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GI Exam 1 > Inguinal Canal > Flashcards

Inguinal Canal Flashcards

1
Q
  • The testes and ovaries develop from what germ layer?
  • They pass through _ and end in scrotum
A
  • Intermediate mesoderm
  • Inguinal canal
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2
Q
  • Steps of Testicular Migration
A
  1. Develop on posterior abdominal wall
  2. Follows gubernaculum
  3. Passes through muscle layers and inguinal canal
  4. Ends migration in scrotum
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3
Q
  • What is the remnant of the gubernaculum in males and females?
A
  • Males
    • Scrotal ligament
  • Females
    • Round ligament of the uterus
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4
Q
  • As the testes descend, which muscle DOES NOT get pulled along with it?
A
  • Transversus abdominis m.
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5
Q
  • Name the following structures
A
  1. Deep Inguinal Ring
  2. Superficial Inguinal Ring
  3. Scrotum (skin and dartos)
  4. External spermatic fascia
  5. Cremasteric fascia
  6. Internal spermatic fascia
  7. Tunica vaginalis (parietal)
  8. Tunica vaginalis (visceral)
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6
Q
  • What innervates the dartos m.?
  • What innervates the cremasteric m.?
A
  • Sympathetics
  • Genital branch of genitofemoral n.
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7
Q
  • What are the layers of the scrotum?
A
  • Skin
  • Dartos fascia
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8
Q
  • Blood supply to the scrotum
A
  • Posterior scrotal branches from pudendal artery
  • Anterior scrotal branches from deep external pudendal artery
  • Cremasteric artery (from inferior epigastric)
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9
Q
  • Nerve supply to the scrotum
A
  • Posterior scrotal nerves (from pudendal n.)
    • Supply posterior surface
  • Perineal branches of posterior cutaneous n. of thigh (pudendal n.)
    • Supply posteroinferior surface
  • Anterior scrotal nerves
    • Supply anterior surface (from ilioinguinal n. L1)
  • Genital branch of genitofermoral n.
    • Supply anterolateral surface
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10
Q
  • Label parts of the scrotum
A
  1. Dartos fascia
  2. External spermatic fascia
  3. Cremaster m.
  4. Internal spermatic fascia
  5. Parietal layer of tunica vaginalis
  6. Epididymios
  7. Visceral layer of tunica vaginalis
  8. Skin
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11
Q
  • Hydrocele
A
  • Fluid in persistent processus vaginalis (aka fluid between the parietal and visceral layer of the tunica vaginalis)
  • Detected via transillumination
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12
Q

Identify where portions of the spermatic cord originated from

A
  1. External oblique aponeurosis forms external spermatic fascia
  2. Cremasteric fascia from internal oblique
  3. Internal spermatic fascia from transversalis fascia
  4. Processus vaginalis
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13
Q
  • Contents of the spermatic cord
A
  • Ductus deferens
  • Artery to ductus deferens (from inferior vesicular artery)
  • Testicular artery
  • Pampiniform plexus of veins (thermoregulation)
  • Sympathetics and visceral afferents (to regulate dartos m.)
  • Lymphatics
  • Remnants of processus vaginalis
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14
Q
  • Where does the gonadal/testicular artery originate from (on each side)
A
  • From aorta on right side
  • Left renal artery on left side
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15
Q
  • Varicocele
  • Which side is more common?
A
  • Scrotal fullness caused by dilated and tortuous veins in the pampiniform plexus surrounding the spermatic cord
  • Bag of worms appearance on physical exam (increases with standing or the Valsalva maneuver)
  • Left
    • Since left side drains into left renal vein (which is more easily compressed)
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16
Q
  • What nerve is responsible for the cremasteric reflex?
A
  • Genitofemoral n.
17
Q
  • Define the inguinal region
  • The inguinal region is a common site for _
  • Label the structures of the inguinal region
A
  • Region where structures enter and exit the abdominal cavity
  • Inguinal region is a common site of herniation
  1. Herniation
  2. Spermatic cord (males) Round ligament of the uterus (females)
  3. Deep inguinal ring
  4. Superficial inguinal ring
18
Q
  • What makes up the floor of the inguinal canal?
A
  • Iliopubic tract
  • Inguinal Ligament
  • Lacunar Ligament
19
Q
  • *The medial crus of the inguinal ligament attaches to the _*
  • *The lateral crus of the inguinal ligament attaches to the _*
A
  • Pubic crest (MC)
  • Pubic tubercle (TL)
20
Q
  • Identify the structures of the external oblique aponeurosis
A
  • Lateral crus
  • Inguinal ligament
  • Subinguinal space
  • Pectineal ligament
  • Medial crus
  • Superficial inguinal ring
  • Pubic tubercle
  • Lacunar ligament
21
Q
  • Identify the following structures
A
  • Internal obliques
  • Transversus abdominis
  • Conjoint tendon
  • Cremasteric m.
  • Lacunar ligament
  • Superficial inguinal ring
  • Transversalis fascia
  • Conjoint tendon
22
Q
  • The transversalis fascia helps make up the _ tract
A
  • Iliopubic
23
Q
  • Label the following
A
  1. Inferior epigastric veins
  2. Lacunar ligament
  3. Transcersalis fascia
  4. Iliopubic tract (parallels inguinal ligament)
  5. Deep inguinal ring
  6. Gonadal/Testicular Vessels
  7. Ductus Deferens (Vas deferens)
24
Q
  • What three anatomical structures make up the border of the inguinal triangle/Hasselbach’s triangle?
A
  1. Rectus abdominus
  2. Inguinal ligament
  3. Inferior epigastric vessels
25
Q
  • What two landmarks can be used to identify the deep inguinal ring?
A
  • Testicular/Gonadal Vessels
  • Ductus/Vas Deferens
26
Q
  • The conjoint tendon inserts on the _
A
  • Pectineal line
27
Q
  • Direct versus indirect inguinal hernia
A
  • Direct
    • Medial to inferior epigastric vessels
    • Direct-Medial (DM)
  • Indirect
    • Lateral to inferior epigastric vessels
    • Inferior-Lateral (IL)
28
Q
  • Are direct or indirect hernias more common?
A
  • Indirect (most common hernia in both males and females)
29
Q
  • What occurs in an indirect inguinal hernia?
A
  • Gut contents move thru deep inguinal ring and pierce layers of spermatic cord and can pass thru the superficial inguinal ring
30
Q
  • What occurs in a direct inguinal hernia?
A
  • Conjoint tendon is weak
  • Abdominal contents press down on parietal peritoneum and transversalis fascia
  • Does not go through deep inguinal ring
  • Tries to come out at superficial inguinal ring
31
Q
  • Femoral hernia occurs _ to inguinal ligament
  • More common in males or females?
A
  • Inferior
  • Females
  • 40% present as emergencies with incarceration or strangulation
32
Q
  • Lumbar nodes of the inguinal canal
A
  • Testes/Ovaries
  • to
  • Lumbar, Aortic, Caval
33
Q
  • Superficial inguinal lymph nodes
A
  • Lower limb
  • Superficial drainage of inferolateral quardant of trunk (inferior to umbilicus)
  • Gluteal region
  • Scrotum

GI Exam 1 (10 decks)

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