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Gross Anatomy > Abdomen: Inguinal Region > Flashcards

Abdomen: Inguinal Region Flashcards

1
Q

Inguinal region

A
  • Area between ASIS and pubic tubercle
  • Structures enter/exit abdominal cavity to/from
    lower extremity
    Scrotum/labia majora
    Clinical: site of inguinal hernias
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2
Q

Structures of inguinal region enter/exit abdominal cavity to/from

A
  • Lower extremity

- Scrotum/labia majora

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3
Q

Clinical importance of inguinal region

A
  • Site of inguinal hernias
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4
Q

Inguinal canal

A
  • Oblique passageway through inferior abdominal wall

- Narrower in females

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5
Q

Inguinal canal is formed by

A
  • Layers of abdominal wall

- Parallels inguinal ligament

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6
Q

Inguinal canal is the pathway for

A
  • Structures to pass from abdomen to external genitalia
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7
Q

Inguinal canal in males transmits

A
  • Spermatic cord with all of its content
  • Ilioinguinal nerve (males and females)
  • Genital branch of genitofemoral nerve (males and females)
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8
Q

Inguinal canal in females transmits

A
  • Round ligament (females)
  • Ilioinguinal nerve (males and females)
  • Genital branch of genitofemoral nerve (males and females)
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9
Q

Inguinal canal is strengthened by

A
  • Oblique orientation
  • Abdominal wall muscle contraction
  • Aponeuroses and fascias
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10
Q

Posterior boundary of inguinal canal

A
  • Transversalis fascia

- Conjoint tendon (falx inguinalis)

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11
Q

Conjoint tendon (falx inguinalis)

A
  • Combined aponeurosis of TA and IO
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12
Q

Conjoint tendon (falx inguinalis) inserts onto

A
  • Pubic crest

- Pectineal line (pecten pubis)

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13
Q

Anterior boundary of inguinal canal

A
  • EO aponeurosis & IO muscle
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14
Q

Roof of inguinal canal

A
  • TA and IO
  • Transversalis fascia
  • Medial crus
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15
Q

Floor of inguinal canal

A
  • Lateral crus
  • Inguinal ligament
  • Lacunar ligament
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16
Q

2 openings of inguinal canal

A
  • Deep inguinal ring

- Superficial inguinal ring

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17
Q

Deep inguinal ring is created by

A
  • Created by invagination of transversalis fascia
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18
Q

Deep inguinal ring is located

A
  • Lateral to inferior epigastrics

- Above midpoint of inguinal ligament

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19
Q

Superficial inguinal ring

A
  • Opening located ~ 1cm superolateral to pubic tubercle
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20
Q

Superficial inguinal ring is created by

A
  • External oblique aponeurosis
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21
Q

Superficial inguinal ring is formed by

A
  • Medial and lateral crura

- Intercrural fibers

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22
Q

Derivatives of EO aponeurosis

A
  • Inguinal ligament (Pouparts ligament)
  • Superficial inguinal ring
  • Lacunar ligament (Gimbernat)
  • Pectineal ligament (Cooper)
  • Reflected inguinal ligament
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23
Q

Inguinal ligament (Pouparts ligament)

A
  • Inferior reflection of EO aponeurosis
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24
Q

Inguinal ligament (Pouparts ligament) attaches to

A
  • ASIS to pubic tubercle
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25
Q

Superficial inguinal ring is formed by

A
  • Medial crus

- Lateral crus

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26
Q

Medial crus (of superficial inguinal ring) attaches to

A
  • Pubic symphysis
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27
Q

Lateral crus (of superficial inguinal ring) attaches to

A
  • Pubic tubercle
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28
Q

Lacunar ligament (Gimbernat) attaches to

A
  • Superior pubic ramus
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29
Q

Pectineal ligament (Cooper) runs along

A
  • Pectineal line of pubis (pecten pubis)
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30
Q

Testes develop in

A
  • Upper lumbar region
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31
Q

Gubernaculum

A
  • Fibrous cord

- Attaches testes/ovaries to anterolateral abdominal wall

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32
Q

Gubernaculum is involved in

A
  • Gonadal descent
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33
Q

Gubernaculum degenerates, and remnant becomes

A
  • Posterior scrotal ligament (M)

- Ovarian & round ligaments (F)

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34
Q

Process vaginalis

A
  • Diverticulum of the peritoneum
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35
Q

Process vaginalis outpouches and

A
  • Carries abdominal wall layers with it
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36
Q

Process vaginalis degenerates except for

A
  • Distal portion (tunica vaginalis)
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37
Q

Testes descend into scrotum and become

A
  • Ensheathed by abdominal wall layers

* Except for transversus abdominis*

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38
Q

Cryptorchidism

A
  • Undescended testicle
39
Q

Scrotum

A
  • Outpouching of lower abdominal wall

- Thin, pigmented skin

40
Q

Content of scrotum

A
  • Testicles
  • Epididymis
  • Spermatic cord
41
Q

Layers of the scrotum

A
  • Skin
  • Dartos fascia/muscle (superficial fascia)
  • External spermatic fascia
  • Cremaster fascia/muscle
  • Internal spermatic fascia
  • Tunica vaginalis parietal layer
  • Tunica vaginalis visceral layer
42
Q

Dartos fascia/muscle (superficial fascia) contains

A
  • Fat free superficial fascia (contains smooth muscle)
  • Continuous abdominal superficial fascia
  • Dartos muscle
43
Q

