Inguinal Canal

Question 1

Boundaries

Answer 1

1. Inguinal canal: 3-5 cm tunnel they abdominal wall along inguinal ligament
2. Under 3 arches of Ab. Wall muscle
3. Deep ring: spermatic cord thru endoabdominal fascia
4. Superficial ring: cord thru external oblique
5. Inguinal ligament: thanked terminal external oblique fascia from ASIS to pubic tubercle
6. Lacunar ligament: attaches inguinal ligament to pectinate line

Question 2

Fascial layers surrounding testes

Answer 2

1. Parietal peritoneum -> tunica vaginalis
   A. Serous membrane
   B. Attaches cremasteric fascia
2. Endoabdominal fascia -> inner spermatic fascia
3. Transversus abdominis -> nothing
   A. Goes over canal, not part of it
   B. Ends at inner ring
4. Internal oblique -> middle cremasteric fascia and muscle fibers
   A. Cremaster muscle: reflex and temp regulation
5. External oblique -> external spermatic fascia
6. Subcutaneous deep membranous fascia (Scarpa’s fascia) -> dartos fascia and muscle
   A. Autonomic control
   B. Temp regulation

Question 3

Inguinal canal contents

Answer 3

1. Spermatic cord
   A. Vas deferens: sperm pathway
   B. Vasculature
   
   1. Testicular artery: off aorta (L2), below renal arteries
   2. Cremasteric artery: from inf. Epigastric
   3. Papiniform venous plexus
      A. Right draining IVC
      B. Left into left renal
      C. Important for heat dissipation
      C. Nerves
   4. Genital branch of genitofemoral n.: innervates cremaster muscle
   5. Sympathetics
      A. Testicular plexus: w/ testicular artery and vas deferens (sympathetic chain T11-L1)
      B. Dartos: sympathetic n. Runs w/ ilioinguinal and post scrotal n. (Outside spermatic cord)
   6. Parasympathetics: from pelvic splanchnic S2-4
      D. Lymphatic drainage: testes (para-aortic nodes)
      E. Vestige of process is vaginalis if not obliterated
      F. Testes

Question 4

Gubernaculum

Answer 4

Ligament-like primordia

1. Attaches dev. Testes/ovaries and scrotal/labia folds
2. Course thru abdominal wall -> site of inguinal canal

Question 5

Processes vaginalis

Answer 5

Finger-like projection formed as gubernaculum pulls testes/ovaries thru abdominal wall
1. Becomes tunica vaginalis

Question 6

Inguinal canal dev in females

Answer 6

1. Ovaries pulled by gubernaculum
2. Stop before pelvic brim
3. Gubernaculum -> ovarian lig superiority and round lig of uterus inferior
4. Round lig thru inguinal canal -> labia majora
5. Processes vaginalis -> canal of nuck

Question 7

Hernia

Answer 7

Abdominal viscera protrudes thru fascia w/ inc. pressure
1. Direct: medial inguinal fossa (hasselbach triangle)
A. Borders
1. Inf. Epigastric a.
2. Inguinal lig.
3. Lateral rectus abdominus
B. Contains by external oblique or thru superficial ring

2. Indirect (congenital): thru processus vaginalis w/in spermatic cord or canal of nuck
3. Femoral: they femoral ring, along femoral vessels

Question 8

Hydrocele and hematocele

Answer 8

Fluid/blood w/in layers of tunica vaginalis

Question 9

Sebaceous cyst

Answer 9

Cyst w/in epidermis

1. Usually involve hair follicle

Question 10

Spermatocele

Answer 10

Cyst w/in head of epididymis

1. Most common cyst in scrotum

Question 11

Cryptorchidism

Answer 11

Undescended teste

1. 3% full term babies
2. 30% premies
3. 80% descend w/in first year

Question 12

Monorchism

Answer 12

One teste

Question 13

Polyorchism

Answer 13

Extra testes

Question 14

Ectopic testes

Answer 14

Lodged in abdominal cavity

Question 15

Vasectomy

Answer 15

Vas deferens clipped and tied