Conjoint tendon A weakening of the conjoint tendon can precipitate a direct inguinal hernia. A direct inguinal hernia will protrude through Hesselbach's triangle, whose borders are the rectus abdominis (medially), inferior epigastric artery and vein (superolaterally), and the inguinal ligament (inferiorly). The hernia will lie medial to the inferior epigastric artery. This is in contrast to an indirect inguinal hernia, 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. Conjoint tendon The conjoint tendon (previously known as the inguinal aponeurotic falx) is a structure formed
Superficial epigastric artery Superficial epigastric artery The superficial epigastric artery (not to be confused with the superior epigastric artery) arises from the front of the femoral artery about 1 cm below the inguinal ligament, and, passing through the femoral sheath and the fascia cribrosa, turns upward in front of the inguinal ligament, and ascends between the two layers of the superficial fascia of the abdominal wall nearly as far as the umbilicus. It distributes branches to the superficial subinguinal lymph glands, the superficial fascia, and the integument; it anastomoses with branches of the inferior epigastric, and with its fellow of the opposite side.