Dartos muscle

A
  • Thermoregulation (autonomically innervated)
44
Q

External spermatic fascia is derived from

A
  • EO aponeurosis
45
Q

Cremaster fascia/muscle is derived from

A
  • IO aponeurosis
46
Q

Internal spermatic fascia is derived from

A
  • Transversalis fascia
47
Q

Tunica vaginalis parietal layer is derived from

A
  • Process vaginalis
48
Q

Tunica vaginalis visceral layer is derived from

A
  • Process vaginalis
49
Q

Testes

A
  • Male reproductive organ
  • Suspended by spermatic cord
  • Consists of lobules of seminiferous tubules
50
Q

Testes are involved with

A
  • Production of spermatozoa and testosterone
51
Q

Tunica albuginea

A
  • Fibrous covering of the testes
52
Q

Pathway of testes

A
  • Seminiferous tubules > straight tubules > rete teste (MT) > efferent ductules > epididymis
53
Q

Epididymis

A
  • Storage and maturation of sperm

- Highly convoluted and densely packed tube

54
Q

Epididymis consists of

A
  • Head
  • Body
  • Tail: connected to vas deferens
55
Q

Tunica vaginalis

A
  • Closed off distal part of process vaginalis (outpouching of peritoneum)
  • Visceral and parietal layer
56
Q

Visceral layer of tunica vaginalis

A
  • Covers testis, epididymis
57
Q

Parietal layer of tunica vaginalis

A
  • Lines internal spermatic fascia & distal spermatic cord
58
Q

Cavity of tunica vaginalis

A
  • Between parietal and visceral layers

- Small amounts of fluid

59
Q

Spermatic cord

A
  • Contains structures going to and from testis

- Passes into the scrotum

60
Q

Vas deferens

A
  • Connects epididymis to ejaculatory duct
61
Q

Testicular artery

A
  • Arises from abdominal aorta

- Supplies testis and epididymis

62
Q

Artery to vas deferens

A
  • Arises from inferior vesicular artery
63
Q

Cremasteric artery

A
  • Arises from inferior epigastric artery
64
Q

Pampiniform venous plexus

A
  • Network of veins

- Converge to form testicular vein

65
Q

Lymph vessels

A
  • Drain into lumbar lymph nodes
66
Q

Sympathetic nerves

A
  • Travel with testicular artery and ductus deferens
67
Q

Genital branch of genitofemoral nerve

A
  • Supplies cremaster muscles
68
Q

3 fascial layers of spermatic cord

A
  • Internal spermatic fascia
  • Cremasteric muscle and fascia
  • External spermatic fascia
69
Q

Ilioinguinal nerve is NOT a content of the spermatic cord, but a content of the

A
  • Inguinal canal
70
Q

Ilioinguinal nerve doesn’t pass through deep ring, but does exit the

A
  • Superficial ring
71
Q

Testicular arteries (paired) pathway

A
  • Branch from abdominal aorta
  • Cross ureter
  • Enter deep inguinal ring and pass through inguinal canal
72
Q

Pampiniform plexus

A
  • Network of veins (8-12)
  • Surround testicular artery in spermatic cord
  • Converge to form testicular veins
73
Q

Function of pampiniform plexus surrounding testicular artery in spermatic cord

A
  • Thermoregulation

- Cools arterial blood

74
Q

Right testicular vein drains to

A
  • IVC
75
Q

Left testicular vein drains to

A
  • Left renal vein
76
Q

Lymphatic drainage of testes

A
  • Lumbar nodes (paraaortic)
77
Q

Lymphatic drainage of scrotum

A
  • Superficial inguinal nodes
78
Q

Hydrocele

A
  • Accumulation of fluid in the cavity of tunica vaginalis
79
Q

Hydrocele is commonly caused by

A
  • Patent process vaginalis

- Transilluminates

80
Q

Testicular hematocele

A
  • Accumulation of blood in cavity of TV
81
Q

Varicocele

A
  • Varicose veins of the pampiniform plexus

- “bag of worms”

82
Q

Varicocele cause

A
  • Defective venous valves or venous problem
  • Left more common than right
  • Can cause fertility problems
  • Do not transilluminate
83
Q

Inguinal Hernia

A
  • Abnormal protrusion of abdominal content
    from area where it normally resides
  • M >F
84
Q

Indirect Inguinal Hernia

A
  • Usually the result of a patent process vaginalis

- Most common inguinal hernia

85
Q

Indirect Inguinal Hernia enters

A
  • Deep ring, lateral to inferior epigastric vessels

- Can exit superficial ring and pass into scrotum

86
Q

Direct Inguinal Hernia occurs in

A
  • Inguinal triangle
87
Q

Direct Inguinal Hernia enters

A
  • Medial to inferior epigastric a.
  • Can exit through superficial ring
  • Rarely enters scrotum
88
Q

Inguinal Triangle Boundaries

A
  • Medial: rectus abdominis
  • Lateral: inferior epigastric vessels
  • Inferior: inguinal ligament
89
Q

Inguinal triangle medial boundary

A
  • Rectus abdominis
90
Q

Inguinal triangle lateral boundary

A
  • Inferior epigastric vessels
91
Q

Inguinal triangle inferior boundary

A
  • Inguinal ligament
92
Q

Femoral Hernia

A
  • Passes through femoral ring and canal
  • Posterior-inferior to inguinal ligament
  • F>M because of wider bone structure
93
Q

The necks of inguinal hernias are

A
  • Superomedial to pubic tubercle
94
Q

The necks of femoral hernias are

A
  • Inferolateral to pubic tubercle

Gross Anatomy (50 decks)

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