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BMSC Regional Gross Anatomy 1 > Inguinal canal and scrotum > Flashcards

Inguinal canal and scrotum Flashcards

1
Q

how long is the inguinal canal in adults

A

4cm

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2
Q

why is the inguinal canal particularly important in males

A

allows the testes to descend from the abdominal cavity into the scrotum

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3
Q

what nerve is carried in the inguinal canal

A

ilioinguinal nerve

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4
Q

what is carried in the inguinal canal in females

A

round ligament of uterus

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5
Q

the inguinal canal carries the round ligament of the uterus in females from the pelvis to the

A

labia majora

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6
Q

function of the inguinal canal

A

allows the passage of structures from abdominal cavity into inguinal region and from there towards the perineum

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7
Q

describe the course of the ilioinguinal nerve in the inguinal canal

A

travels through part of the canal and exits via the superficial ring

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8
Q

what forms the anterior wall of the inguinal canal

A

aponeurosis of external oblique

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9
Q

what is the superficial inguinal ring

A

defect in the aponeurosis of external oblique forming an opening in the inguinal canal

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10
Q

what shape is the inguinal ring and why

A

triangular

due to the shape of the strong sides of the opening - crura

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11
Q

what fascia arises from the edges (crura) of the superficial inguinal ring

A

external spermatic fascia of the spermatic cord that passes to the testes arises from the edges of the superficial ring

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12
Q

base of the superficial inguinal ring formed by the

A

pubic crest

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13
Q

what 2 parts of the inguinal canal does the external oblique form

A

anterior wall of canal

inguinal ligament in floor of canal

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14
Q

why is the inguinal canal easier to see in males

A

follow spermatic cord from scrotum to abdominal wall and point it disappears it is passing through the superficial ring

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15
Q

why is the superficial inguinal ring harder to see in females

A

round ligament of the uterus is fibrous and may blend with wall of the canal

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16
Q

where does the ilioinguinal nerve enter the inguinal canal

A

pierces the posterior wall then travels along to exit at superficial ring

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17
Q

what is the name of the internal entrance of the inguinal canal

A

deep inguinal ring

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18
Q

what is the deep inguinal ring

A

oval opening in the transversalis fascia that forms the posterior wall of the canal

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19
Q

the deep inguinal ring lies more ____ than the superficial ring creating an _____ passage

A

deep inguinal ring lies more lateral than the superficial ring, creating an oblique passage through the wall

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20
Q

what is the advantage of an oblique passage through the wall

A

makes it more difficult for structures to push through the wall (herniate)

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21
Q

where is the deep inguinal ring found

A

half way between the ASIS and the pubic symphysis

1.3cm above the inguinal ligament

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22
Q

what fascia is formed from the edges of the deep inguinal ring

A

internal fascia of the spermatic cord

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23
Q

what does the deep inguinal ring give rise to in females

A

round ligament

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24
Q

describe the path of the inferior epigastric vessels in relation to the deep inguinal ring

A

inferior epigastric vessels that run directly inferior to rectus abdominis, pass to the medial side of the deep ring

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25
Q

what structures pass through the deep inguinal ring in males

A

contents of the spermatic cord - vas deferens, genital branch of genitofemoral nerve, testicular artery and testicular vein

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26
Q

what structures pass through the deep inguinal ring in females

A

round ligament of the uterus

genital branch of genitofemoral nerve

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27
Q

what forms the anterior wall of the inguinal canal

A

aponeurosis of external oblique

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28
Q

how does external oblique form the anterior wall of the inguinal canal

A

it passes down the abdominal wall towards the pelvis then rolls over on itself to attach to the ASIS and the pubic tubercle

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29
Q

how is the inguinal ligament formed

A

the aponeurosis of the external oblique that attaches between the ASIS and the pubic tubercle thickens

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30
Q

what forms the floor of the inguinal canal

A

inferior rolled edge of external oblique aponeurosis (inguinal ligament)
medially the lacunar ligament

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31
Q

what forms the roof of the inguinal canal

A

fibres of internal oblique and transversus abdominis muscles

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32
Q

how does the internal oblique contribute to the inguinal canal

A

supports the lateral part of the anterior wall and also forms roof of canal with transversus abdominis

