Inguinal Canal Flashcards
Inguinal ligament
Inferior border of external oblique muscle aponeurosis, is attached to ASIS and pubic tubercle
Conjoint tendon (inguinal falx)
Combined aponeurosis of inferior.medial margins of internal oblique and transversus abdominal muscle inserting into pubis
Lacunar ligament
Ligament between pubic rami and inguinal ligament; anchors inguinal ligament to pubis
Pectineal ligament
Continuation of fibers from lacunar ligament running along pectic pubis
Femoral canal (subinguinal space)
Lies immediately lateral to lacunar ligament
Deep inguinal ring
Superior to inguinal ligament and lateral to inferior epigastric artery; where vas deferens and gonadal vessels/nerves pass in males and round ligament
Superficial inguinal ring
Exit of inguinal canal, where spermatic cord/round ligament exit from the canal. The ring is really a partial split in the external oblique aponeurosis
What are the 6 abdonimal layers?
- External oblique aponeurosis
- Internal oblique m
- Transversus abdominus m
- Transversalis fascia
- Parietal peritoneum
- Inguinal ligament (lower fibers of external oblique aponeurosis)
Iliohypogastric nerve
L1: Transverses inguinal canal, exits superficial ring lateral to cord. Motor to abdominal muscles (IO and TA), skin over upper/medial thigh and skin at root of penis.clit and anterior scrotum/labia
Genitofemoral nerve
L1-L2: genital branch, motor - cremasteric muscle (temperature regulation), sensory - small part of medial thigh and scrotal/labial fascia
Processus vaginalis
Envagination of peritoneal cavity; communication usually closes within 1st year postnatally
Cryptorchid testis
Undescended testis, at increased risk of developing testicular cancer
Testicular varicocele
Varicosities of pampiniform plexus, swelling in scrotum with dull and recurring pain in scrotum
Persistent processus vaginalis
Patent connection between tunica vaginalis and abdomen
Hydrocele
Peritoneal fluid accumulation within tunica vaginalis, can see through with flashlight (trans-illumination)
More common in babies. In adults, inflammation or injury in the scrotum, testis or epididymus
Hematocele = accumulation of blood in tunica vaginalis
Ovarian descent
Begins descending but gubernaculum becomes attached to developing uterus.
Gubernaculum forms ovarian ligament and round ligament of uterus.
Round ligament of the uterus - enters deep rings and exits superficial ring attaching to labial swellings
Female inguinal canal
Has deep and superficial rings, medial/lateral crus, lacunar/pectineal ligaments, conjoint tendon, round ligament of uterus, ilioinguinal nerve, genitofemoral nerve (genital branch)
Lymph drainage of testes and scrotum
From scrotum/labia, drains into superficial inguinal nodes and eventually travels into lumbar nodes.
Gonads in both sexes drain into upper pelvic lymph nodes and then into pre-aortic lymph nodes
Inguinal (Hasselbach’s) Triangle
Inguinal ligament, lateral border of rectus abdominus, lateral umbilical ligament (fold), iliopubic tract (thickened transversalis fascia running posterior to inguinal ligament, reinforces floor of inguinal canal)
Direct hernia
Medial to inferior epigastric artery, peritoneum/transversalis fascia outside of spermatic cord
Indirect hernia
Enters deep ring, peritoneum within spermatic cord
Femoral hernia
Below inguinal ligament, more common in women, 40% present as emergencies with incarceration or strangulation
Abdominal wall hernia sites (ventral)
Umbilical, epigastric (weakness in middle wall fusion point), spigelian (through fascia between the abdominal muscles but along the semilunar line of rectus abdominus muscle)
Groin hernia sites
Inguinal, femoral
Flank lumbar hernia
Defects in posterolateral abdominal wall allowing the tissues inside the abdomen to protrude
