A patient with an indirect inguinal hernia has the sac passing through the deep inguinal ring lateral to the inferior epigastric vessels. Which structure forms the inner boundary (posteromedial wall) of the deep inguinal ring that must be carefully preserved during herniorrhaphy?
- A Transversalis fascia forming an inverted U-shaped margin around the ring ✓
- B Conjoint tendon (inguinal falx)
- C Inferior epigastric vessels
- D Lacunar ligament
Explanation
The deep inguinal ring is an opening in the transversalis fascia, forming a U-shaped (or oval) hiatus. The transversalis fascia forms the margins of the ring and is the layer immediately surrounding the spermatic cord. Care must be taken not to injure this during herniorrhaphy, as it must be repaired to prevent recurrence. The inferior epigastric vessels lie medial to the ring (and are used as a landmark — the ring is lateral to them). The conjoint tendon reinforces the medial posterior inguinal wall, not the deep ring. The lacunar ligament forms the medial border of the femoral ring.
Reference: BD Chaurasia's Human Anatomy, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.