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GI II > Inguinal Canal > Flashcards

Inguinal Canal Flashcards

1
Q

What is the Dartos tunic in the scrotum continuous with?

A

The membranous (Scarpa’s) fascia of the anterior abdominal wall.

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2
Q

What does the membranous (Scarpa’s) fascia of the anterior abdominal wall merge with at the inguinal ligament?

A

The fascia lata (deep fascia of the thigh).

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3
Q

What does the ilioinguinal nerve run along?

A

It runs along the inguinal border and down with the spermatic cord.

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4
Q

Where are the ilioinguinal and iliohypogastric nerves located?

A

Between the external and internal obliques.

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5
Q

What is the location of the neurovascular plane of the anterior abdominal wall?

A

Between the internal oblique and the transversus abdominus.

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6
Q

What is the conjoint tendon?

A

The conjoint tendon is formed by the arching fibers of the transversus abdominus and the medial fibers of the internal oblique.

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7
Q

What do the inferior epigastric arteries come off of?

A

The external iliac arteries.

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8
Q

What do the superior epigastric arteries come off of?

A

The internal thoracic artery.

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9
Q

What does the inguinal ligament extend from?

A

From the ASIS to the pubic tubercle.

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10
Q

What is the inguinal ligament continuous with?

A

The aponeurosis of the external oblique.

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11
Q

Where did the testes begin embryologically and what does this mean about their mature position?

A

The testes began as part of the posterior abdominal (retroperitoneal) wall and had to descend into the scrotal sac.

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12
Q

What is the gubernaculum?

A

A fibrous CT that connects the testes to the floor of the scrotal sac. Is what pulled the testes into the sac during development.

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13
Q

Where did the testes first enter the anterior abdominal wall?

A

At the deep inguinal ring located in the transversalis fascia.

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14
Q

Where did the testes exit?

A

The superficial inguinal ring located in the external oblique.

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15
Q

What layers of the anterior abdominal wall did the testes “pick up” to form the spermatic cord?

A

The transversalis fascia, internal oblique, and external oblique. They missed the transversus abdominus due to its overarching fibers.

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16
Q

What derived the internal spermatic fascia of the spermatic cord?

A

The transversalis fascia.

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17
Q

What derived the middle/cremasteric muscle/fascia of the spermatic cord?

A

The internal oblique.

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18
Q

What derived the external spermatic fascia of the spermatic cord?

A

The external oblique.

19
Q

What does the ilioinguinal nerve run along within the spermatic cord?

A

It runs superficial to the cremasteric fascia/muscle.

20
Q

What nerve is contained deep to the internal spermatic fascia alongside the ductus deferens, etc.?

A

The genital branch of the genito-femoral nerve.

21
Q

What nerve runs between the middle/cremasteric fascia and the external spermatic fascia?

A

The ilioinguinal nerve.

22
Q

What is the cremasteric reflex?

A

Touching the ipsilateral inner thigh to invoke raising of the testes (cremaster muscle).

23
Q

What is the afferent limb of the cremasteric reflex?

A

The ilioinguinal nerve (why touching the inner thigh will initiate the reflex).

24
Q

What is the efferent limb of the cremasteric reflex?

A

The genital branch of the genito-femoral nerve.

25
Q

What spinal cord level does the cremasteric reflex asses?

A

L1

26
Q

What is the gubernaculum attached to besides the scrotum?

A

The parietal peritoneum.

27
Q

What happens to the peritoneum during the descent of the testes due to its attachment to the gubernaculum?

A

During the descent of the testes a sheath of peritoneum is pulled into the scrotum.

28
Q

What happens to the peritoneal sheath?

A

It closes off and forms the tunica vaginalis surrounding the testes.

29
Q

What happens when the peritoneal sheath doesn’t close off?

A

It forms an open pathway from the abdominal cavity into the scrotum, predisposing to inguinal hernias.

30
Q

What happens when the peritoneal sheath incompletely closes off?

A

It forms a fluid filled hydrocele that can create a potential weakness for inguinal hernias.

31
Q

What is the medial border of the inguinal triangle?

A

The lateral border of the rectus abdominus.

32
Q

What is the lateral border of the inguinal triangle?

A

The inferior epigastric vessels.

33
Q

What is the inferior border of the inguinal triangle?

A

The inguinal ligament.

34
Q

What defines an indirect inguinal hernia?

A

When the loop of bowel enters the deep inguinal ring and the inguinal canal.

35
Q

What defines a direct inguinal hernia?

A

When the loop of bowel exits through a tear in the anterior abdominal wall (traumatic injury).

36
Q

How can a direct inguinal hernia be differentiated from an indirect inguinal hernia?

A

An indirect inguinal hernia will occur lateral to the inferior epigastric vessels while a direct will occur within the inguinal triangle (medial to the inferior epigastric vessels).

37
Q

What does the round ligament of the uterus travel though?

A

It originates from the uterus, travels through the inguinal canal (female equivalent to the spermatic cord) and will attach to the skin of the labia majus.

38
Q

Why are inguinal hernias less common in females?

A

Because the round ligament of the uterus is not as large as the spermatic cord, plus the inguinal ligament is wider in females (path of least resistance).

39
Q

What forms the fascia of the femoral sheath?

A

The transversalis fascia and the iliacus fascia.

40
Q

What are the contents of the femoral sheath from lateral to medial?

A

The femoral nerve, artery, vein, and lymphatics (NAVL).

41
Q

What is important about the femoral artery, vein, and lymphatics?

A

They are contained within their own separate compartments within the femoral sheath.

42
Q

What does the femoral canal convey and what does it predispose to?

A

The femoral canal is where the lymphatics are contained within the femoral sheath, but it also provides a path for femoral hernias.

43
Q

What is the saphenous opening?

A

An opening in the fascia lata that allows the great saphenous vein to drain into the femoral vein.

44
Q

What is clinically relevant about the saphenous opening?

A

It is an additional structure that bowel can herniate through in a femoral hernia.

GI II (7 decks)

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