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Lacunar Ligament
The lacunar ligament, also named Gimbernat's ligament, is a ligament in the inguinal region. It connects the inguinal ligament to the pectineal ligament, near the point where they both insert on the pubic tubercle. Structure The lacunar ligament is the part of the aponeurosis of the external oblique muscle that is reflected backward and laterally and is attached to the pectineal line of the pubis. It is about 1.25 cm. long, larger in the male than in the female, almost horizontal in direction in the erect posture, and of a triangular form with the base directed laterally. Its ''base'' is concave, thin, and sharp, and forms the medial boundary of the femoral ring. Its ''apex'' corresponds to the pubic tubercle. Its ''posterior margin'' is attached to the pectineal line, and is continuous with the pectineal ligament. Its ''anterior margin'' is attached to the inguinal ligament. Its surfaces are directed upward and downward. Clinical significance The lacunar ligament is ...
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Inguinal Ligament
The inguinal ligament (), also known as Poupart's ligament or groin ligament, is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may develop. Structure The inguinal ligament runs from the anterior superior iliac crest of the ilium to the pubic tubercle of the pubic bone. It is formed by the external abdominal oblique aponeurosis and is continuous with the fascia lata of the thigh. There is some dispute over the attachments. Structures that pass deep to the inguinal ligament include: * Psoas major, iliacus, pectineus * Femoral nerve, artery, and vein * Lateral cutaneous nerve of thigh *Lymphatics Function The ligament serves to contain soft tissues as they course anteriorly from the trunk to the lower extremity. This structure demarcates the superior border of the femoral triangle. It demarcates the inferior border of the inguinal triangle. The midpoint ...
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Pubic Tubercle
The pubic tubercle is a prominent tubercle on the superior ramus of the pubis bone of the pelvis. Structure The pubic tubercle is a prominent forward-projecting tubercle on the upper border of the medial portion of the superior ramus of the pubis bone. The inguinal ligament attaches to it. Part of the abdominal external oblique muscle inserts onto it. The inferior epigastric artery passes between the pubic tubercle and the anterior superior iliac spine. The pubic spine is a rough ridge that extends from the pubic tubercle to the upper border of the pubic symphysis. Clinical significance The pubic tubercle may be palpated. It serves as a landmark for local anaesthetic A local anesthetic (LA) is a medication that causes absence of all sense, sensation (including pain) in a specific body part without loss of consciousness, providing local anesthesia, as opposed to a general anesthetic, which eliminates all sen ... of the genital branch of the genitofemoral nerve, whi ...
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Pectineal Line (pubis)
The pectineal line of the pubis (also pecten pubis) is a ridge on the superior ramus of the pubic bone. It forms part of the pelvic brim. Lying across from the pectineal line are fibers of the pectineal ligament, and the proximal origin of the pectineus muscle. In combination with the arcuate line, it makes the iliopectineal line. References External links * () {{Authority control Bones of the pelvis Pubis (bone) ...
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Inguinal Canal
The inguinal canal is a passage in the anterior abdominal wall on each side of the body (one on each side of the midline), which in males, convey the spermatic cords and in females, the round ligament of the uterus. The inguinal canals are larger and more prominent in males. Structure The inguinal canals are situated just above the medial half of the inguinal ligament. The canals are approximately 4 to 6 cm long, angled anteroinferiorly and medially. In males, its diameter is normally 2 cm (±1 cm in standard deviation) at the deep inguinal ring.The diameter has been estimated to be ±2.2cm ±1.08cm in Africans, and 2.1 cm ±0.41cm in Europeans. A first-order approximation is to visualize each canal as a cylinder. Walls To help define the boundaries, these canals are often further approximated as boxes with six sides. Not including the two rings, the remaining four sides are usually called the "anterior wall", "inferior wall ("floor")", "superior wall ("roof")", and "po ...
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Inguinal Ligament
The inguinal ligament (), also known as Poupart's ligament or groin ligament, is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may develop. Structure The inguinal ligament runs from the anterior superior iliac crest of the ilium to the pubic tubercle of the pubic bone. It is formed by the external abdominal oblique aponeurosis and is continuous with the fascia lata of the thigh. There is some dispute over the attachments. Structures that pass deep to the inguinal ligament include: * Psoas major, iliacus, pectineus * Femoral nerve, artery, and vein * Lateral cutaneous nerve of thigh *Lymphatics Function The ligament serves to contain soft tissues as they course anteriorly from the trunk to the lower extremity. This structure demarcates the superior border of the femoral triangle. It demarcates the inferior border of the inguinal triangle. The midpoint ...
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Pectineal Ligament
The pectineal ligament, sometimes known as the inguinal ligament of Cooper, is an extension of the lacunar ligament. It runs on the pectineal line of the pubic bone. The pectineal ligament is the posterior border of the femoral ring. Structure The pectineal ligament connects to the lacunar ligament, and therefore to the inguinal ligament. It connects to the pectineus muscle on its ventral and superior aspects. It connects to the rectus abdominis muscle, and the abdominal internal oblique muscle, of the anterior abdominal wall. The pectineal ligament is usually around 6 cm long in adults. It is close to the major vasculature of the pelvis, including external iliac vein. Clinical significance The pectineal ligament is strong, and holds suture well. This facilitates reconstruction of the floor of the inguinal canal. It is a useful landmark for pelvic surgery. A variant of non-prosthetic inguinal hernia repair, first used by Georg Lotheissen in Austria, now bears his nam ...
