Lacunar ligament

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Lacunar ligament
Gray394.png
The inguinal and lacunar ligaments. (Lacunar ligament labeled at center top.)
Details
From inguinal ligament, pubic tubercle
To pectineal line
Identifiers
Latin ligamentum lacunare (Gimbernati)
TA98 A04.5.01.010
TA2 2366
FMA 20184
Anatomical terminology

The lacunar ligament, also named Gimbernat's ligament, is a ligament in the inguinal region. [1] It connects the inguinal ligament to the pectineal ligament, [2] near the point where they both insert on the pubic tubercle. [3]

Contents

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 the only boundary of the femoral canal that can be cut during surgery to release a femoral hernia. Care must be taken when doing so as up to 25% of people have an aberrant obturator artery (corona mortis) which can cause significant bleeding. [4]

History

The lacunar ligament is sometimes called Gimbernat's ligament after Antoni de Gimbernat. [5]

Additional images

See also

Related Research Articles

<span class="mw-page-title-main">Inguinal canal</span> Human abdominal anatomy

The inguinal canal is a passage in the anterior abdominal wall on each side of the body, 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.

<span class="mw-page-title-main">Groin</span> The two creases at the junction of the torso with the thighs, on either side of the pubic area

In human anatomy, the groin also known as the inguinal region or iliac region, is the junctional area between the torso and the thigh. The groin is at the front of the body on either side of the pubic tubercle, where the lower part of the abdominal wall meets the thigh. A fold or crease is formed at this junction known as the inguinal groove, or crease. This is also the area of the medial compartment of the thigh that contains attachments of the adductor muscles of the hip or the groin muscles. The groin is the common site for a hernia.

<span class="mw-page-title-main">Inguinal ligament</span> Band running from the pubic tubercle to the anterior superior iliac spine

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.

<span class="mw-page-title-main">External iliac artery</span> Arteries of the pelvis

The external iliac arteries are two major arteries which bifurcate off the common iliac arteries anterior to the sacroiliac joint of the pelvis.

<span class="mw-page-title-main">Anterior superior iliac spine</span> Bony projection of the iliac bone

The anterior superior iliac spine (ASIS) is a bony projection of the iliac bone, and an important landmark of surface anatomy. It refers to the anterior extremity of the iliac crest of the pelvis. It provides attachment for the inguinal ligament, and the sartorius muscle. The tensor fasciae latae muscle attaches to the lateral aspect of the superior anterior iliac spine, and also about 5 cm away at the iliac tubercle.

<span class="mw-page-title-main">Inferior epigastric artery</span> Blood vessel

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 umbilical fold The inferior epigastric artery then traverses the arcuate line of rectus sheath to enter the rectus sheath, then anastomoses with the superior epigastric artery within the rectus sheath.

<span class="mw-page-title-main">Pubis (bone)</span> Most forward-facing of the three main regions making up the os coxa

In vertebrates, the pubis or pubic bone forms the lower and anterior part of each side of the hip bone. The pubis is the most forward-facing of the three bones that make up the hip bone. The left and right pubic bones are each made up of three sections, a superior ramus, inferior ramus, and a body.

<span class="mw-page-title-main">Conjoint tendon</span> Medial part of the posterior wall of the inguinal canal

The conjoint tendon is a sheath of connective tissue formed from the lower part of the common aponeurosis 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.

<span class="mw-page-title-main">Obturator artery</span>

The obturator artery is a branch of the internal iliac artery that passes antero-inferiorly 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.

In human anatomy, the inguinal region refers to either the groin or the lower lateral regions of the abdomen. It may also refer to:

Femoral hernias 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.

<span class="mw-page-title-main">Transversalis fascia</span> Aponeurosis between the transverse abdominal muscle and the extraperitoneal fat

The transversalis fascia is the fascial lining of the anterolateral abdominal wall situated between the inner surface of the transverse abdominal muscle, and the preperitoneal fascia. It is directly continuous with the iliac fascia, the internal spermatic fascia, and pelvic fascia.

<span class="mw-page-title-main">Pubic tubercle</span> Bone

The pubic tubercle is a prominent tubercle on the superior ramus of the pubis bone of the pelvis.

<span class="mw-page-title-main">Femoral ring</span> Base of the femoral canal

The femoral ring is the opening at the proximal, abdominal end of the femoral canal, and represents the 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.

<span class="mw-page-title-main">Femoral canal</span> Anatomy of the leg

The femoral canal is the medial compartment of the three compartments of the femoral sheath. It is conical in shape. The femoral canal contains lymphatic vessels, and adipose and loose connective tissue, as well as - sometimes - a 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.

<span class="mw-page-title-main">Iliac fascia</span> Fascia of the pelvis

The iliac fascia is the fascia overlying the iliacus muscle.

<span class="mw-page-title-main">Iliopubic tract</span>

The iliopubic tract is a thickened band of fibers curving over the external iliac vessels, at the spot where they become femoral, on the abdominal side of the inguinal ligaments and loosely connected with it. It is apparently a thickening of the transversalis fascia joined laterally to the iliac crest, and arching across the front of the femoral sheath to be inserted by a broad attachment into the pubic tubercle and pectineal line, behind the conjoint tendon. In some subjects this structure is not very prominently marked, and not infrequently it is altogether wanting. It can be of clinical significance in hernia repair.

<span class="mw-page-title-main">Pectineal ligament</span>

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.

<span class="mw-page-title-main">Aponeurosis of the abdominal external oblique muscle</span> Membranous structure

The aponeurosis of the abdominal external oblique muscle is a thin but strong membranous structure, the fibers of which are directed downward and medially.

<span class="mw-page-title-main">Crura of superficial inguinal ring</span>

The superficial inguinal ring is bounded below by the crest of the pubis; on either side by the margins of the opening in the aponeurosis, which are called the crura of the ring; and above, by a series of curved intercrural fibers.

References

PD-icon.svgThis article incorporates text in the public domain from page 412 of the 20th edition of Gray's Anatomy (1918)

  1. Lytle WJ (May 1979). "Inguinal anatomy". J. Anat. 128 (Pt 3): 581–94. PMC   1232909 . PMID   468709.
  2. Moore, K.L., & Agur, A.M. (2007). Essential Clinical Anatomy: Third Edition. Baltimore: Lippincott Williams & Wilkins. 128. ISBN   978-0-7817-6274-8
  3. Netter, Frank (2010). "Plate 255". Atlas of Human Anatomy. Saunders. ISBN   978-1-4160-5951-6.
  4. "Corona Mortis Archived 7 November 2017 at the Wayback Machine ". Medical Terminology Daily. Clinical Anatomy Associates, Inc. 4 December 2012. Retrieved 13 February 2017.
  5. Arráez-Aybar, LA & Bueno-López, JL. (2013). Antonio Gimbernat y Arbós: An Anatomist-surgeon of the Enlightenment (In the 220th Anniversary of his ‘‘A New Method of Operating the Crural Hernia’’). Clinical Anatomy 26:800–809