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, along with epithelial tissue, muscle tissue, and nervous tissue. It develops from the mesenchyme derived from the mesoderm the middle embryonic germ layer. Connective tiss ...

formed from the lower part of the common

aponeurosis An aponeurosis (; plural: ''aponeuroses'') is a type or a variant of the deep fascia, in the form of a sheet of pearly-white fibrous tissue that attaches sheet-like muscles needing a wide area of attachment. Their primary function is to join musc ...

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 fiber ...

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 which is deep to (layered below) t ...

, joining the muscle to the

pelvis The pelvis (plural pelves or pelvises) is the lower part of the trunk, between the abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also called bony pelvis, or pelvic skeleton). The ...

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

inguinal canal The inguinal canals are the two passages in the anterior abdominal wall of humans and animals 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. ...

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 pubic bone. It gives attachment to the conjoint tendon, the rectus abdominis, the abdominal external oblique muscle, and the pyramidalis m ...

and the pectineal line immediately behind the superficial inguinal ring. It is usually conjoint with the tendon of the

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 fibe ...

, 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 v ...

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

direct inguinal hernia An inguinal 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 in about a third ...

will protrude through

Hesselbach's triangle In human anatomy, the inguinal triangle is a region of the abdominal wall. It is also known by the eponym Hesselbach's triangle, after Franz Kaspar Hesselbach. Structure It is defined by the following structures: * Medial border: Lateral margin ...

, whose borders are the

rectus abdominis The rectus abdominis muscle, ( la, straight abdominal) also known as the "abdominal muscle" or simply the "abs", is a paired straight muscle. It is a paired muscle, separated by a midline band of connective tissue called the linea alba. It exte ...

(medially),

inferior epigastric artery In human anatomy, inferior epigastric artery refers to the artery that arises from the external iliac artery. It anastomoses with the superior epigastric artery. Along its course, it is accompanied by a similarly named vein, the inferior epig ...

and

inferior epigastric vein In human anatomy, inferior epigastric vein refers to the vein that drains into the external iliac vein and anastomoses from the superior epigastric vein. Along its course, it is accompanied by a similarly named artery, the inferior epigastri ...

(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 dev ...

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

indirect inguinal hernia An inguinal hernia is a hernia (protrusion) of abdominal cavity, 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