Six relationships to use before memorising a diagnosis.
The dividing landmark for inguinal sacs
Inferior epigastric vessels
A sac neck medial to these vessels points to a direct route; a neck lateral to them entering the deep ring points to an indirect route. Classify by the neck of the sac, rather than the direction of a large swelling.
Relationship map · not a physical anatomical illustration
Above the inguinal ligament
Below the inguinal ligament
References and further reading
Original Clinora learning material. Reference check: 2 October 2026. Some descriptions vary between anatomy texts; this lesson distinguishes conventional exam relationships from real anatomical variation.