Inguinal Canal

Question 1

What is the entrance to the inguinal canal?

Answer 1

-deep inguinal ring = beginning of invagination of peritoneum into transversalis fascia

Question 2

Where is the deep inguinal ring in relation to other anatomical structures?

Answer 2

• superior to inguinal ligament

- lateral to inferior epigastric A.

Question 3

What structures pass through the inguinal canal in males vs. females?

Answer 3

• males: vas deferens, gonadal neurovasculature

- females: round ligament of the uterus

Question 4

What is the exit from the inguinal canal?

Answer 4

• superficial inguinal ring = a split in the external oblique M. aponeurosis
• where the spermatic cord (male) or round ligament of the uterus (female) exit

Question 5

What comprises the roof of the inguinal canal?

Answer 5

• transversalis fascia
• transversus abdominis
• internal oblique

Question 6

What comprises the floor of the inguinal canal?

Answer 6

• inguinal ligament

- lacunar ligament

Question 7

What comprises the posterior wall of the inguinal canal?

Answer 7

-transversalis fascia

Question 8

What comprises the anterior wall of the inguinal canal?

Answer 8

• external oblique

- internal oblique

Question 9

Where in the embryo do gonads form?

Answer 9

T10 axial level

Question 10

How are the embryonic gonads connected in males vs. females?

Answer 10

• by the gubernaculum
• males: connected to future scrotal swellings
• females: become connected to uterus

Question 11

What is the mechanism of testicular descent?

Answer 11

• the gubernaculum shortens
• outpocketing of peritoneal cavity (processus vaginalis)
• connection to peritoneum closes

Question 12

What is the adult derivative of the processus vaginalis?

Answer 12

-tunica vaginalis

Question 13

What layers of the abdominal wall are carried by the descent of the testes?

Answer 13

• transversalis fascia
• internal oblique
• external oblique

Question 14

In regards to the testes, what does the external oblique become?

Answer 14

-external spermatic fascia

Question 15

In regards to the testes, what does the internal oblique become?

Answer 15

cremaster M.

Question 16

In regards to the testes, what does the transversalis fascia become?

Answer 16

-internal spermatic fascia

Question 17

In regards to the adult female anatomy, what does the gubernaculum become?

Answer 17

• upper portion = ovarian ligamen

- lower portion = round ligament of the uterus

Question 18

What (technically) is the inguinal ligament?

Answer 18

-“rolled under” inferior border of the external oblique aponeurosis

Question 19

What is the conjoint tendon?

Answer 19

-combined aponeurosis of inferomedial margins of internal oblique M. and transversus abdominis M. where they insert into the pubis

Question 20

What is the iliopubic tract?

Answer 20

-thickening of the transversalis fascia, running posterior to the inguinal ligament

Question 21

From what are the parietal and visceral layers of the tunica vaginalis derived?

Answer 21

-peritoneum

Question 22

What are the contents of the spermatic cord?

Answer 22

• vas deferens
• testicular A.
• testicular vv. (Pampiniform plexus)

Question 23

Where does lymph drainage from the testes go?

Answer 23

-lumbar and pre-aortic lymph nodes

Question 24

Where does lymph drainage from the scrotum go?

Answer 24

-superficial inguinal lymph nodes

Question 25

What are the boundaries of the inguinal (Hasselbach’s) triangle?

Answer 25

rectus abdominis M.
inguinal ligament
inferior epigastric A. (lateral umbilical fold)

Question 26

What are the folds of the anterior abdominal wall, medial to lateral, with their “causes”?

Answer 26

• median umbilical fold (urachus)
• medial umbilical folds (umbilical A.)
• lateral umbilical folds (inferior epigastric A.)

Question 27

What are the fossae of the anterior abdominal wall, medial to lateral?

Answer 27

• supravesical fossa
• medial inguinal fossa
• lateral inguinal fossa

Question 28

What is a cryptorchid testical with its clinical significance?

Answer 28

• undescended testicle
• -increased risk of testicular cancer

-usually self-rectifies in a few months

Question 29

What allows for the development of a hydrocele or hematocele?

Answer 29

-persistent processus vaginalis

Question 30

What is a hydrocele?

Answer 30

• peritoneal fluid accumulation within the tunica vaginalis
• more common in babies, self-rectifies
• happens in men d/t inflammation or injury of scrotum
• communicating, non-, and hydrocele of the cord
• detected by transillumination

Question 31

What is a hematocele?

Answer 31

-accumulation of blood within the tunica vaginalis

Question 32

What is a varicocele?

Answer 32

-varicosities = swollen pampiniform plexus; swelling in scrotum w/ dull and recurring pain

• diagnosed by ultrasound
• “bag of worms”

Question 33

What is the purpose of the pampiniform plexus?

Answer 33

-closely wraps around arteries to cool the temperature for optimum spermatogenesis

Question 34

What is a direct hernia?

Answer 34

• within Hasselbach’s Triangle
• alongside spermatic cord
• covered by peritoneum and transversalis fascia

Question 35

What is an indirect hernia?

Answer 35

• enters the deep inguinal ring
• within the spermatic cord
• covered by peritoneum and transversalis fascia

Question 36

What is a femoral hernia?

Answer 36

• below the inguinal ligament
• more common in women
• covered by peritoneum and transversalis fascia

Question 37

What are common sites for abdominal hernias?

Answer 37

• ventral (epigastric, spigelian, umbilical)
• groin (inguinal, femoral)
• flank (d/t defects in posterolateral abdominal wall

Question 38

Where does an epigastric hernia happen?

Answer 38

-weakness in wall at midline fusion point (linea alba)

Question 39

Where does a spigelian hernia happen?

Answer 39

-through fascia b/w the abdominal muscles, along the semilunar line of the rectus abdominis M.