also known as superior tendon of abdominal cavity. 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, a group of cells that are similar in structure, along with epithelial tissue, muscle tissue, and nervous tissue. It develops mostly from the mesenchyme, derived from the mesod ...

formed from the lower part of the common

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 ...

of the

abdominal internal oblique muscle The abdominal internal oblique muscle, also internal oblique muscle or interior oblique, is an abdominal muscle in the abdominal wall that lies below the external oblique muscle and just above the transverse abdominal muscle. Structure Its fib ...

and the

transversus abdominis muscle The transverse abdominal muscle (TVA), also known as the transverse abdominis, transversalis muscle and transversus abdominis muscle, is a muscle layer of the anterior and lateral (front and side) abdominal wall, deep to (layered below) the inter ...

, joining the muscle to the

pelvis The pelvis (: pelves or pelvises) is the lower part of an Anatomy, anatomical Trunk (anatomy), trunk, between the human abdomen, abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also c ...

. It forms the medial part of the posterior wall of the

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 lar ...

Structure

The conjoint tendon is formed from the lower part of the common aponeurosis of the

and the

. 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 pubis (bone), pubic bone. It gives attachment to the conjoint tendon, the rectus abdominis, the abdominal external oblique muscle, and the ...

and the pectineal line immediately behind the

superficial inguinal ring 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 large ...

. 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 vi ...

. A weakening of the conjoint tendon can precipitate a direct inguinal hernia. A

direct inguinal hernia An inguinal hernia or groin 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 abse ...

will protrude through Hesselbach's triangle, whose borders are the

rectus abdominis The rectus abdominis muscle, () also known as the "abdominal muscle" or simply better known as the "abs", is a pair of segmented skeletal muscle on the ventral aspect of a person, person's abdomen. The paired muscle is separated at the midline b ...

(medially),

inferior epigastric artery In human anatomy, the inferior epigastric artery is an artery that arises from the external iliac artery. It is accompanied by the inferior epigastric vein; inferiorly, these two inferior epigastric vessels together travel within the lateral um ...

and inferior epigastric vein (superolaterally), and 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 ...

(inferiorly). The hernia lies medial to the inferior epigastric artery. This is in contrast to an

indirect inguinal hernia An inguinal hernia or groin 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 ...

, 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