Where is the deep inguinal ring located?
The ring is located in the lower part of the transversalis fascia (fascia transversalis), which lines the transversus abdominis muscle from the inside, forms the posterior wall of the inguinal canal, and is fused with the parietal peritoneum.
From the peritoneal cavity side, the deep ring corresponds to the lateral inguinal fossa (fossa inguinalis lateralis). This fossa is paired and lies lateral to the lateral umbilical fold. An important topographical landmark is the inferior epigastric vessels (a. et v. epigastricae inferiores): the deep inguinal ring is located lateral to them.
Structure
The structure is an oval opening in the fascia transversalis measuring approximately 2.5–3.0 × 1.0–2.5 cm.
The margins of the ring are reinforced by fibers of the transversalis fascia. At the site of the internal opening of the inguinal canal, the transversalis fascia forms a funnel-shaped depression extending into the inguinal canal.
This is the origin of the internal spermatic fascia (fascia spermatica interna)—an extension of the transversalis fascia covering the spermatic cord and testis.
Topography and relation to the inguinal triangle (Hesselbach's triangle)
The inguinal canal runs obliquely lateromedially and craniocaudally: from the superficial inguinal ring posteriorly, superiorly, and laterally toward the deep inguinal ring.
The roof of the inguinal canal is formed by the arching lower borders of the internal oblique and transversus abdominis muscles.
The degree of protection of the deep ring depends on the shape of the inguinal triangle:
- Slit-oval shape: the internal oblique muscle adequately covers the deep inguinal ring. Upon contraction, it exerts a sphincter-like valve function, archwise compressing the spermatic cord. This provides good protection against hernias.
- Triangular shape: the internal oblique muscle runs horizontally toward the rectus sheath; the posterior wall of the canal is largely uncovered by muscles, and the valve function is absent. This creates favorable conditions for the development of inguinal hernias.
What passes through the deep inguinal ring?
The contents of the inguinal canal vary depending on sex:
- In males: the spermatic cord (funiculus spermaticus). Its structures include: ductus deferens, a. testicularis, plexus pampiniformis of veins, a./v. cremasterica, a. ductus deferentis, lymphatic vessels, ramus genitalis n. genitofemoralis, and sympathetic and parasympathetic fibers.
- In females: the round ligament of the uterus (lig. teres uteri) with its neurovascular bundle.
Clinical significance: hernias and surgeries
The deep inguinal ring is associated with the pathway of an indirect inguinal hernia: the hernia enters through the deep inguinal ring, traverses the entire inguinal canal, and exits through the superficial ring. An indirect inguinal hernia lies within the spermatic cord beneath the internal spermatic fascia; the elements of the cord closely adhere to the sac. It may descend into the scrotum in males or the labium majus in females.
Surgical aspects:
- When dissecting the deep ring in incarcerated hernias, the medially located inferior epigastric vessels must be taken into account to avoid damaging them.
- During inguinal canal plastic repair according to Girard–Spasokukotsky and Kimbarovsky, it is important to create the opening without compressing the elements of the spermatic cord. Before tying the final suture, the little finger is inserted into the deep ring.
- In Postempski's autoplasty, the deep inguinal ring is displaced laterally; the inguinal canal is completely obliterated, and the spermatic cord is relocated into the subcutaneous tissue.
Class and exam questions
What is the difference between the pathways of indirect and direct inguinal hernias relative to the deep ring?
An indirect inguinal hernia enters the canal through the deep inguinal ring and is located inside the spermatic cord. A direct inguinal hernia protrudes in the region of the medial inguinal fossa, stretches the posterior wall of the canal, and is located outside the spermatic cord.
Which fascia forms the deep inguinal ring?
The deep inguinal ring is formed by the transversalis fascia (fascia transversalis).
Which vessels serve as an important landmark during the dissection of the deep ring?
The inferior epigastric artery and vein (a. et v. epigastricae inferiores). They are located medially to the deep inguinal ring.
What else to study on this topic
- Inguinal canal (canalis inguinalis)
- Superficial inguinal ring (anulus inguinalis superficialis)
- Transversalis fascia (fascia transversalis)
- Indirect and direct inguinal hernias
Study the complete topic in the Anatomy course
This is a summary. The course covers everything tested in classes and exams.
- Complete study guide on the "Deep inguinal ring" topic and 1,363 other pages of the subject
- Assignments and quizzes after every topic — just like in a colloquium
- AI tutor answers questions on the topic anytime
- 295 video lessons by subject
Other topics in the "Anatomical Structures" section
Free video lessons: AnatomyShort lessons with study notes — no registration required.
Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.