"Gross Anatomy Inguinal Canal Amanda C. Conta Steencken" 3/23

Question 1

What is the pelvic girdle?

Answer 1

paired hip (coxal) bones joined at the back at the sacroiliac joints, and at the front by the pubic symphysis

Question 2

Where is the narrowest point of the birth canal?

Answer 2

The distance between the ischial spines.

Question 3

What three muscles make up the levator ani muscle?

Answer 3

The levator ani muscle is made up of three muscles;
1. puborectalis closest to the rectal hiatus
2. pubococcygeus, directly lateral to puborectalis
3. iliococcygeus, which lies below and 90 degrees to the top two
Together, they form a sling

Levator ani and coccygeus muscle make up the pelvic floor.

Question 4

What does “water under the bridge” mean?

Answer 4

The ureter travels beneath the uterine (gonadal) artery in most specimens, and serves as a good landmark.

The uterine artery is a branch off the anterior division of the internal iliac artery.

Question 5

Where does the superior vesicular artery go?

Answer 5

The superior vesicular artery is a branch off the anterior division of the internal iliac artery and travels to the bladder.

Question 6

What is the blood supply of the perineal region?

Answer 6

The perineal region gets blood from the internal pudendal artery, which is a branch off the anterior division of the internal iliac artery.

Question 7

What is the inguinal canal?

Answer 7

The inguinal canal runs parallel and right above the inguinal ligament . The deep ring is at the top and the superficial ring is at the bottom. It contains either the spermatic cord or the round ligament of the uterus.

Question 8

What forms the inguinal ligament?

Answer 8

The aponeurotic fibers of the external abdominal oblique form the inguinal ligament. The inguinal ligament is part of the floor of the inguinal canal.

Question 9

What are the landmarks for finding the deep ring?

Answer 9

The deep ring can be found be locating the inferior epigastric artery and the rectus abdominus muscle on the anterior abdominal wall. This is the site for DIRECT inguinal hernias. (Inguinal triangle of hesselbach)

Direct hernias are more common in old people bc they have weak abdominal walls.

Question 10

What is another name for a direct inguinal hernia?

Answer 10

A medial inguinal hernia, bc the hernia is medial to the inferior epigastric artery.

Question 11

What is the risk factor for a direct inguinal hernia?

Answer 11

In a male, having a patent processus vaginalis (that becomes a patent plica vaginalis)

Question 12

What make up the acquired coverings of the testes?

Answer 12

The acquired coverings of the testes are made up by the external oblique, internal oblique, transversus abdominus and transversalis (but NOT the peritoneum).

Question 13

The vas deferens, pampiniform venous plexus (testicular vein) and testicular lymphatics make up the:

Answer 13

spermatic cord

Question 14

The arteries of the spermatic cord (3) are:

Answer 14

1. testicular a (branch of abdominal aorta)
2. artery to vas deferens
3. cremaster a (branch of inferior epigastric a)

Question 15

What muscle gives rise to the cremaster muscle and the middle spermatic fascia?

Answer 15

The internal abdominal oblique

Question 16

The cremaster muscle maintains the temperature of the scrotum by moving the testes around. What nerve innervates it?

Answer 16

The cremaster muscle is innervated by the genital branch of the genitofemoral nerve, and is somatic motor.

Question 17

The spermatic cord has 3 nerves: testicular nerves (sympathetics), genital branch of genitofemoral, and ilioinguinal nerve. Which one does not enter the deep ring, and how does it travel?

Answer 17

Ilioinguinal nerve (the rebel) goes laterally and avoids the deep ring of the inguinal canal, and runs along the inguinal ligament instead, where it turns south and joins the spermatic cord. *He does exit the superficial ring.

Question 18

Where do ilioinguinal and genitofemoral nerves originate?

Answer 18

Ilioinguinal nerve originates at L1.

Genitofemoral never originates at L1-L2.

Question 19

What structure maintains the uterus in an anteverted position during pregnancy?

Answer 19

The round ligament of the uterus.

Question 20

What is chryptorchidism?

Answer 20

Incomplete testicular descent

Question 21

What are the symptoms of testicular torsion?

Answer 21

1. PAIN
2. Absent cremaster reflex

Bell clapper deformity is a risk factor for testicular torsion, which is a medical surgical emergency.

Question 22

Which type of hernia can cause small bowel to protrude into the scrotum?

Answer 22

An indirect or lateral hernia (lateral to the inferior epigastric artery), more common in males bc of the processus vaginalis.

Question 23

What kind of hernia is more common in women?

Answer 23

Femoral hernia, hernia through the femoral canal