Inguinal Canal Flashcards
How does testicular migration form the inguinal canal?
As it descends, it pulls the musculature down, follows the gubernaculum until it ends up in the scrotum
What is the one layer that the testes do not pull?
Transversus abdominus m
What are the layers of the spermatic cord?
External spermatic fascia
Cremasteric fascia
Internal spermatic fascia
Tunica vaginalis parietal
Tunica vaginals visceral
What is the scrotum innervated by?
Sympathetics
If cold, will cause dartos fascia to contract
What is cremasteric fascia innervated by?
Under voluntary control - Genitofemoral n
Contracts when not breeding season
What type of muscle does the dartos fascia include?
Smooth muscle
What is the blood supply of the scrotum?
Posterior scrotal branches; from pudendal artery
Anterior scrotal branches; from deep external pudendal artery
Cremasteric a; from inferior epigastric
What is the nerve supply of the scrotum?
Posterior scrotal nerves; supply posterior surface
Perineal branches of posterior cutaneous of thigh; supply posterior inferior surface
Anterior scrotal nerves: supply anterior surface
Genital branch of genitofemoral n supplies anterolateral surface
What is a hydrocele?
Excess fluid accumulating into the scrotum due to persistent processus vaginalis
Could have a cyst or herniation of gut contents into the scrotum as well
What structures pass through the deep and superficial inguinal rings?
Ductus deferens
Artery to ductus deferens
Testicular a (gonadal a)
Pampiniform plexus of veins
Cremasteric a & v
Genitofemoral n
Sympathetics and visceral afferents
Lymphatics
Remnants of the processus vaginalis
What is a varicocele?
It is when the pampiniform plexus of veins become enlarged; causes dull pain
What are the boundaries of the inguinal region?
ASIS to pubic tubercle
What are the structures that come out of the superficial inguinal ring for males and females?
Males - spermatic cord
Females - round ligament of uterus
What are the boundaries of the inguinal canal?
Posterior wall - transversalis fascia and conjoint tendon
Anterior wall - internal oblique, aponeurosis of external oblique
Roof - transversalis fascia, aponeurosis of internal and external oblique
Floor - iliopubic tract, inguinal ligament, lacunar ligament
What is the lacunar ligament?
Extra fibers from the inguinal ligament; make floor of inguinal canal
What is the pectineal ligament?
Fibers from the inguinal ligament and lacunar ligament that travel superiorly at the bottom of the subinguinal space
What is the conjoint tendon?
Merging of the internal oblique and transversus abdominus; on posterior wall of inguinal canal; attaches to pectineal line
What is the iliopubic tract?
Transversalis fascia; it parallels the inguinal ligament
What structures of the inguinal canal are derived from the external oblique?
Deep inguinal ring, superficial inguinal ring, medial and lateral crus
What is the boundary between the indirect and direct hernia?
The epigastric arteries;
direct are medial to inferior epigastric a.
Indirect hernias are lateral to the inferior epigastric aa. Most common in men and women (bc of gubernaculum weakening wall)
Which nerve goes through the superficial inguinal ring?
Ilioinguinal n to innervate scrotum and thigh
What are the boundaries of the inguinal triangle?
Rectus abdominal muscle, inguinal ligament and epigastric vessels
Where do femoral hernias happen?
Inferior to the inguinal ligament
More common in women; most in emergencies because of the lacunar ligament being very tough and cutting off blood supply to the gut
What is crytorchid testis?
undescended testis
