Inguinal Canal

Question 1

Inguinal ligament

Answer 1

Inferior border of external oblique muscle aponeurosis, is attached to ASIS and pubic tubercle

Question 2

Conjoint tendon (inguinal falx)

Answer 2

Combined aponeurosis of inferior.medial margins of internal oblique and transversus abdominal muscle inserting into pubis

Question 3

Lacunar ligament

Answer 3

Ligament between pubic rami and inguinal ligament; anchors inguinal ligament to pubis

Question 4

Pectineal ligament

Answer 4

Continuation of fibers from lacunar ligament running along pectic pubis

Question 5

Femoral canal (subinguinal space)

Answer 5

Lies immediately lateral to lacunar ligament

Question 6

Deep inguinal ring

Answer 6

Superior to inguinal ligament and lateral to inferior epigastric artery; where vas deferens and gonadal vessels/nerves pass in males and round ligament

Question 7

Superficial inguinal ring

Answer 7

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

Question 8

What are the 6 abdonimal layers?

Answer 8

1. External oblique aponeurosis
2. Internal oblique m
3. Transversus abdominus m
4. Transversalis fascia
5. Parietal peritoneum
6. Inguinal ligament (lower fibers of external oblique aponeurosis)

Question 9

Iliohypogastric nerve

Answer 9

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

Question 10

Genitofemoral nerve

Answer 10

L1-L2: genital branch, motor - cremasteric muscle (temperature regulation), sensory - small part of medial thigh and scrotal/labial fascia

Question 11

Processus vaginalis

Answer 11

Envagination of peritoneal cavity; communication usually closes within 1st year postnatally

Question 12

Cryptorchid testis

Answer 12

Undescended testis, at increased risk of developing testicular cancer

Question 13

Testicular varicocele

Answer 13

Varicosities of pampiniform plexus, swelling in scrotum with dull and recurring pain in scrotum

Question 14

Persistent processus vaginalis

Answer 14

Patent connection between tunica vaginalis and abdomen

Question 15

Hydrocele

Answer 15

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

Question 16

Ovarian descent

Answer 16

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

Question 17

Female inguinal canal

Answer 17

Has deep and superficial rings, medial/lateral crus, lacunar/pectineal ligaments, conjoint tendon, round ligament of uterus, ilioinguinal nerve, genitofemoral nerve (genital branch)

Question 18

Lymph drainage of testes and scrotum

Answer 18

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

Question 19

Inguinal (Hasselbach’s) Triangle

Answer 19

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)

Question 20

Direct hernia

Answer 20

Medial to inferior epigastric artery, peritoneum/transversalis fascia outside of spermatic cord

Question 21

Indirect hernia

Answer 21

Enters deep ring, peritoneum within spermatic cord

Question 22

Femoral hernia

Answer 22

Below inguinal ligament, more common in women, 40% present as emergencies with incarceration or strangulation

Question 23

Abdominal wall hernia sites (ventral)

Answer 23

Umbilical, epigastric (weakness in middle wall fusion point), spigelian (through fascia between the abdominal muscles but along the semilunar line of rectus abdominus muscle)

Question 24

Groin hernia sites

Answer 24

Inguinal, femoral

Question 25

Flank lumbar hernia

Answer 25

Defects in posterolateral abdominal wall allowing the tissues inside the abdomen to protrude