Inguinal anatomy

Question 1

Where is the inguinal canal in relation to the inguinal ligament?

Answer 1

Superior and parallel

Question 2

What does the inguinal canal serve as?

Answer 2

A pathway through which structures can pass from the abdominal wall to the external genitalia.

Question 3

Why is the inguinal canal of clinical importance?

Answer 3

It is a potential weakness in the abdominal wall and therefore, a common site of herniation.

Question 4

What is the inguinal canal?

Answer 4

The pathway by which the testes leave the abdomen cavity and enter the scrotum.

Question 5

Where is the mid-inguinal point?

Answer 5

Halfway between the pubic symphysis and the ASIS.

Question 6

What can be palpated at the mid-inguinal point?

Answer 6

Femoral pulse

Question 7

Where is the midpoint of the inguinal ligament?

Answer 7

Halfway between the pubic tubercle and the ASIS

Question 8

What is the midpoint of the inguinal ligament located just below?

Answer 8

The opening to the inguinal canal

Question 9

What are the 2 openings of the inguinal canal?

Answer 9

The deep and superficial rings

Question 10

What forms the anterior wall of the inguinal canal?

Answer 10

Aponeurosis of the external oblique (reinforced by the internal oblique muscle laterally)

Question 11

What forms the posterior wall of the inguinal canal?

Answer 11

Transversals fascia

Question 12

What forms the roof of the inguinal canal?

Answer 12

Transversals fascia
Internal oblique
Transversus abdominis

Question 13

What forms the floor of the inguinal canal?

Answer 13

Inguinal ligament (a ‘rolled’ up portion of the external oblique aponeurosis)

Question 14

What does the deep ring mark?

Answer 14

The internal opening of the inguinal canal

Question 15

Where is the deep ring of the inguinal canal found?

Answer 15

Above the midpoint of the inguinal ligament (lateral to epigastric vessels)

Question 16

What is the deep ring of the inguinal canal created by?

Answer 16

The transversals fascia (this then invaginate to form a covering for the contents of the inguinal canal)

Question 17

What does the superficial inguinal ring mark?

Answer 17

The external end of the inguinal canal.

Question 18

Where is the superficial ring of the inguinal canal found?

Answer 18

Just superior to the pubic tubercle

Question 19

What is the superficial ring of the inguinal canal formed by?

Answer 19

Invagination of the external oblique (also forms a covering for the contents of the inguinal canal)

Question 20

What does the superficial ring of the inguinal canal contain?

Answer 20

Intercrural fibres which prevent the ring from widening

Question 21

Name the 3 things contained within the inguinal canal in males.

Answer 21

Spermatic cord
Ilioinguinal nerve
Genital branch of the genitofemoral nerve

Question 22

Name the 3 things contained within the inguinal canal in females.

Answer 22

Round ligament
Ilioinguinal nerve
Genital branch of the genitofemoral nerve

Question 23

What structure only travels through part of the inguinal canal (does not pass through deep ring)?

Answer 23

Ilioinguinal nerve

Question 24

Which nerve is most at risk of damage during an inguinal hernia repair?

Answer 24

Ilioinguinal nerve

Question 25

Where does the inguinal ligament attach to?

Answer 25

ASIS

Question 26

What is an inguinal hernia?

Answer 26

A protrusion of the abdominal cavity contents trough the inguinal canal.

Question 27

Give 3 ways that indirect (75%) inguinal hernias canoe distinguished from direct ones.

Answer 27

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

Question 28

Where do inguinal hernias appear?

Answer 28

Medial to the pubic tubercle

Question 29

Where do femoral hernias appear?

Answer 29

Below and lateral to the pubic tubercle

Question 30

What structures to the deep inguinal lymph nodes drain?

Answer 30

Deep parts of lower limbs Penis ClitorisW

Question 31

Where do the deep inguinal lymph nodes drain to?

Answer 31

External iliac nodes > pelvic and para-aortic nodes.

Question 32

Where do the superficial inguinal nodes drain to?

Answer 32

Deep inguinal nodes.

Question 33

What do the inferior superficial inguinal lymph nodes drain?

Answer 33

Lower legs

Question 34

What do the super-lateral superficial inguinal lymph nodes drain?

Answer 34

Buttocks Lower abdominal wall

Question 35

What do the superomedial superficial inguinal lymph nodes drain?

Answer 35

Perineum Outer genitalia (incl. scrotum) Anus below pectinate line

Question 36

Where does lymph from the testes drain to?

Answer 36

Para-aortic lymph nodes

Question 37

Where does lymph from the scrotum drain to?

Answer 37

Superficial inguinal lymph nodes