Inguinal Canal

Question 1

What is the inguinal ligament attached to?

Answer 1

ASIS and pubic tubercule

Question 2

What is the inguinal ligament?

Answer 2

rolled-under border of EOM aponeurosis

–>forms outer edge of inguinal canal

Question 3

What is the conjoint tendon/ inguinal falx?

Answer 3

aponeurosis of IOM and transversus abdominis M

Question 4

Where does the conjoint tendon insert?

Answer 4

pubis

Question 5

What is the external opening within aponeurosis for spermatic cord/round ligament of uterus?

Answer 5

Superficial ring

Question 6

What crural fibers are involved in the inguinal canal area (define the superficial ring)?

Answer 6

Medial crus
Lateral crus
Intercrural fibers

Question 7

What is the ligament that anchors the inguinal ligament to pubis?

Answer 7

Lacunar ligament

–> between pubic rami and inguinal ligament

Question 8

What ligament is a continuation of fibers from lacunar ligament running along the pectin pubis?

Answer 8

Pectineal ligament

Question 9

What is the femoral canal in relation to the inguinal canal?

Answer 9

immediately lateral to lacunar ligament

Question 10

What is the difference between the crural fibers and ligaments of inguinal canal?

Answer 10

Lacunar/pectinate ligaments attach inguinal ligament to pubic bone

Crural fibers are etensions of aponeurosis that form the boundary of superficial inguinal ring

Question 11

What is the function of the conjoint tendon?

Answer 11

supports weak spot in the abdominal wall where the inguinal canal is

Question 12

What occurs with weakened conjoint tendon?

Answer 12

Direct hernia

Question 13

Where is the conjoint tendon in relation to the inguinal canal?

Answer 13

makes up posterior portion of canal

Question 14

What is superior to inguinal ligament and lateral to inferior epigastric artery?

Answer 14

deep ring of inguinal canal

Question 15

What begins the invagination of peritoneum into transversalis fascia?

Answer 15

deep ring of inguinal canal

Question 16

What is essentially a partial split in the EOM aponeurosis?

Answer 16

Superficial ring of inguinal canal

–>defined by crural fibers

Question 17

What is thickening of transversalis fascia posterior to inguinal ingament?

Answer 17

iliopubic tract

Question 18

What innervates the skin above pubis, motor to IO and TA?

Answer 18

Iliohypogastric N

Question 19

What nerve transverses inguinal canal and exits superficial ring LATERAL to cord?

Answer 19

Ilioinguinal N

Question 20

Where does the ilioinguinal nerve exit inguinal canal r/t spermatic cord?

Answer 20

exits LATERAL to cord

Question 21

What nerve is motor to the cremasteric muscle?

Answer 21

Genital branch of genitofemoral N

Question 22

What does the gubernaculum connect?

Answer 22

gonads to future scrotal swellings

Question 23

What is an out-pocketing of peritoneal cavity into future scrotum?

Answer 23

Processus vaginalis

Question 24

What is the remains of the processus vaginalis around testes?

Answer 24

tunica vaginalis

–>represents closed connection to peritoneum

Question 25

What layers of abd wall are carried in the spermatic cord?

Answer 25

Transversalis fascia IOM EOM

Question 26

What is cryptorchid testis?

Answer 26

undescended testis

Question 27

What does cryptorchid testis cause increased risk of?

Answer 27

testicular cancer

Question 28

Abdominal muscle layers make up testicle/ spermatic cord EXCEPT?

Answer 28

Transversus abdominis M -->fascia is but not the actual muscle

Question 29

What does the transversalis fascia make in r/t spermatic cord?

Answer 29

internal spermatic fascia

Question 30

What does the IOM make in r/t spermatic cord?

Answer 30

Cremasteric M

Question 31

What does the EOM make in r/t spermatic cord?

Answer 31

External spermatic fascia

Question 32

What is in the spermatic cord?

Answer 32

Vas deferens testicular A and V ------->pampiniform plexus gonadal N and lymph

Question 33

What is a testicular varicocele?

Answer 33

Varicosities of pampiniform plexus | ------>swelling in scrotum with dull and recurring pain

Question 34

What is a persistent processus vaginalis?

Answer 34

patent connection b/t tunica vaginalis and abdomen

Question 35

What is a hydrocele?

Answer 35

peritoneal fluid accumulated within tunica vaginalis

Question 36

What is a hematocele?

Answer 36

accumulation of blood in tunica vaginalis

Question 37

What is the tunica albuginea?

Answer 37

directly covers testes, covered by visceral layer of tunica vaginalis

Question 38

How do you detect hydrocele vs hematocele?

Answer 38

hydroillumination --> light shines through fluid of hydrocele

Question 39

What does the gubernaculum form in ovarian descent?

Answer 39

Ovarian Ligament and Round Ligament of Uterus

Question 40

What ligament attaches to labial swellings after it exits the inguinal canal?

Answer 40

Round ligament of uterus

Question 41

What is contained in the female inguinal canal?

Answer 41

Round L of uterus Ilioinguinal N Geniofemoral N (genital branch)

Question 42

Where does lymph drain to from scrotum?

Answer 42

Superficial inguinal nodes--> iliac and lymbar LN

Question 43

Where does lymph from the testes drain?

Answer 43

directly into lumbar and pre-aortic LN

Question 44

What is the remnant of the urachus?

Answer 44

median umbilical fold/L of ant abd wall

Question 45

What is the remnant of distal umbilical As?

Answer 45

medial umbilical L/fold of ant abd wall

Question 46

What fold is due to the inferior epigastric A and V in the post aspect of ant abd wall?

Answer 46

Lateral umbilical fold/L -->hypotenuse of inguinal triangle (d/t angle of travel of inferior epigastric A)

Question 47

What is the function of the iliopubic tract?

Answer 47

reinforces floor of inguinal canal

Question 48

What is Hasselbach's Triangle?

Answer 48

Inguinal Triangle: - inguinal L - lateral border of rectus abdominis M - Lateral umbilical fold

Question 49

Where is a direct hernia in relation to the inguinal triangle?

Answer 49

inferior to conjoint tendon medial to lateral umbilical fold

Question 50

What type of hernia enters the deep inguinal ring?

Answer 50

indirect hernia

Question 51

What hernia has peritoneum WITHIN the spermatic cord?

Answer 51

indirect hernia

Question 52

What type of hernia is peritoneum or transversalis fascia ALONGSIDE the spermatic cord?

Answer 52

direct hernia

Question 53

What hernia occurs below the inguinal ligament?

Answer 53

femoral hernia

Question 54

What hernia is more common in women?

Answer 54

femoral hernia -->emergency d/t strangulation

Question 55

What type of hernia is due to defects in posterolateral abdominal wall (abd tissues protrudes)?

Answer 55

Flank/Lubar

Question 56

What hernia goes through fascia between abd muscles, along semilunar line of rectus abdominis M?

Answer 56

Spigelian