Inguinal Canal and Scrotum

Question 1

Inguinal Canal

• Some information on it
• Contents in males
• Contents in females

Answer 1

• Oblique passage, about 4cm long, through the lower part of the anterior abdominal wall
• Carries structures to/from the testis and abdomen. Also carries the ilioinguinal nerve.
• Carries the round ligament of the uterus from the pelvis to the labia majora. Also carries the ilioinguinal nerve.

Question 2

Superficial Inguinal Ring

• What is it?
• Where is it?
• Margins
• What exits through it in males and in females?

Answer 2

• Triangular shaped defect
• Aponeurosis of the external oblique. The base is formed by the pubic crest.
• Referred to as crura. These give rise to the external spermatic fascia.
• Spermatic cord exits through it in males, and round ligmanet of the uterus in females.

Question 3

Deep Inguinal Ring

• What is it?
• Location
• Gives origin to…?

Answer 3

• An oval opening which allows structures into the inguinal canal.
• Between the anterior superior iliac spine and pubic symphysis - about 1.3cm above the inguinal ligament. Inferior epigastic vessels are medial to it.
• Spermatic or round ligament fascia

Question 4

Borders

• Anterior wall
• Floor
• Roof
• Posterior wall
• Conjoint tendon

Answer 4

• Aponeurosis of external oblique plus internal oblique in the final third
• Inferior rolled edge of the external oblique aponeuroris (inguinal ligament). Medially the lacunar ligament
• Fibres of internal oblique and transversus abdominis muscles
• Transversalis fascia plus conjoint tendon in medial third
• Common insertion of internal oblique and transversus to pubic crest and pectineal line

Question 5

Inguinal ligament

• Inguinal ligament
• Lacunar ligament
• Medial edge of femoral ring
• Lacunar ligament joins…?

Answer 5

• Formed as the aponeurosis of the external oblique rolls back on itself.
• Extends superiorly and posteriorly to the pectineal line from the medial end of the inguinal ligament.
• Formed by the free edge of the lacunar ligament
• Thick periosteum of the the pectineal line/ligmament.

Question 6

_Spermatic Cord Basics _

• What is it?
• Fascia layers
• Runs from/to?
• What does it contain?

Answer 6

• A collection of structures passing along the male inguinal canal to and from the testis
• 3 concentric layers which are derived from the anterior abdominal wall
• Begins at deep inguinal ring and runs to testis
• Ductus deferens (plus artery), testicular artery and veins, cremasteric artery, the genital branch of the genitofemoral nerve, lymph vessels, and some autonomic nerves.

Question 7

Spermatic Cord Coverings

• Passes through deep inguinal ring
• Passes through internal oblique
• Through external oblique aponeurosis and creates superficial inguinal ring

Answer 7

• Internal spermatic fascia
• Cremaster muscle (fascia)
• External spermatic fascia

Question 8

Spermatic Cord Contents

• Vas deferens
• Testicular artery
• Testicular veins
• Lymph vessels
• Autonomic nerves

Answer 8

• Cordlike muscular duct. Transports spermatazoa to urethra from epididymis.
• L2 branch of aorta. Supplies testis and epididymis
• Pampiniform plexus from the testis forms a single vessel at the level of the deep inguinal ring.
• To para-aortic nodes at the root of the testicular artery
• Sympathetic on artery from either the renal or aortic plexuses

Question 9

Additional Contents of Spermatic Cord

• Cremasteric artery
• Vans deferens
• Genitofemoral nerve

Answer 9

• From inferior epigastric to cremaster fascia
• Artery of the vans deferens
• Genital branch of the genitofemoral nerve

Question 10

Scrotum

• What is it?
• Contents
• Fat replaced by..?
• Cremaster muscle function
• Tunica vaginalis

Answer 10

• Outpouching of skin from abdominal wall
• Contains testes, epididymis and the lower end of the spermatic cord
• Replaced with smooth muscle (dartos), but superficial fascia is continuous with that of the body wall
• Raises the testes and scrotum closer to the body for warmth and protection
• Lies within spermatic fasciae and is a closed-off sac

Question 11

Testes

• Surrounded by
• Lobules
• Ductules
• Cooling
• Epididymis function

Answer 11

• A tough fibrous capsule around each testis
• Each have 1-3 seminiferous tubules which open up into rete testis
• Efferent ductules connect rete to epididymis
• 3% cooler than abdomen. Dartos, cremaster and heat exchange between vessels aids in cooling
• Stores sperm and becomes vans deferens

Question 12

_- Scrotal wall and fascia- _

• Scrotal wall and fascia
• Testis and epididymis

Answer 12

• Superficial inguinal nodes
• Para-aortic nodes at the root of the testicular artery