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Aponeurosis
An aponeurosis (; : aponeuroses) is a flattened tendon by which muscle attaches to bone or fascia. Aponeuroses exhibit an ordered arrangement of collagen fibres, thus attaining high tensile strength in a particular direction while being vulnerable to tensional or shear forces in other directions. They have a shiny, whitish-silvery color, are histologically similar to tendons, and are very sparingly supplied with blood vessels and nerves. When dissected, aponeuroses are papery and peel off by sections. The primary regions with thick aponeuroses are in the ventral abdominal region, the dorsal lumbar region, the ventriculus in birds, and the palmar (palms) and plantar (soles) regions. Anatomy Anterior abdominal aponeuroses The anterior abdominal aponeuroses are located just superficial to the rectus abdominis muscle. It has for its borders the external oblique, pectoralis muscles, and the latissimus dorsi. Posterior lumbar aponeuroses The posterior lumbar aponeuroses are sit ...
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External Oblique Muscle
The abdominal external oblique muscle (also external oblique muscle or exterior oblique) is the largest and outermost of the three flat abdominal muscles of the lateral anterior abdomen. Structure The external oblique is situated on the lateral and anterior parts of the abdomen. It is broad, thin, and irregularly quadrilateral, its muscular portion occupying the side, its aponeurosis the anterior wall of the abdomen. In most humans, the oblique is not visible, due to subcutaneous fat deposits and the small size of the muscle. It arises from eight fleshy digitations, each from the external surfaces and inferior borders of the fifth to twelfth ribs (lower eight ribs). These digitations are arranged in an oblique line which runs inferiorly and anteriorly, with the upper digitations being attached close to the cartilages of the corresponding ribs, the lowest to the apex of the cartilage of the last rib, the intermediate ones to the ribs at some distance from their cartilages. The ...
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Femoral Ring
The femoral ring is the opening at the proximal, abdominal end of the femoral canal, and represents the (superiorly directed/oriented) base of the conically-shaped femoral canal. The femoral ring is oval-shaped, with its long diameter being directed transversely and measuring about 1.25 cm.'''' The opening of the femoral ring is filled in by extraperitoneal fat, forming the femoral septum. Part of the intestine can sometimes pass through the femoral ring into the femoral canal causing a femoral hernia. Boundaries The femoral ring is bounded as follows:'''' * anteriorly by the inguinal ligament The inguinal ligament (), also known as Poupart's ligament or groin ligament, is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may .... * posteriorly by the pectineal ligament. * medially by the crescentic base of the lacunar ligament. * laterally by the fibro ...
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Femoral Canal
The femoral canal is the medial (and smallest) compartment of the three compartments of the femoral sheath. It is conical in shape. The femoral canal contains lymphatic vessels, and Adipose tissue, adipose and loose connective tissue, as well as - sometimes - a Cloquet's node, deep inguinal lymph node. The function of the femoral canal is to accommodate the distension of the femoral vein when venous return from the leg is increased or temporarily restricted (e.g. during a Valsalva maneuver). The proximal, abdominal end of the femoral canal forms the femoral ring. The femoral canal should not be confused with the nearby adductor canal. Anatomy The femoral canal is bordered: * anterosuperiorly by the inguinal ligament * posteriorly by the pectineal ligament lying anterior to the superior pubic ramus * Medially by the lacunar ligament * Laterally by the femoral vein Physiological significance The position of the femoral canal medially to the femoral vein is of physiologic importa ...
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Femoral Hernia
Femoral hernias are hernias which occur just below the inguinal ligament, when abdominal contents pass through a naturally occurring weakness in the abdominal wall called the femoral canal. Femoral hernias are a relatively uncommon type, accounting for only 3% of all hernias. While femoral hernias can occur in both males and females, almost all develop in women due to the increased width of the female pelvis. Femoral hernias are more common in adults than in children. Those that do occur in children are more likely to be associated with a connective tissue disorder or with conditions that increase intra-abdominal pressure. Seventy percent of pediatric cases of femoral hernias occur in infants under the age of one. Definitions A hernia is caused by the protrusion of a viscus (in the case of groin hernias, an intra-abdominal organ) through a weakness in the abdominal wall. This weakness may be inherent, as in the case of inguinal, femoral and umbilical hernias. On the other ...
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Obturator Artery
The obturator artery is a branch of the internal iliac artery that passes antero-inferiorly (forwards and downwards) on the lateral wall of the pelvis, to the upper part of the obturator foramen, and, escaping from the pelvic cavity through the obturator canal, it divides into an anterior branch and a posterior branch. Structure In the pelvic cavity this vessel is in relation, laterally, with the obturator fascia; medially, with the ureter, ductus deferens, and peritoneum; while a little below it is the obturator nerve. The obturator artery usually arises from the internal iliac artery. Inside the pelvis the obturator artery gives off iliac branches to the iliac fossa, which supply the bone and the Iliacus, and anastomose with the ilio-lumbar artery; a vesical branch, which runs backward to supply the bladder; and a pubic branch, which is given off from the vessel just before it leaves the pelvic cavity. The pubic branch ascends upon the back of the pubis, communicating with ...
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