Inguinal Canal Flashcards
What is the entrance to the inguinal canal?
-deep inguinal ring = beginning of invagination of peritoneum into transversalis fascia
Where is the deep inguinal ring in relation to other anatomical structures?
- superior to inguinal ligament
- lateral to inferior epigastric A.
What structures pass through the inguinal canal in males vs. females?
- males: vas deferens, gonadal neurovasculature
- females: round ligament of the uterus
What is the exit from the inguinal canal?
- superficial inguinal ring = a split in the external oblique M. aponeurosis
- where the spermatic cord (male) or round ligament of the uterus (female) exit
What comprises the roof of the inguinal canal?
- transversalis fascia
- transversus abdominis
- internal oblique
What comprises the floor of the inguinal canal?
- inguinal ligament
- lacunar ligament
What comprises the posterior wall of the inguinal canal?
-transversalis fascia
What comprises the anterior wall of the inguinal canal?
- external oblique
- internal oblique
Where in the embryo do gonads form?
T10 axial level
How are the embryonic gonads connected in males vs. females?
- by the gubernaculum
- males: connected to future scrotal swellings
- females: become connected to uterus
What is the mechanism of testicular descent?
- the gubernaculum shortens
- outpocketing of peritoneal cavity (processus vaginalis)
- connection to peritoneum closes
What is the adult derivative of the processus vaginalis?
-tunica vaginalis
What layers of the abdominal wall are carried by the descent of the testes?
- transversalis fascia
- internal oblique
- external oblique
In regards to the testes, what does the external oblique become?
-external spermatic fascia
In regards to the testes, what does the internal oblique become?
cremaster M.
In regards to the testes, what does the transversalis fascia become?
-internal spermatic fascia
In regards to the adult female anatomy, what does the gubernaculum become?
- upper portion = ovarian ligamen
- lower portion = round ligament of the uterus
What (technically) is the inguinal ligament?
-“rolled under” inferior border of the external oblique aponeurosis
What is the conjoint tendon?
-combined aponeurosis of inferomedial margins of internal oblique M. and transversus abdominis M. where they insert into the pubis
What is the iliopubic tract?
-thickening of the transversalis fascia, running posterior to the inguinal ligament
From what are the parietal and visceral layers of the tunica vaginalis derived?
-peritoneum
What are the contents of the spermatic cord?
- vas deferens
- testicular A.
- testicular vv. (Pampiniform plexus)
Where does lymph drainage from the testes go?
-lumbar and pre-aortic lymph nodes
Where does lymph drainage from the scrotum go?
-superficial inguinal lymph nodes
What are the boundaries of the inguinal (Hasselbach’s) triangle?
rectus abdominis M.
inguinal ligament
inferior epigastric A. (lateral umbilical fold)
What are the folds of the anterior abdominal wall, medial to lateral, with their “causes”?
- median umbilical fold (urachus)
- medial umbilical folds (umbilical A.)
- lateral umbilical folds (inferior epigastric A.)
What are the fossae of the anterior abdominal wall, medial to lateral?
- supravesical fossa
- medial inguinal fossa
- lateral inguinal fossa
What is a cryptorchid testical with its clinical significance?
- undescended testicle
- -increased risk of testicular cancer
-usually self-rectifies in a few months
What allows for the development of a hydrocele or hematocele?
-persistent processus vaginalis
What is a hydrocele?
- 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
What is a hematocele?
-accumulation of blood within the tunica vaginalis
What is a varicocele?
-varicosities = swollen pampiniform plexus; swelling in scrotum w/ dull and recurring pain
- diagnosed by ultrasound
- “bag of worms”
What is the purpose of the pampiniform plexus?
-closely wraps around arteries to cool the temperature for optimum spermatogenesis
What is a direct hernia?
- within Hasselbach’s Triangle
- alongside spermatic cord
- covered by peritoneum and transversalis fascia
What is an indirect hernia?
- enters the deep inguinal ring
- within the spermatic cord
- covered by peritoneum and transversalis fascia
What is a femoral hernia?
- below the inguinal ligament
- more common in women
- covered by peritoneum and transversalis fascia
What are common sites for abdominal hernias?
- ventral (epigastric, spigelian, umbilical)
- groin (inguinal, femoral)
- flank (d/t defects in posterolateral abdominal wall
Where does an epigastric hernia happen?
-weakness in wall at midline fusion point (linea alba)
Where does a spigelian hernia happen?
-through fascia b/w the abdominal muscles, along the semilunar line of the rectus abdominis M.
