Inguinal Canal

Question 1

How does testicular migration form the inguinal canal?

Answer 1

As it descends, it pulls the musculature down, follows the gubernaculum until it ends up in the scrotum

Question 2

What is the one layer that the testes do not pull?

Answer 2

Transversus abdominus m

Question 3

What are the layers of the spermatic cord?

Answer 3

External spermatic fascia

Cremasteric fascia

Internal spermatic fascia

Tunica vaginalis parietal

Tunica vaginals visceral

Question 4

What is the scrotum innervated by?

Answer 4

Sympathetics

If cold, will cause dartos fascia to contract

Question 5

What is cremasteric fascia innervated by?

Answer 5

Under voluntary control - Genitofemoral n

Contracts when not breeding season

Question 6

What type of muscle does the dartos fascia include?

Answer 6

Smooth muscle

Question 7

What is the blood supply of the scrotum?

Answer 7

Posterior scrotal branches; from pudendal artery

Anterior scrotal branches; from deep external pudendal artery

Cremasteric a; from inferior epigastric

Question 8

What is the nerve supply of the scrotum?

Answer 8

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

Question 9

What is a hydrocele?

Answer 9

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

Question 10

What structures pass through the deep and superficial inguinal rings?

Answer 10

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

Question 11

What is a varicocele?

Answer 11

It is when the pampiniform plexus of veins become enlarged; causes dull pain

Question 12

What are the boundaries of the inguinal region?

Answer 12

ASIS to pubic tubercle

Question 13

What are the structures that come out of the superficial inguinal ring for males and females?

Answer 13

Males - spermatic cord

Females - round ligament of uterus

Question 14

What are the boundaries of the inguinal canal?

Answer 14

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

Question 15

What is the lacunar ligament?

Answer 15

Extra fibers from the inguinal ligament; make floor of inguinal canal

Question 16

What is the pectineal ligament?

Answer 16

Fibers from the inguinal ligament and lacunar ligament that travel superiorly at the bottom of the subinguinal space

Question 17

What is the conjoint tendon?

Answer 17

Merging of the internal oblique and transversus abdominus; on posterior wall of inguinal canal; attaches to pectineal line

Question 18

What is the iliopubic tract?

Answer 18

Transversalis fascia; it parallels the inguinal ligament

Question 19

What structures of the inguinal canal are derived from the external oblique?

Answer 19

Deep inguinal ring, superficial inguinal ring, medial and lateral crus

Question 20

What is the boundary between the indirect and direct hernia?

Answer 20

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)

Question 21

Which nerve goes through the superficial inguinal ring?

Answer 21

Ilioinguinal n to innervate scrotum and thigh

Question 22

What are the boundaries of the inguinal triangle?

Answer 22

Rectus abdominal muscle, inguinal ligament and epigastric vessels

Question 23

Where do femoral hernias happen?

Answer 23

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

Question 24

What is crytorchid testis?

Answer 24

undescended testis

Question 25

What is a hematocele?

Answer 25

accumulation of blood tunica vaginalis