Inguinal Canal Flashcards
What is the inguinal ligament? What is it attached to?
rolled-under the inferior border of external oblique muscle aponeurosis
attached to ASIS and pubic tubercle
What is the conjoint tendon (inguinal falx)? Where does it insert?
combined aponeurosis of inferior/medial margins of internal oblique and transversus abdominal m.
inserting into pubis
What is the lancunar ligament? What does it continue as along the pectin pubis?
between pubic rami and inguinal ligament, anchors inguinal ligament into pubis
Pectineal ligament
Where is the femoral canal?
Subinguinal space, lateral to lacunar ligament
Is the deep inguinal ring an entrance or exit? What passes through?
entrance to inguinal canal and beginning of invagination of peritoneum into transversalis fascia
vas deferens and gonadal vessels in males and round lig in females
Is the superficial inguinal ring an entrance or exit? What passes through? What splits it?
exit from inguinal canal
spermatic cord or round
external oblique aponeurosis
What level in the genitofemoral nerve? What does it supply?
L1 and 2
Motor to cremasteric m.
Sensory to medial thigh and scrotal/labia fascia
Describe testicular descent
Descent along with out pocketing of peritoneal cavity aka procesuss vaginalis into future scrotum carrying vessels and nerves (supersensory lig)
Connection to peritoneum closed, tunica vaginalis represents the remains of processus vaginalis around testes
What happens as the spermatic cord develops?
Layers of abdominal wall carried: transversalis fascia
–> internal spermatic fascia, internal oblique –> cremasteric muscle and external oblique -> external spermatic fascia
What are the contents of the spermatic cord?
vas deferens, testicular artery and veins (pampinform plexus), gonadal nerves, and lymphatics
When does the processus vaginalis normally close?
1st year postnatally
What are cryptorchid testis?
undescended testis, increase risk of testicular cancer
What is testicular varicocele?
varicosities of pampiniform plexus, swelling in scrotum with dull recurring pain
What is persistent processus vagingalis?
patent connection between abdomen and tunica vag
What is hydrocele?
Peritoneal fluid accumulation within tunica vaginalis –> swollen scrotum
Most common in babies, communicating and non-communicating types
What is hematocele?
Accumulation of blood in tunica vaginalis
Describe ovarian descent
begins descending but gubernaculum becomes attached to developing uterus
What does the gubernaculum form?
ovarian ligament and round ligament of uterus
Where is the round ligament?
enters deep ring and exits superficial attaching to labial swellings
Where does lymph from the scrotum drain into?
superificial inguinal LNs which travel to iliac and lumbar LNs
Where does lymph from the testes drain?
into lumbar and pre-aortic LNs
What composes the female inguinal canal and what are its contents?
Superficial and deep rings, medial/lateral curs, lacunar/pectineal ligs, conjoint tendon
Round lig of uterus, ilioinguinal n, genitofemoral nerve, scrotal/labia relation
What is the iliopubic tract?
thickened transversalis fascia running posterior to inguinal lig, reinforces floor of inguinal canal
What is the lateral umbilical ligament?
direct hernia inf to conjoint tendon and medial to lateral umbilical lig
Describe a direct inguinal hernia
medial to inf epigastric a, peritoneum/transversalis fascia alongside the spermatic cord
Describe a indirect inguinal hernia
enters deep ring, peritoneum within spermatic cord
Describe a femoral hernia
below inguinal lig, more common in women, emergent with incarceration or strangulation
What causes a flank hernia?
defects in posterolateral abdominal wall allowing tissue inside abdomen to protrude
What can cause a hernia at a ventral site?
umbilical epigastric (weakness in wall in midline fusion point), Spigelian (through fascia between abdominal muscles but along semilunar line of rectus abdominis
