Inguinal Canal

Question 1

What makes up the conjoint tendon

Answer 1

Combined aponeuroses of inferior/medial margins of internal oblique and transversus abdominis m., inserting into pubis

Question 2

The fibers of the ____ ____ and the ______ _____ surround the opening of the superficial inguinal ring

Answer 2

Medial crus; lateral crus

[connected via intracrural fibers]

Question 3

______ = ligament between pubic rami and inguinal ligament; anchors inguinal ligament to pubis

Answer 3

Lacunar ligament

Question 4

________ = continuation of fibers from lacunal ligament running along pectin pubis

Answer 4

Pectineal ligament

Question 5

External opening within aponeurosis for spermatic cord or round ligament

Answer 5

Superficial inguinal ring

Question 6

What lies immediately lateral to the lacunar ligament?

Answer 6

Femoral canal (subinguinal space)

Question 7

Describe deep inguinal ring

Answer 7

Entrance to inguinal canal and beginning of evagination into the transversalis fascia

Lies superior to inguinal ligament and lateral to the inferior epigastric

Where vas deferens and gonadal vessels/nerves pass in males and round ligament passes in females

Question 8

Describe superficial inguinal ring

Answer 8

Exit from inguinal canal

Where spermatic cord or round ligament exit

Question 9

The superficial inguinal ring is really a split in the aponeurosis of what muscle?

Answer 9

External oblique m.

Question 10

Abdominal layers from external oblique m. to inguinal ligament

Answer 10

External oblique aponeurosis
Internal oblique m.
Transversus abdominis m.
Transversalis fascia
Parietal peritoneum
Inguinal ligament (lower fibers of external oblique aponeurosis)

Question 11

What two ligaments form a “shelf” for the spermatic cord?

Answer 11

Lacunar ligament

Pectineal ligament

Question 12

_____ = thickening of transversalis fascia located posterior to inguinal ligament

Answer 12

Iliopubic tract

Question 13

3 major nerves associated with inguinal ligament, canal, and ring

Answer 13

Iliohypogastric n. (L1)

Ilioinguinal n. (L1)

Genitofemoral n. (L1, L2)

Question 14

Motor and sensory functions of iliohypogastric n. (L1)

Answer 14

Motor = abdominal mm.

Sensory = skin over pubis

Question 15

Motor and sensory functions of ilioinguinal n. (L1)

Answer 15

Motor = abdominal mm.

Sensory = skin over upper/medial thigh and skin at root of penis, clitoris, and anterior scrotum/labia

Question 16

What nerve traverses the inguinal canal and exits the superficial ring lateral to the spermatic cord?

Answer 16

Ilioinguinal n.

Question 17

Motor and sensory functions of the genital branch of the genitofemoral n. (L1, L2)

Answer 17

Motor = cremasteric m.

Sensory = small part of medial thigh and scrotal/labial fascia

Question 18

During male embryonic development, gonads form near the _____ axial level and are connected to future scrotal swellings by _____________

They descend along with an out-pocketing of peritoneal cavity called the _____ _______ into the future scrotum. This connection to the peritoneum later closes and its embryonic remnant is known as the ______ ______ which surrounds the testes.

Answer 18

T10; gubernaculum

Processus vaginalis; tunica vaginalis

Question 19

When does the processus vaginalis usually close?

Answer 19

Within the 1st year postnatally

Question 20

What condition is characterized by undescended testis and an increased risk of developing testicular cancer?

Answer 20

Cryptorchid testis

Question 21

During male embryonic development, as the gonad herniates along with its blood supply and vas deferens, it carries layers of the abdominal wall with it, forming the ____ _____.

What layers of the abdominal wall are carried with it?

Answer 21

Spermatic cord

Carried with it:
External oblique
Internal oblique
Transversalis fascia

Question 22

In males, what embryonic fascia comes from external oblique aponeurosis?

Answer 22

External spermatic fascia

Question 23

In males, what embryonic fascia comes from internal oblique?

Answer 23

Cremasteric fascia

Question 24

In males, what embryonic fascia comes from transversalis fascia?

Answer 24

Internal spermatic fascia

Question 25

In males, what embryonic fascia comes from processus vaginalis (peritoneum)?

Answer 25

Parietal and visceral layers of the tunica vaginalis

Question 26

What are the contents of the spermatic cord?

Answer 26

``` Vas deferens Testicular a. Testicular vv. (Pampiniform plexus) Gonadal nn. Gonadal lymphatics ```

Question 27

What condition is characterized by varicosities of the pampiniform plexus, leading to scrotal swelling with dull and recurring pain?

Answer 27

Testicular varicocele

Question 28

A persistent processus vaginalis may lead to a patent connection between the tunica vaginalis and abdomen. What condition might this lead to, involving peritoneal fluid accumulation within the tunica vaginalis?

Answer 28

Hydrocele [more common in babies, in adults can result from inflammation or injury in scrotum/testis/epididymis, communicating and non-communicating types]

Question 29

What condition is characterized by an accumulation of blood in the tunica vaginalis?

Answer 29

Hematocele

Question 30

How would you determine whether a hydrocele was filled with blood vs. serous fluid?

Answer 30

Trans-illumination If serous fluid, will be more transparent

Question 31

In terms of embryonic development in females, ovaries begin descending but the ______ becomes attached to the developing uterus

Answer 31

Gubernaculum

Question 32

In female embryonic development, what does the gubernaculum become?

Answer 32

Ovarian ligament and round ligament of uterus

Question 33

Contents of female inguinal canal

Answer 33

Round ligament of uterus Ilioinguinal n Genitofemoral n.

Question 34

Lymph drainage of testes and scrotum: From scrotum/labia, lymph drains into _____ _____ nodes Gonads in both sexes drain into ____ _____ lymph nodes and travel into lumbar area and then into ______ lymph nodes

Answer 34

Superficial inguinal Upper pelvic; pre-aortic

Question 35

On the posterior aspect of the anterior abdominal wall, the median fold exists as a remnant of the _____

Answer 35

Urachus

Question 36

On the posterior aspect of the anterior abdominal wall, the medial fold exists as a remnant of the ____

Answer 36

Distal umbilical aa.

Question 37

On the posterior aspect of the anterior abdominal wall, the lateral folds exist due to what vessel(s)?

Answer 37

Inferior epigastric a. and v.

Question 38

What are the borders of the inguinal (Hasselbach’s) triangle?

Answer 38

Inguinal ligament Lateral border of rectus abdomins Lateral umbilical ligament (fold)

Question 39

Differentiate between direct, indirect, and femoral hernias

Answer 39

Direct = medial to inferior epigastric; peritoneum outside of spermatic cord Indirect = enters dep ring; peritoneum within spermatic cord Femoral = below inguinal ligament, more common in women

Question 40

Possible hernia sites in ventral abdominal wall

Answer 40

Umbilical Epigastric (weakeness in wall in midline fusion point) Spigelian (through fascia between abdominal muscles but along the semilunar line of the rectus abdominis m.)

Question 41

Groin hernia sites

Answer 41

Inguinal | Femoral

Question 42

What (in general) might cause a flank/lumbar hernia?

Answer 42

Defects in posterolateral abdominal wall allowing tissues inside abdomen to protrude