2- Inguinal Canal Flashcards
This is the rolled-under inferior border of the EO m. aponeurosis. It’s attached to the ASIS and Pubic Tubercle.
Inguinal L.
This is the combined aponeurosis of the inferior/medial margins of the IO and TA ms. inserting into the Pubis.
Conjoint Tendon (Inguinal Falx)
This is the external opening within the aponeurosis for the Spermatic Cord or Round Ligament.
Superficial Ring
The crural fibers surround and help strengthen the Superficial Ring. What are these fibers?
Medial Crus
Lateral Crus
Intercrural Crus
This ligament is between the Pubic Rami and Inguinal Ligament, and anchors the Inguinal Ligament to the Pubis.
Lacunar Ligament
This ligament is a continuation of fibers from the Lacunar Ligament running along the Pectin Pubis.
Pectineal Ligament
This lies immediately lateral to the Lacunar Ligament.
Femoral Canal (Subinguinal Space)
This is the entrance to the Inguinal Canal and the beginning of the invagination of peritoneum into Transversalis Fascia.
Deep Inguinal Ring
This ring is superior to the Inguinal Ligament and lateral to the Inferior Epigastric A.
Deep Inguinal Ring
What passes through the Deep Inguinal Ring?
Males = Vas Deferens and Gonadal vessels/nerves
Females = Round Ligament
This is the exit for the Inguinal Canal.
Superficial Inguinal Ring
***Remember, Spermatic Cord or Round Ligament exits from here!
The Superficial Inguinal Ring is really a partial split in the aponeurosis of what muscle?
External Oblique M.
What are the abdominal layers near the Inguinal Ring from superficial to deep (start with EO)?
- EO Aponeurosis
- IO M.
- TA M.
- Transversalis Fascia
- Parietal Peritoneum
This is part of the lower fibers of the EO aponeurosis.
Inguinal Ligament
This is the thickening of the Transversalis Fascia running posterior to the Inguinal Ligament.
Iliopubic Tract
This nerve provides motor innervation to the abdominal muscles (IO and TA), and sensory innervation to the skin above the pubis (hypogastric region).
Iliohypogastric N. (L1)
This nerve traverses the Inguinal Canal and exits the Superficial Ring lateral to the cord.
Ilioinguinal N. (L1)
This nerve provides motor innervation to the abdominal muscles (IO and TA), and sensory innervation to the skin over the upper/medial thigh and skin at the root of the penis/clitoris and anterior scrotum/labia.
Ilioinguinal N. (L1)
This nerve and branch provide motor innervation to the Cremasteric M. and sensory innervation to a small part of the medial thigh and scrotal/labial fascia.
Genital Branch of Genitofemoral N. (L1, L2)
The gonads form near the _______ axial level.
T10
Gonad are connected to future scrotal swellings by __________.
Gubernaculum
The testes will descend along with an out-pocketing of peritoneal cavity called ________ ________ into the future scrotum carrying vessels and nerves with them (future ________ ________).
Processus Vaginalis
Suspensory Ligament
After testes descend, connection to the peritoneum is closed, and ________ ________ represents the remains of Processus Vaginalis around the testes.
Tunica Vaginalis
This is an undescended testis (increases risk of developing testicular cancer).
Cryptorchid Testis
As the gonad “herniates” along with its blood supply and Vas Deferens out, it carries layers of abdominal wall with it forming the Spermatic Cord. What layers do the muscles form?
Transversalis Fascia = Internal Spermatic Fascia
Internal Oblique = Cremasteric M./Fascia
External Oblique = External Spermatic Fascia
What are the Spermatic Cord contents?
Vas Deferens (Ductus Deferens) Testicular A. Testicular Vs. (Pampiniform Plexus) Gonadal Ns. Gonadal lymphatics
This is varicosities of the Pampiniform Plexus that causes swelling in the scrotum with dull and recurring pain.
Testicular Varicocele
This is the patent connection between the Tunica Vaginalis and abdomen (usually closes off). Often results in hydrocele.
Persistent Processus Vaginalis
This is the peritoneal fluid accumulation within the Tunica Vaginalis. It is more common in babies, and in adults it can cause inflammation or injury in the scrotum, testis or epididymis. Can be communicating or non-communicating.
Hydrocele
***Non-communicating is without a connection, communicating is due to an opening to peritoneum.
This is an accumulation of blood in the Tunica Vaginalis, often due to injury to the spermatic vessels.
Hematocele
Hydrocele presents with a swollen scrotum due to accumulation of peritoneal serous fluid. Approx. 10% of male infants are born with this, and most self-rectify. How do we detect hydrocele?
Trans-illumination
In ovarian descent, they begin descending but the _________ becomes attached to the developing uterus.
Gubernaculum
In females, the gubernaculum forms what?
Ovarian Ligament
Round Ligament
This ligament enters the deep ring and exits superficial ring attaching to labial swellings.
Round Ligament
What are the contents of the female Inguinal Canal?
Round Ligament (of uterus)
Ilioinguinal N.
Geniofemoral N. (genital branch)
What is the lymph drainage of the scrotum?
Scrotum drains into Superficial Inguinal LNs and eventually travel into Iliac and Lumbar LNs
What is the lymph drainage of the testes?
Testes drain into Lumbar and Pre-Aortic LNs
This fold is a remnant of the urachus.
Median Umbilical Fold
This fold is a remnant of the distal-most portion of the umbilical arteries.
Medial Umbilical Fold
This fold is due to Inferior Epigastric As. and Vs.
Lateral Umbilical Fold
What are the borders of the Inguinal (Hasselbach’s) Triangle?
Inguinal Ligament (inferior) Lateral border of Rectus Abdominis (medial) Lateral Umbilical Fold (lateral)
Where does a Direct Hernia occur?
Inferior to Conjoint Tendon and medial to Lateral Umbilical Fold (Ligament)
This is is thickened Transversalis Fascia running posterior to the Inguinal Ligament. It reinforces the floor of the Inguinal Canal.
Iliopubic Tract
This type of hernia is medial to the Inferior Epigastric A. Involves the periotneum/transversalis fascia alongside the Spermatic Cord.
Direct Hernia
This type of hernia enters the deep ring and involves peritoneum within the Spermatic Cord.
Indirect Hernia
This type of hernia is below the Inguinal L. and is more common in women. 40% present as emergencies with incarceration or strangulation.
Femoral Hernia
What are the types of ventral hernias?
Umbilical
Epigastric
Spigelian
This type of hernia is due to a weakness in the midline fusion point.
Epigastric
***Ventral
This type of hernia is through fascia between the abdominal muscles but along the semilunar line of the Rectus Abdominis M.
Spigelian
***Ventral
What are the types of groin hernias?
Inguinal
Femoral
This type of hernia is due to defects in the posterolateral abdominal wall, allowing the tissues inside the abdomen to protrude.
Flank (Lumbar)