in intra
abdominal pressure as in
coughing , sneezing, lifting heavy
weights all these mechanisms come
to play, so that the inguinal canal is
obliterated, its openings are
closed, and herniation of abdominal
viscera is prevented.
STRUCTURES RELATED WITH
INGUINAL CANAL
From within outwards, these are as
follows:

1.The internal spermatic fascia ,

derived from the fascia transversalis;
it covers the cord in its whole extent .

2.The cremasteric fascia is made up of

the muscle loops costituting the
cremaster muscle, and the
intervening areolar tissue. It is derived
from the internal oblique and
 Round ligament of
uterus
The round ligaments are two
fibro muscular flat bands ,10 to
12 cm long, which lie between
the two layers of broad
ligament , begins at the lateral
angle of the uterus, passes
through the deep inguinal ring
,traverses the inguinal canal and
merges with the areolar tissue of
the labium majus
HESSELBACHS TRIANGLE
Hesselbachs (Inguinal) Triangle
is an important structure as it is
the site for direct hernias. The
triangle has the following
borders:
1) Medial border of rectus
abdominus(medially)
2) Inguinal ligament (inferiorly)
3) Inferior epigastric
CLINICAL ANATOMY OF
INGUINAL CANAL
A Brief Mention of Hernias
Hernias are abnormal outpouchings of the
abdominal contents (such as the small
intestine) from the cavity in which they
belong. There are two main types of hernias
that occur at the inguinal region. Direct
hernia and indirect hernia.

.
The posterior wall of the canal is particularly
weak laterally because of the deep inguinal ring
The anterior wall opposite the deep ring is
reinforced laterally by the internal oblique
muscles.
A hernia (e.g. of small bowel) that comes
through the deep inguinal ring will have to
travel along the inguinal canal as it cannot
push into the reinforced layers of muscle in the
anterior wall of the canal directly opposite the
deep inguinal ring
The anterior wall of the canal is weak medially
where the superficial inguinal ring is situated
The posterior wall, opposite the superficial
ring, is reinforced medially by the conjoint
tendon that is formed by fibres of the internal
oblique and transversus abdominis muscles
Abdominal contents cannot normally force
themselves through the superficial ring
directly because of the reinforced posterior
wall medially
Indirect or oblique
hernia
These are the most common inguinal
hernias, in this the contents of the
abdomen enter the deep inguinal ring and
traverse the whole length of the inguinal
canal to come out through the superficial
inguinal ring
Coverings of indirect hernias
Peritoneum
Internal spermatic fascia
(from transversalis fascia)
Cremaster muscle & fascia
(from transversus abdominis and
internal oblique mm.)
External spermatic fascia
(from external oblique m.)
Superficial fascia
Skin

44
Direct Hernias
Direct hernias occurs lateral to the epigastric
vessels. They do not protrude through any
ring, but through an area of weakness in the
posterior wall of the inguinal canal; this area
is likely to be Hesselbachs Triangle. The
hernia is often parallel to the spermatic cord,
but almost never enters the scrotum
Coverings of direct hernias
Peritoneum
Transversalis fascia
Conjoint tendon
External oblique aponeurosis
Superficial fascia
Skin

46
Inguinal hernia results because pressure
finds weak spot at inguinal canal
THANK YOU