The conjoint tendon (previously known as the inguinal aponeurotic falx) is a sheath of

connective tissue Connective tissue is one of the four primary types of animal tissue, along with epithelial tissue, muscle tissue, and nervous tissue. It develops from the mesenchyme derived from the mesoderm the middle embryonic germ layer. Connective tissue ...

formed from the lower part of the common

aponeurosis An aponeurosis (; plural: ''aponeuroses'') is a type or a variant of the deep fascia, in the form of a sheet of pearly-white fibrous tissue that attaches sheet-like muscles needing a wide area of attachment. Their primary function is to join muscl ...

of the abdominal internal oblique muscle and the transversus abdominis muscle, joining the muscle to the pelvis. It forms the medial part of the posterior wall of the

inguinal canal The inguinal canals are the two passages in the anterior abdominal wall of humans and animals 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 conjoint tendon is formed from the lower part of the common aponeurosis of the abdominal internal oblique muscle and the transversus abdominis muscle. It inserts into the

pubic crest Medial to the pubic tubercle is the pubic crest, which extends from this process to the medial end of the pubic bone. It gives attachment to the conjoint tendon, the rectus abdominis, the abdominal external oblique muscle, and the pyramidal ...

and the pectineal line immediately behind the

superficial inguinal ring The inguinal canals are the two passages in the anterior abdominal wall of humans and animals 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. T ...

. It is usually conjoint with the tendon of the internal oblique muscle, but they may be separate as well. It forms the medial part of the posterior wall of the

Clinical significance

The conjoint tendon serves to protect what would otherwise be a weak point in the

abdominal wall In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls. There is a common set of layers covering and forming all the walls: the deepest being the v ...

. A weakening of the conjoint tendon can precipitate a direct inguinal hernia. A direct inguinal hernia will protrude through Hesselbach's triangle, whose borders are the

rectus abdominis The rectus abdominis muscle, ( la, straight abdominal) also known as the "abdominal muscle" or simply the "abs", is a paired straight muscle. It is a paired muscle, separated by a midline band of connective tissue called the linea alba. It exte ...

(medially), inferior epigastric artery and inferior epigastric vein (superolaterally), and the inguinal ligament (inferiorly). The hernia lies medial to the inferior epigastric artery. This is in contrast to an

indirect inguinal hernia An inguinal hernia is a hernia (protrusion) of abdominal-cavity contents through the inguinal canal. Symptoms, which may include pain or discomfort especially with or following coughing, exercise, or bowel movements, are absent in about a third ...

, which will protrude laterally to the inferior epigastric artery and is most commonly due to an embryological defect in the closure of the deep inguinal ring.

History

The conjoint tendon is also known as the inguinal aponeurotic falx, and Henle's ligament.

Additional images

File:Slide4Nemo.JPG, Anterior abdominal wall.Intermediate dissection.Anterior view

References

External links