A 65-year-old man presents with a groin lump that descends through the femoral ring, medial to the femoral vein, and protrudes below the inguinal ligament. The neck of this femoral hernia lies in relation to which structures?

• A Medially by the femoral artery, laterally by pectineal muscle, anteriorly by iliopectineal arch
• B Medially by the pubic tubercle, laterally by the iliacus muscle, posteriorly by hip joint capsule
• C Medially by the lacunar ligament, laterally by the femoral vein, anteriorly by the inguinal ligament, and posteriorly by the pectineal (Cooper's) ligament ✓
• D Medially by conjoint tendon, laterally by inferior epigastric vessels, anteriorly by inguinal ligament

Explanation

The femoral ring (the abdominal opening of the femoral canal) is bounded: anteriorly by the inguinal ligament, posteriorly by the pectineal ligament (Cooper's ligament — a thickening of the periosteum over the superior pubic ramus), medially by the lacunar ligament (the turned-under medial part of the inguinal ligament, which is the sharp unyielding edge responsible for femoral hernia strangulation), and laterally by the femoral vein. Because the lacunar ligament is sharp and rigid, femoral hernias have the highest strangulation rate of all hernias. The medial femoral canal contains fat and lymphatics (including Cloquet's node).

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

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Written and medically reviewed by the StethoPrep medical team.