A surgeon exploring an indirect inguinal hernia notes that the sac passes through the deep inguinal ring, traverses the inguinal canal, and exits through the superficial ring. The deep inguinal ring is located in relation to which structure?

• A A defect in the external oblique aponeurosis, 1 cm above the midpoint of the inguinal ligament
• B A defect in the transversalis fascia, 1.25 cm above the midpoint of the inguinal ligament (midpoint between ASIS and pubic symphysis) ✓
• C At the lateral edge of the rectus abdominis, at the level of the pubic tubercle
• D A defect in the internal oblique, directly above the femoral vessels

Explanation

The deep inguinal ring is a U-shaped defect in the transversalis fascia situated approximately 1.25 cm above the midpoint of the inguinal ligament (i.e., the midinguinal point, midway between the anterior superior iliac spine and the pubic symphysis). The inferior epigastric vessels lie medial to the deep ring; an indirect hernia passes lateral to these vessels, while a direct hernia bulges medial to them through Hesselbach's triangle. The external oblique aponeurosis, not the transversalis fascia, forms the superficial ring.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.