Answer to Technicalities: Read the Fine Print
Correct answer is D, the deep inguinal ring. To answer this question correctly, it is necessary to read the stem of the question carefully. It is asking you where a piece of small bowel, a hernia, will enter the inguinal canal in older men. While you may think that the region indicated by C, the area of the femoral sheath is an option, this would be classified as a femoral hernia and they are more frequent in women. A femoral hernia is also not an inguinal hernia. But why is the superficial inguinal ring not a correct answer? Again, one must read the stem of the question carefully. You are being asked where does the hernia enter the inguinal canal, not where it exits. Once the hernia exits there, it is exiting the inguinal canal into the scrotum. Hence, the only answer that is plausible is B.
= Superficial inguinal ring
= Inguinal ligament
= Area of femoral sheath
= Deep inguinal ring
= Arcuate line
Answer to this question is based on material presented in lectures 7 of the Abdomen Lecture Series.
