Inguinal Canal Flashcards
What is the Inguinal Ligament?
Basically is the rolled under inferior border of external oblique muscle aponeurosis
-attached to ASIS and pubic tubercle
What is the conjoint tendon?
also known as the inguinal falx
-Combined aponeurosis of inferior/medial margins of internal oblique and transversus abdominal muscle that inserts into the pubis
what is the Lacunar ligament?
what is the Pectineal ligament?
Lacunar ligament: is the ligament between the pubic rami and inguinal ligament
- anchors the inguinal ligament to the pubis
- femoral canal lies immediately lateral to lacunar ligament
Pectineal ligament:
-continuation of fibers from lacunar ligament running along the pectin pubis
What are the two inguinal rings and what passes through them and their location
Deep ring:
- entrance to the inguinal canal and beginning of the invagination of peritoneum into transversalis fascia
- superior to inguinal ligament and later to inferior epigastric artery
- where vas deferens and gonadal vessels/nerves passin males and round ligament in females
Superficial ring
- exit for inguinal canal
- where spermatic cord or round ligament exit from the canal
- ring is really a partial split in the external oblique muscle aponeurosis
what is the iliopubic tract?
it is the thickening of the transversalis fascia running posterior to the inguinal ligament
what are the three nerves that run near the inguinal ligament, canal, and ring and where do they run and what do they innervate?
Iliohypogastric Nerve: L1
- motor to abdominal muscles of IO and TA
- Skin above pubis (hypogastric region)
- runs outside of the inguinal canal
Ilioguinal nerve: L1
- transverses inguinal canal and exits superficial ring lateral to cord
- Motor to abdominal muscles (IO and TA)
- skin over upper medial thigh and skin at root of penis/clitoris and anterior scrotum/labia
Genitofemoral nerve: L1, L2
- runs in the spermatic cord
- Genital branch
- Motor for cremasteric muscle
- sensory for small part of medial thigh and scrotal/labia fascia
How does the Testicular Descent occur?
- Gonads form near T10 axial level
- Gonads are connected to future scrotal swellings by gubernaculum
- Descent along with an out pocketing of peritoneal cavity called the process vaginalis, into the future scrotum carrying vessels and nerves with them that will form the future suspensory ligament
-The connection to the peritoneum is closed and the tunica vaginalis represents the remains of processus vaginalis around the testes
what are the layers of the abdominal wall that are carried as the spermatic cord develops and what will they become?
- Transversalis fascia: internal spermatic fascia
- Internal oblique M: cremasteric muscle
- External oblique: external spermatic fascia
the processus vaginalis is the evagination of the peritoneal cavity that follows with the testes descent and contains serous fluid
- will close within the 1st year postnatally
- makes up the parietal, cavity, and visceral layer of the tunica vaginalis,
what is a cryptorchid testis?
Undescended testis
-increases the risk of developing testicular cancer
what are the Spermatic cord contents?
-Vas deferens (ductus deferens)
-Testicular veins
(pampiniform plexus that closely wraps the arteries)
- Gonadal nerves
- Gonadal lymphatics
What is Testicular Varicocele?
Varicosites of the pampiniform plexus
-swelling in scrotum with dull and recurring pain in scrotum
What is Persistent Processus Vaginalis and Hydroceles and the two types?
Persistent Processsus Vaginalis: patent connection between the tunica vaginalis and abdomen
Hydrocele: Peritoneal fluid accumulation within the tunica vaginalis
- common in babies
- in adults lead to inflammation and injury to the scrotum, testis, or epididymis
- Communicating = still open connection wiith peritoneal cavity
- Non-communicating = not open to peritoneal cavity
-can detect via trans-illumination
What is Hematocele?
accumulation of blood in tunica vaginalis
How does the Ovarian Descent occur?
- Begins descending but gubernaculum becomes attached to developing uterus
- Gubernaculum forms ovarian ligament and round ligament of the uterus
- Round ligament of the uterus, enters deep ring and exits superficial ring attaching to labial swellings
what makes up the female inguinal canal and what are its contents
- Deep and superficial rings
- Medial and lateral crus on either side of ring
- Lacunar/pectineal ligaments
- Conjoint tendon (inguinal falx)
Contents of the inguinal canal
- Round ligament of uterus
- ilioinguinal nerve
- Geniofemoral nerve
round ligament attaches to the labia
