2. Inguinal Canal

Question 1

The inguinal canal, also know as the groin, is made by testicular and ovary migration from the posterior abdominal wall. They pass through muscles and fascia via ________- to end in the?

Answer 1

inguinal canal to end in the scrotum

Question 2

Testicles will follow the gubernaculum which passes through muscles to the scrotum. What does the gubernaculum become in men and women?

Answer 2

Men: spermatic cord
Women: round ligament of the uterus

Question 3

The testes pass through all the muscles and fascia of the abdomen EXCEPT which layer?

Answer 3

Transversus abdominus M.

Question 4

What are the muscles and fascia that the testes pull into the scrotum during migration? (6)

Answer 4

Skin
Scarpa's fascia
External oblique M
Internal Oblique M
Transversalis fascia
Peritoneum

Question 5

The scrotum is from skin and dartos fascia (smooth M innervated via sympathetics). What do the external and internal oblique muscles made when they are brought down into the scrotum?

Answer 5

External: external spermatic fascia
Internal: cremaster fascia / cremaster muscle

Question 6

Transveralis fascia will become internal spermatic fascia in the scrotum. What does the peritoneum form?

Answer 6

Tunica vaginalis parietal & visceral

Also makes the procesus vaginalis which disintegrates

Question 7

The blood supply to the scrotum includes posterior scrotal branches from the pudenal artery, anterior scrotal branches from the deep external pudendal artery and the cremasteric artery from the inferior epigastric A. What is the main nerve supply? (4)

Answer 7

Posterior/Anterior scrotal nerves (pudendal/ilioinguinal)
perineal branches of posterior cutaneous N
genital branch of genitofemoral N

Question 8

What occurs during hydrocele and how can it be detected?

Answer 8

Hydrocele occurs when there is fluid in a persistent processus vaginalis. Can be detected via transillumination

Question 9

What forms from the processus vaginalis (from the peritoneum)?

Answer 9

parietal and visceral layer of the tunica vaginalis

Question 10

Ductus deferens, and its artery, along with the testicular A, pampiniform plexus of veins and cremasteric A/V are all within the spermatic cord. What else? (4)

Answer 10

Genital branch of genitofemoral N (cremaster M.)
Sympathetics and visceral afferents (dartos)
Lymphatics
Remnants of processus vaginalis

Question 11

The gonadal artery (ovarian A/testicular A) comes from the aorta on the right side and from the ______ on the left side.

Answer 11

left renal artery

Question 12

Varicocele occurs in 15-20% of males post puberty on the left side. is known as scrotal fullness, feeling like a bag of worms. asymptomatic with dull ache. What is it due to?

Answer 12

enlarged pampiniform plexus of veins

Question 13

What is the afferent and efferent innervation for the cremasteric reflex?

Answer 13

Afferent: ilioinguinal N
Efferent: Genitofemoral N

Question 14

The inguinal region is where structures exit and enter abdominal cavity and where herniation occurs. Testes must go through the deep inguinal ring, muscle and superficial inguinal ring. What does the gubernaculum form in men and women?

Answer 14

men: spermatic cord
women: round ligament of the uterus

Question 15

What is the floor of the inguinal canal from the deep ring to the superficial ring?

Answer 15

Iliopubic tract
Inguinal ligament
Lacunar Ligament

Question 16

What is the roof of the inguinal canal from deep ring to superficial ring?

Answer 16

Transversalis fascia
musculo-aponeurotic arches of IO/TA
medial crus of aponeurosis EO

Question 17

What is the Anterior wall of the inguinal canal from deep ring to superficial ring?

Answer 17

IO and lateral crus from aponeurosis of EO
Aponeurosis of EO (lateral crus/intercrural fibers)
Aponeurosis of EO with fascia of EO as external spermatic fascia

Question 18

What is the posterior wall of the inguinal canal from the deep ring to the superficial ring?

Answer 18

Transversalis fascia
Transversalis fascia
Conjoin tendon

Question 19

Where do the medial and lateral crus attach to?

Answer 19

medial to pubic crest

lateral to pubic tubercle

Question 20

What are all the things made from the external oblique aponeurosis? (6)

Answer 20

Lateral crus
medial crus
pectineal ligament
Inguinal ligament
lacunar ligament 
superficial inguinal ring

Question 21

What is the lacunar ligament made from and where does it attach? (Note: the pectineal ligament is made from the same fibers)

Answer 21

Made from extra fibers from the inguinal ligament which attaches to the pectineal line

Question 22

What merges together to form the conjoint tendon which makes up part of the posterior wall and attaches to the pectineal line?

Answer 22

the internal oblique muscles and trasnversus abdominis M

Question 23

What forms the borders for the inguinal triangle, also known as hasselbachs traingle?

Answer 23

Medial: Rectus Abdominis M
Lateral: Inferior epigastric vessels
Inferior: Inguinal Ligament

Question 24

What is the most common hernia in males and females that occurs lateral to the inferior epigastric A.? Where does the hernia go?

Answer 24

Indirect inguinal hernia- into deep/superficial inguinal ring into the scrotum

Question 25

The ilioinguinal N goes between IO/TA and does NOT go through?

Answer 25

the deep inguinal ring

Question 26

A direct inguinal hernia occurs how?

Answer 26

Medial to the inferior epigastric A, only covered by parietal peritoneum and TF, in hesselbachs triangle

Question 27

A femoral hernia is more common in women and occurs inferior to inguinal ligament. 40% occur as emergencies… why?

Answer 27

Becuase the lacunar ligament is extremely tough and can block blood supply through the femoral A/V

Question 28

Where do the testis/ovary typically drain lymph to?

Answer 28

Lumbar/Caval/Aortic LNs

Question 29

Where does the lower limb, superficial drainage inferior to umbilicus, gluteal region, and scrotum drain lymph to?

Answer 29

Superficial inguinal nodes

Question 30

What is important to remember about the Testes lymph drainage versus the scrotum?

Answer 30

teste to lumbar LN

scrotum to superficial inguinal LN

Question 31

What follows the iliopubic tract, which is in the transversalis fascia?

Answer 31

the inguinal ligament

Question 32

if you have an infection in your testes, what lymph node would most likely be affected?

Answer 32

Lumbar/Caval/Aortic LN