abdominal wall 2

Question 1

what is an inguinal region?

Answer 1

region that extends between ASIS and Pubic tubercle

Question 2

significance of inguinal region

Answer 2

• region where structures enter and exit abdominopelvic cavity
• clinically: site for hernia because of the pathways and inlet and exit are sites of herniation

Question 3

what is an inguinal canal

Answer 3

• oblique intermuscular passage in the inguinal region, 4 cm long in adult in males and also related to testicular development
• it lies parralel superior to the medial half of inguinal ligament
• directed downward and medially

Question 4

main contents of inguinal canal

Answer 4

spermatic cord for males
round ligament of uteres for females

Question 5

what are is the nerve presented in inguinal canal

Answer 5

illioinguinal canal

Question 6

inguinal canal connects to opening:

Answer 6

• deep internal inguinal ring (defect in transversalis fascia), located half inch above inguinal ligament. (lateral to the inferior epigastric vessels)
• superficial (external) inguinal ring, a split that occurs in the external oblique apeneurosis, superiolateral to pubic tubercle

these openings are weak and contribute to hernias

Question 7

boundaries of the inguinal canal

Answer 7

conjoint tendon, inferior epigastric arteries & vein, reflected inguinal ligament, aponeurosis of external and internal oblique & transversus abdominis

• Posterior wall: formed by Transversalis fascia; conjoint tendon and reflected part of the inguinal ligament.
• Anterior wall: formed by external oblique aponeurosis throughout the length of the canal and by the fibers of the internal oblique at the lateral part
• Roof: formed by arched fibers of the internal obliques and transversus abdominis muscles
• Floor: formed mainly by the inguinal ligament and illiopubic tract

Question 8

mechanism of inguinal canal

Answer 8

shutter mechanism

flap valve mechanism

ball valve mechanism

slit valve mechanism

protection of superior inguinal ring posteriorly by conjoint tendon and reflected inguinal ligament

Question 9

Types of hernias

Answer 9

inguinal hernia and femoral hernia

Question 10

inguinal hernia

Answer 10

occurs above and lateral to pubic tubercle

• direct hernia
• indirect hernia

Question 11

Direct inguinal hernia

Answer 11

site: inguinal triangle → conjoint tendon→ inguinal canal (doesn’t typically descend to scrotum)

it is acquired

the sac around it is from the peritoneum and transversalis fascia

Question 12

indirect inguinal hernia

Answer 12

site: deep inguinal ring → superficial ring →scrotal sac

occurs lateral to inferior epigastric

congenital

covered by peritoneum and coverings of the spermatic cord

Question 13

femoral hernia

Answer 13

occur below and medial to the pubic tubercle

common in females

Question 14

hernia complications

Answer 14

irreducibility

obstruction

strangulation in gangrene (tissue death due to lack of blood supply)

Question 15

deep inguinal test

Answer 15

to differentiate between direct and indirect hernia