Location and anatomy
Lacunar ligament (lig. lacunare), also called Gimbernat's ligament [Gimbernat], is situated in the angle between the inguinal ligament and the pecten of the pubic bone (pecten ossis pubis). Anatomically, this structure is the medial continuation of the inguinal ligament (lig. inguinale) at the pubic tubercle.
Involvement in the formation of the inguinal canal
The inguinal canal (canalis inguinalis) is an oblique, slit-like canal about 4–5 cm long, located in the lower part of the anterolateral abdominal wall. It lies 1.0–1.5 cm superior and parallel to the inguinal ligament. The canal runs obliquely lateromedially and craniocaudally from the superficial inguinal ring to the deep ring. The lacunar ligament participates in the formation of its inferior wall.
Walls of the inguinal canal:
- Floor (inferior wall) — formed by the inguinal ligament (lig. inguinale), which medially, near the pubic tubercle, continues into the lacunar ligament (lig. lacunare).
- Anterior wall — aponeurosis of the external oblique abdominal muscle (laterally reinforced by fibers of the internal oblique).
- Posterior wall — transversalis fascia (fascia transversalis), medially reinforced by the conjoined tendon (falx inguinalis / conjoined tendon) and lig. interfoveolare.
- Roof (superior wall) — arched inferior borders of the internal oblique and transversus abdominis muscles.
Inside the canal, the spermatic cord (funiculus spermaticus) passes in men, and the round ligament of the uterus (lig. teres uteri) with the neurovascular bundle in women.
Topography of the vascular and muscular lacunae
The space inferior to the inguinal ligament is divided into two lacunae. The vascular lacuna (lacuna vasorum) lies medial to the muscular lacuna.
Walls of the vascular lacuna:
- Medially — lacunar ligament (lig. lacunare).
- Anteriorly — inguinal ligament.
- Posteriorly — pecten of the pubic bone.
- Laterally — iliopectineal arch (arcus iliopectineus).
The contents of the vascular lacuna include the femoral vein (located medially), the femoral artery (located laterally), and the femoral branch of the genitofemoral nerve.
By comparison, the muscular lacuna (lacuna musculorum) corresponds to the lateral 2/3 of the inguinal ligament. It is bounded anteriorly by the inguinal ligament, posteriorly by the pecten of the pubic bone, and medially by the iliopectineal arch. Through it, the iliopsoas muscle (m. iliopsoas) and the femoral nerve (n. femoralis) emerge onto the anterior surface of the thigh.
Clinical significance: hernias and surgery
The deep femoral ring (anulus femoralis) is the deep opening of the femoral canal through which a hernia can protrude from the abdominal cavity. The ring is located in the most medial part of the vascular lacuna.
Boundaries of the deep femoral ring (4 borders):
- Medially — lacunar ligament (lig. lacunare).
- Anteriorly — inguinal ligament.
- Posteriorly — pectineal ligament (lig. pectineale, Cooper's ligament [Cooper]), located on the pecten of the pubic bone.
- Laterally — femoral vein.
The femoral canal (canalis femoralis) normally contains lymphatic structures, and in the case of a hernia, a hernia sac that opens into the saphenous opening (hiatus saphenus) beneath the fascia lata of the thigh. The inguinal ligament serves as the superior boundary during standard inguinal-femoral lymphadenectomy and as the base of the femoral triangle.
Class and exam questions
What structures bound the deep femoral ring?
Anteriorly, the ring is bounded by the inguinal ligament; posteriorly, by the pectineal ligament (Cooper's); medially, by the lacunar ligament (Gimbernat's); and laterally, by the femoral vein.
Where exactly is the lacunar ligament located?
It is located in the angle between the inguinal ligament and the pecten of the pubic bone. Anatomically, it is the medial continuation of the inguinal ligament at the pubic tubercle.
In the formation of which spaces does the lacunar ligament participate?
It forms the medial wall of the vascular lacuna (lacuna vasorum) and the medial boundary of the deep femoral ring (anulus femoralis).
What is the relationship of the lacunar ligament to the inguinal canal?
It is the medial continuation of the inguinal ligament, which in turn forms the floor (inferior wall) of the inguinal canal.
What else to study on this topic
- Inguinal canal and its walls
- Vascular and muscular lacunae
- Femoral canal and deep femoral ring
- Femoral triangle
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