1.3 Inguinal Canal Flashcards
When is the inguinal canal formed?
During the relocation of the gonads during foetal development
What is the inguinal canal formed from?
Layers of anterior abdominal wall as these layers push through the wall obliquely, thus forming a canal
How long is the inguinal canal?
Approx 4cm
Where does the inguinal canal lie in relation to the medial half of the inguinal ligament?
Parallel to and above
Which 2 bony points of the hip bone is the inguinal ligament attached to?
Superolaterally = anterior superior iliac crest Inferomedially = pubic tubercle
What are the boundaries of the inguinal ligament?
Anterior wall
Posterior wall
Roof
Floor
What forms the anterior wall of the inguinal canal?
‘2 Aponeuroses’
Aponeurosis of external oblique reinforced laterally by aponeurosis of internal oblique
What forms the posterior wall of the inguinal canal?
‘2 Ts’
Transversalis fascia
Conjoint Tendon
What forms the roof of the inguinal canal?
'2 Muscles' Internal oblique Transversus abdominis (laterally by transversalis fascia) (medially by medial crus and intercrural fibres)
What forms the floor of the inguinal canal?
‘2 Ligaments’
Inguinal ligament
(thickened by) Lacunar ligament
What is found in the medial 1/3rd of the anterior wall of the inguinal canal?
The superficial inguinal ring
What is found in the lateral 1/3rd of the anterior wall of the inguinal canal?
The muscular part of the internal oblique
What is found in the medial 1/3rd of the posterior wall of the inguinal canal?
The conjoint tendon
What is found in the lateral 1/3rd of the posterior wall of the inguinal canal?
The deep inguinal ring
What is the inguinal ligament?
A ‘rolled up’ portion of the external oblique aponeurosis
Where is the deep inguinal ring situated?
An opening found superiorly
Where is the superficial inguinal ring situated?
An opening found inferiorly
What is the relationship of the deep inguinal ring to the inferior epigastric vessels?
It is lateral to the inferior epigastric artery/vein
Where does the superficial ring lie in relation to the pubic tubercle?
Ring is bound superolaterally by tubercle
What are the epigastric vessels branches of superiorly?
Internal thoracic artery
What are the epigastric vessels branches of inferiorly?
External iliac artery
List the contents of the male inguinal canal?
- spermatic cord
- blood & lymphatic vessels
- ilioinguinal nerve
List the contents of the female inguinal canal?
- round ligament of uterus
- blood & lymphatic vessels
- ilioinguinal nerve
What are the 3 types of hernia?
- inguinal
- femoral
- umbilical
What is the most common type of hernia?
Inguinal
How can inguinal hernias be classified?
Direct and indirect (indirect is more common - 2/3rds of inguinal hernias)
What does an indirect hernia result from?
A congenital weakness in the deep inguinal ring, allowing abdominal contents to enter into the inguinal canal lateral to the inferior epigastric vessels, and even out of the deep inguinal ring
What happens in a direct hernia?
Abdominal contents do not pass through the deep inguinal ring, but push through a weak spot in the muscles making up the posterior wall of the inguinal canal, allowing contents to enter the canal and, again, even pass through the superficial inguinal ring
Where do femoral hernias occur?
Below the inguinal ligament
What happens in a femoral hernia?
When Abdominal Contents pass into the weak area at the Posterior Wall of the Femoral Canal (medial to the Inferior Epigastric Vessels) (more common in females & risk of strangulation is high)
What happens in an umbilical hernia?
Abdominal Contents pass through a weakness at the site of the passage of the Umbilical Cord through the Abdominal Wall. In adults these are acquired rather than congenital, although abnormal Linea Alba fibers can contribute to this
