Exam 1 Review - The Inguinal Region

Question 1

What structure does not enter or leave the inguinal region by passing deep to the inguinal canal?

Answer 1

Obturator nerve

Question 2

An indirect inguinal hernia may occur when the processus vaginalis remains patent, and an internal organ pass through the ______ ________ ____.

Answer 2

Deep inguinal ring
Note: Indirect inguinal hernias occur lateral to the inferior epigastric vessels. An organ can even pass completely through the inguinal canal (through both rings!) and lie in the scrotum.

Question 3

A direct inguinal hernia may occur when the internal organ pushes through the ____ ______ ____ without traversing the inguinal canal.

Answer 3

Superficial inguinal ring

Note: Direct inguinal hernias occur medial to the inferior epigastric vessels, in an area called Hesselbach’s triangle.

Question 4

The cremasteric reflex is a contraction of the cremasteric muscle after stroking the inner thigh, resulting in a lifting of the scrotum and testis on the side stroked. What nerve is responsible for this response?

Answer 4

Efferent fibers of the genitofemoral nerve

Note: Muscle supplied by the cremasteric artery from the inferior epigastric artery

Question 5

What ligament (in females) passed through the inguinal canal and continues on to the labia majora?

Answer 5

Round ligament of the uterus

Question 6

The posterior wall of the inguinal canal is formed by what three structures?

Answer 6

Transversalis fascia;
Conjoint tendon (medial 1/3);
Reflected inguinal ligament of external abdominal oblique (medial 1/3)

Question 7

The anterior wall of the inguinal canal is formed by what two structures?

Answer 7

External abdominal oblique over entire length;

internal abdominal oblique on lateral one-third

Question 8

The floor of the inguinal canal is formed by what two ligaments of the external abdominal oblique?

Answer 8

Inguinal ligament; lacunar ligament

Question 9

The roof of the inguinal canal is formed by arched fibers of what two structures?

Answer 9

Internal abdominal oblique muscle;

transversus abdominus

Question 10

The superficial (external) ring of the inguinal canal is an opening in the aponeurosis of _______ muscle?

Answer 10

External oblique muscle

Question 11

The deep (internal) ring of the the inguinal canal is an opening in the _________ ?

Answer 11

Transversalis fascia

Question 12

When abdominal contents put pressure on the transversalis fascia, an internal organ may traverse the posterior wall of the inguinal canal. The contents of the hernia are located between what two fascial layers?

Answer 12

Internal spermatic fascia and cremasteric fascia

Question 13

On the left side the pampiniform plexus drains into what vein?

Answer 13

Left renal vein

Question 14

What is a terminal branch of the inferior mesenteric artery?

Answer 14

Superior rectal artery

Question 15

In 30% of cases, the obturator artery is anomalous and in danger of being divided when a strangulated femoral hernia is surgically corrected. In these instances, what artery does the obturator arise from?

Answer 15

Inferior epigastric artery or external iliac artery.

Note: An anomalous obturator runs close to or across the femoral ring.

Question 16

An inflamed ovary can cause pain where?

Answer 16

On the medial thigh

Question 17

What are four chief supports of the uterus?

Answer 17

1. Levator ani muscles
2. Perineal body
3. Transverse cervical ligament
4. Sacrouterine ligaments

Question 18

The uterine artery crosses the ureter within what ligament?

Answer 18

Cardinal ligament

Question 19

What three structures are enclosed by the broad ligaments?

Answer 19

Uterine Tubes
Ovarian ligaments
Round ligament

Question 20

The superior gluteal artery separates what two nerve structures?

Answer 20

The lumbosacral trunk and the ventral ramus of S1

Question 21

What nerve passes along the ovarian fossa between the pelvic wall and the ovary?

Answer 21

Obturator nerve

Question 22

Where does the lymphatic drainage of the ovary proceed?

Answer 22

Para-aortic (lumbar) nodes

Question 23

In females, the lowest part of the peritoneal cavity is the ______________ ______.

Answer 23

Uterorectal pouch

Question 24

Lymphatic vessels from the upper limbs converge on the ______ nodes; lymphatic vessels from the lower limbs converge on the _______ nodes.

Answer 24

Upper limb - axillary nodes; lower limb - inguinal nodes

Question 25

Deep inguinal nodes drain into the _____ ____ nodes.

Answer 25

External iliac nodes

Question 26

The para-aortic nodes drain what three general structures?

Answer 26

1. Kidneys
2. Suprarenal glands
3. Gonads (ovaries; testes)