Abdomen- groin

Question 1

Layers surrounding testis on their descent into scrotum

Answer 1

Layers from out to in:

Skin

External oblique

Internal oblique

Transversalis fascia

Processus vaginalis

Question 2

The content of inguinal canal

Answer 2

Male: genital branch of genitofemoral, spermatic cord

Female: round ligament of uterus

Both: ilio-inguinal nerve

Question 3

Inguinal canal anterior wall

Answer 3

External oblique aponeurosis

Question 4

Inguinal canal posterior wall

Answer 4

Transversalis fascia

Conjoint tendon (medial one third)

Question 5

Conjoint tendon

Answer 5

formed from the lower part of the common aponeurosis of the internal oblique muscle and the transversus abdominis

Question 6

Roof of inguinal canal

Answer 6

Internal oblique

Transversus abdominis

Question 7

Floor of inguinal canal

Answer 7

External oblique aponeurosis

Inguinal ligament

Lacunar ligament

Question 8

Boundaries of deep inguinal ring

Answer 8

Superolaterally: tranversalis fascia

Inferomedially- inferior epigastric

Question 9

Content of spermatic cord

Answer 9

3 arteries: Vas, cremasteric and testicular

3 nerves: genital of genitofemoral, sympathetic, parasympathetic

3 others: vas deferens lymph, pampiniform plexus

Question 10

Origin of ductus deferens artery

Answer 10

inferior vesical artery (internal iliac)

Question 11

Drainage of pampiniform plexus

Answer 11

testicular vein

Question 12

Origin of cremasteric vessels

Answer 12

Inferior epigastric vessels (from external iliac)

Question 13

Origin of testicular artery

Answer 13

abdominal aorta

Question 14

Spermatic cord fascia covering

Answer 14

External spermatic fascia (external oblique)

Cremasteric fascia (internal oblique)

Internal spermatic fascia (transversalis fascia)

Question 15

Cremasteric reflex

Answer 15

Afferent: ilio-inguinal at upper medial thigh skin

Efferent: genital of genitofemoral to cremasteric muscle

Question 16

Which level of spinal cord does the cremasteric reflex check

Answer 16

L1/L2

Question 17

Indirect inguinal hernia

Answer 17

Peritoneal sac herniates through patent processus vaginalis THROUGH THE DEEP RING

Question 18

Site of direct inguinal hernia

Answer 18

Through posterior wall of inguinal canal

Hesselbach’s triangle

Question 19

Borders of Hesselbach’s triangle

Answer 19

Lateral: ingerior epigastric artery

Medial: rectus abdominis

Inferior: inguinal ligament

Question 20

How to differentiate between direct and indirect inguinal hernias

Answer 20

Direct: medial to epigastric artery

Indirect: lateral to epigastric artery

Question 21

Differentiating between femoral and inguinal hernia

Answer 21

Inguinal: above pubic tubercle

Femoral: below and lateral

Question 22

Femoral canal content

Answer 22

Fat

Lymph nodes of cloquet

Question 23

Mid point of inguinal ligament

Answer 23

Halfway between ASIS and tubercle

Question 24

Which structure associated with mid point of inguinal ligament

Answer 24

Deep inguinal ring

Question 25

Mid inguinal point

Answer 25

Half way between symphysis and ASIS

Question 26

Which structure associated with mid inguinal point

Answer 26

femoral artery

Question 27

Between which layers of the abdominal wall does the inferior epigastric artery sit

Answer 27

Transversus abdominsis and peritoneum

Question 28

Surface marking for inguinal canal

Answer 28

Deep inguinal ring 1.5cm above midpoint of inguinal ligament Superficial ring 1cm above and medial to pubic tubercle

Question 29

Ischio-rectal fossa boundaries

Answer 29

Superior- levator ani Lateral- obturator internus Inferior- Perineal skin

Question 30

Deep perineal pouch content

Answer 30

Membranous urethra Sphincter m Bulbourethral gland Deep transverse perineal muscles Internal pudendal vessels Dorsal nerve of penis