Inguinal Canal

Question 1

Where does the inguinal ligament attach?

Answer 1

ASIS and public tubercle

Question 2

Which two muscles form an aponeurosis that makes up the conjoint tendon (inguinal falx)?

Answer 2

Oblique and transversus abdominal ms.

Question 3

What runs in the deep ring?

Answer 3

Vas deferens and gonadal vessels/nerves-males

round ligament-females

Question 4

What are the abdominal layers?

Answer 4

External oblique aponeurosis

Internal oblique m.

Transversus abdominis m.

Transversalis fascia

Parietal peritoneum

Inguinal ligament

Question 5

What does the iliohypogastric nerve (L1) supply?

Answer 5

Motor-Internal oblique and transversus abdominus m.

Sensory-skin above pubis (hypogastric region)

Question 6

What does the ilioinguinal nerve (L1) supply?

Answer 6

Motor-Internal oblique and transversus abdominus m.

Sensory-skin over upper/medial thigh, penis/clitoris, anterior scrotum/labia

Question 7

What does the genitofemoral nerve (L1, L2) supply?

Answer 7

Motor-cremasteric m.

Sensory-small part of medial thigh and scrotal/labial fascia

Question 8

Describe testicular descent

Answer 8

• Gonads form near T10
• Gonads are connected to future scrotum by gubernalculum
• Gonads descend with processus vaginalis and vessels into future scrotum
• Connection closes. Tunica vaginalis represents remains of processus vaginalis

Question 9

What layers of abdominal wall are carried as spermatic cord develops?

Answer 9

Transversalis fascia -internal spermatic fascia

Internal oblique -cremasteric m.

External oblique -spermatic fascia

Question 10

Persistent processus vaginalis

Answer 10

patent connection between tunica vaginalis and abdomen

Question 11

Hydrocele vs hematocele

Answer 11

Peritoneal fluid accumulation within tunica vaginalis vs blood accumulation -Detect hydrocele with trans-illumination

Question 12

Describe ovarian descent

Answer 12

• Gubernaculum becomes attached to uterus and forms ovarian and round ligament
• Round ligament enters deep ring and exits superficial ring attaching to labial swellings

Question 13

What are the contents of the female inguinal canal?

Answer 13

Round ligament of uterus

Ilioinguinal n.

Geniofemoral n.

Question 14

Which lymph nodes drain the scrotum?

Answer 14

superficial inguinal nodes –>iliac and lumbar nodes

Question 15

What lymph nodes drain the testes?

Answer 15

Lumbar and pre-aortic lymph nodes

Question 16

What are the folds of the anterior abdominal wall?

Answer 16

Median-remnant of urachus

Medial-remnant of distal-most portion of umbilical arteries

Lateral-fold due to inferior epigastric arteries and veins

Question 17

What are the borders of hesslebach’s triangle?

Answer 17

Inguinal L.

Lateral border of rectus abdominis

Lateral umbilical L.

Question 18

What is cryptorchid testis?

Answer 18

Undescended testes

Question 19

Direct hernia

Answer 19

Medial to inferior epigastric a. peritoneum/transversalis fascia alongside the spermatic cord

Question 20

Indirect hernia

Answer 20

enters deep ring; peritoneum within spermatic cord

Question 21

Femoral hernia

Answer 21

below inguinal ligament more common in women

Question 22

Epigastric hernia

Answer 22

weakness in wall in midline fusion point

Question 23

Spigelian hernia

Answer 23

through fascia between the abdominal muscles but along the semilunar line of rectus abdominis m.

Question 24

Flank Hernia

Answer 24

Defects in the posterolateral abdominal wall

Question 25

What runs in the superficial ring?

Answer 25

Spermatic cord/Round ligament

Question 26

What are the contents of the spermatic cord?

Answer 26

Vas deferens

Testicular a & v. (pampiniform plexus)

Gonadal ns.

Gonadal lymphatics

Question 27

What is a testicular varicocele?

Answer 27

Varicosities of pampiniform plexus

-Swelling in scrotum with dull and recurring pain