Inguinal Canal Flashcards
What makes up the conjoint tendon
Combined aponeuroses of inferior/medial margins of internal oblique and transversus abdominis m., inserting into pubis
The fibers of the ____ ____ and the ______ _____ surround the opening of the superficial inguinal ring
Medial crus; lateral crus
[connected via intracrural fibers]
______ = ligament between pubic rami and inguinal ligament; anchors inguinal ligament to pubis
Lacunar ligament
________ = continuation of fibers from lacunal ligament running along pectin pubis
Pectineal ligament
External opening within aponeurosis for spermatic cord or round ligament
Superficial inguinal ring
What lies immediately lateral to the lacunar ligament?
Femoral canal (subinguinal space)
Describe deep inguinal ring
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
Describe superficial inguinal ring
Exit from inguinal canal
Where spermatic cord or round ligament exit
The superficial inguinal ring is really a split in the aponeurosis of what muscle?
External oblique m.
Abdominal layers from external oblique m. to inguinal ligament
External oblique aponeurosis Internal oblique m. Transversus abdominis m. Transversalis fascia Parietal peritoneum Inguinal ligament (lower fibers of external oblique aponeurosis)
What two ligaments form a “shelf” for the spermatic cord?
Lacunar ligament
Pectineal ligament
_____ = thickening of transversalis fascia located posterior to inguinal ligament
Iliopubic tract
3 major nerves associated with inguinal ligament, canal, and ring
Iliohypogastric n. (L1)
Ilioinguinal n. (L1)
Genitofemoral n. (L1, L2)
Motor and sensory functions of iliohypogastric n. (L1)
Motor = abdominal mm.
Sensory = skin over pubis
Motor and sensory functions of ilioinguinal n. (L1)
Motor = abdominal mm.
Sensory = skin over upper/medial thigh and skin at root of penis, clitoris, and anterior scrotum/labia
What nerve traverses the inguinal canal and exits the superficial ring lateral to the spermatic cord?
Ilioinguinal n.
Motor and sensory functions of the genital branch of the genitofemoral n. (L1, L2)
Motor = cremasteric m.
Sensory = small part of medial thigh and scrotal/labial fascia
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.
T10; gubernaculum
Processus vaginalis; tunica vaginalis
When does the processus vaginalis usually close?
Within the 1st year postnatally
What condition is characterized by undescended testis and an increased risk of developing testicular cancer?
Cryptorchid testis
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?
Spermatic cord
Carried with it:
External oblique
Internal oblique
Transversalis fascia
In males, what embryonic fascia comes from external oblique aponeurosis?
External spermatic fascia
In males, what embryonic fascia comes from internal oblique?
Cremasteric fascia
In males, what embryonic fascia comes from transversalis fascia?
Internal spermatic fascia
In males, what embryonic fascia comes from processus vaginalis (peritoneum)?
Parietal and visceral layers of the tunica vaginalis
What are the contents of the spermatic cord?
Vas deferens Testicular a. Testicular vv. (Pampiniform plexus) Gonadal nn. Gonadal lymphatics
What condition is characterized by varicosities of the pampiniform plexus, leading to scrotal swelling with dull and recurring pain?
Testicular varicocele
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?
Hydrocele
[more common in babies, in adults can result from inflammation or injury in scrotum/testis/epididymis, communicating and non-communicating types]
What condition is characterized by an accumulation of blood in the tunica vaginalis?
Hematocele
How would you determine whether a hydrocele was filled with blood vs. serous fluid?
Trans-illumination
If serous fluid, will be more transparent
In terms of embryonic development in females, ovaries begin descending but the ______ becomes attached to the developing uterus
Gubernaculum
In female embryonic development, what does the gubernaculum become?
Ovarian ligament and round ligament of uterus
Contents of female inguinal canal
Round ligament of uterus
Ilioinguinal n
Genitofemoral n.
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
Superficial inguinal
Upper pelvic; pre-aortic
On the posterior aspect of the anterior abdominal wall, the median fold exists as a remnant of the _____
Urachus
On the posterior aspect of the anterior abdominal wall, the medial fold exists as a remnant of the ____
Distal umbilical aa.
On the posterior aspect of the anterior abdominal wall, the lateral folds exist due to what vessel(s)?
Inferior epigastric a. and v.
What are the borders of the inguinal (Hasselbach’s) triangle?
Inguinal ligament
Lateral border of rectus abdomins
Lateral umbilical ligament (fold)
Differentiate between direct, indirect, and femoral hernias
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
Possible hernia sites in ventral abdominal wall
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.)
Groin hernia sites
Inguinal
Femoral
What (in general) might cause a flank/lumbar hernia?
Defects in posterolateral abdominal wall allowing tissues inside abdomen to protrude
