Inguinal anatomy Flashcards
Where is the inguinal canal in relation to the inguinal ligament?
Superior and parallel
What does the inguinal canal serve as?
A pathway through which structures can pass from the abdominal wall to the external genitalia.
Why is the inguinal canal of clinical importance?
It is a potential weakness in the abdominal wall and therefore, a common site of herniation.
What is the inguinal canal?
The pathway by which the testes leave the abdomen cavity and enter the scrotum.
Where is the mid-inguinal point?
Halfway between the pubic symphysis and the ASIS.
What can be palpated at the mid-inguinal point?
Femoral pulse
Where is the midpoint of the inguinal ligament?
Halfway between the pubic tubercle and the ASIS
What is the midpoint of the inguinal ligament located just below?
The opening to the inguinal canal
What are the 2 openings of the inguinal canal?
The deep and superficial rings
What forms the anterior wall of the inguinal canal?
Aponeurosis of the external oblique (reinforced by the internal oblique muscle laterally)
What forms the posterior wall of the inguinal canal?
Transversals fascia
What forms the roof of the inguinal canal?
Transversals fascia
Internal oblique
Transversus abdominis
What forms the floor of the inguinal canal?
Inguinal ligament (a ‘rolled’ up portion of the external oblique aponeurosis)
What does the deep ring mark?
The internal opening of the inguinal canal
Where is the deep ring of the inguinal canal found?
Above the midpoint of the inguinal ligament (lateral to epigastric vessels)
What is the deep ring of the inguinal canal created by?
The transversals fascia (this then invaginate to form a covering for the contents of the inguinal canal)
What does the superficial inguinal ring mark?
The external end of the inguinal canal.
Where is the superficial ring of the inguinal canal found?
Just superior to the pubic tubercle
What is the superficial ring of the inguinal canal formed by?
Invagination of the external oblique (also forms a covering for the contents of the inguinal canal)
What does the superficial ring of the inguinal canal contain?
Intercrural fibres which prevent the ring from widening
Name the 3 things contained within the inguinal canal in males.
Spermatic cord
Ilioinguinal nerve
Genital branch of the genitofemoral nerve
Name the 3 things contained within the inguinal canal in females.
Round ligament
Ilioinguinal nerve
Genital branch of the genitofemoral nerve
What structure only travels through part of the inguinal canal (does not pass through deep ring)?
Ilioinguinal nerve
Which nerve is most at risk of damage during an inguinal hernia repair?
Ilioinguinal nerve
Where does the inguinal ligament attach to?
ASIS
What is an inguinal hernia?
A protrusion of the abdominal cavity contents trough the inguinal canal.
Give 3 ways that indirect (75%) inguinal hernias canoe distinguished from direct ones.
Elliptical in shape (direct are round)
Less likely to be reducible
Less likely to reduce spontaneously on reclining
Slow to appear on standing
Controlled by pressure over deep inguinal ring
More prone to strangulation
Can extend into the scrotum
Where do inguinal hernias appear?
Medial to the pubic tubercle
Where do femoral hernias appear?
Below and lateral to the pubic tubercle
What structures to the deep inguinal lymph nodes drain?
Deep parts of lower limbs
Penis
ClitorisW
Where do the deep inguinal lymph nodes drain to?
External iliac nodes > pelvic and para-aortic nodes.
Where do the superficial inguinal nodes drain to?
Deep inguinal nodes.
What do the inferior superficial inguinal lymph nodes drain?
Lower legs
What do the super-lateral superficial inguinal lymph nodes drain?
Buttocks
Lower abdominal wall
What do the superomedial superficial inguinal lymph nodes drain?
Perineum
Outer genitalia (incl. scrotum)
Anus below pectinate line
Where does lymph from the testes drain to?
Para-aortic lymph nodes
Where does lymph from the scrotum drain to?
Superficial inguinal lymph nodes