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33
Q

why is the lateral part of the anterior wall supported

A

corresponds to where the deep inguinal ring lies in the posterior wall of the canal

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34
Q

what forms the posterior wall of the inguinal canal

A

mainly transversalis fascia - some support from the conjoint tendon at the medial end of the canal

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35
Q

the conjoint tendon supports an area that corresponds to what

A

weak area of superficial ring in anterior wall

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36
Q

how is the conjoint tendon formed

A

common insertion of internal oblique and transversus abdominis to pubic crest and pectineal line

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37
Q

where does the lacunar ligament travel from the medial end of the inguinal ligament

A

extends superiorly and posteriorly to the pectineal line

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38
Q

what is the pectineal line

A

superior ramus of pubis

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39
Q

free edge of the lacunar ligament forms what

A

medial margin of the femoral ring

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40
Q

the lacunar ligament supports the medial edge of the

A

femoral ring

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41
Q

what is the femoral ring

A

where the femoral vessels pass into the lower limb

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42
Q

where does the lacunar ligament join

A

the thick periosteum of the pectineal line (pectineal ligament)

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43
Q

how is herniation through the inguinal canal prevented

A

the inguinal rings are offset from eachother instead of directly aligned creating an oblique canal that is more difficult for structures to pass through

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44
Q

where is the wall of the inguinal canal strengthened

A

anterior wall directly anterior to deep ring

posterior wall directly posterior to superficial ring

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45
Q

what happens to the canal in situations of increased abdominal pressure e.g. coughing

A

abdominal wall muscles contract - internal oblique and transversus abdominis contract and flatten canal

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46
Q

how is the inguinal canal protected during child birth or defecation

A

natural squatting position with hips flexed - thighs up onto abdominal wall to protect it

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47
Q

what is a hernia

A

protrusion of tissue from one area to another

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48
Q

75% of abdominal hernias are ___

A

inguinal

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49
Q

what often herniates in the inguinal region

A

loops of intestine

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50
Q

what is a complication of intestinal herniation

A

loops can become compressed or twisted (torsion) leading to a loss of blood supply and necrosis

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51
Q

what is an indirect hernia

A

inguinal canal entered via congenital weakness at deep inguinal ring

52
Q

what is a direct hernia

A

pushes through weak spot in back of inguinal canal

53
Q

what is a femoral hernia

A

herniation into back of femoral sheath

54
Q

how can you tell if an inguinal hernia is direct or indirect

A

push hernia back in and occlude the deep inguinal ring and get patient to cough - if hernia reappears it is direct

55
Q

tx of hernia

A

surgery to replace/section tissue and put in grid

56
Q

the spermatic cord passes between what

A

deep inguinal ring and testis

57
Q

the spermatic cord carries structures to and from

A

the abdomen and scrotum

58
Q

how many layers of fascia does the spermatic cord have

A

3 concentric layers of fascia

59
Q

what are the layers of fascia of the spermatic cord derived from

A

anterior abdominal wall

60
Q

what is contained in the spermatic cord

A 
vas deferens (plus artery)
testicular artery and veins
cremasteric artery
gential branch of genitofemoral nerve 
lymph vessels 
autonomic nerves
61
Q

what does the vas deferens carry

A

sperm away from the testis towards the ejaculatory duct inside the prostate gland

62
Q

how is the inguinal canal formed

A

part of the peritoneal lining of the abdominal wall forms a pouch that pushes through the abdominal wall creating the inguinal canal

63
Q

how are the coverings of the spermatic cord formed

A

peritoneal diverticulum called processus vaginalis from L1 through abdominal wall acquiring a tubular sheath from each layer

64
Q

where does the processus vaginalis come from

A

L1

65
Q

how is the internal spermatic fascia formed

A

passes through deep inguinal ring (transversalis fascia)

66
Q

what layer does the spermatic cord acquire from the transversus abdominis

A

no covering from this layer - diverticulum passes under rather than through it

67
Q

as the diverticulum passes through internal oblique it forms

A

cremaster muscle (fascia)

68
Q

how is the external spermatic fascia formed

A

as diverticulum passes through external oblique aponeurosis - creates superficial inguinal ring

69
Q

what are the 3 layers of spermatic cord fascia

A

internal
cremaster muscle
external

70
Q

the internal spermatic fascia is continuous with what

A

transversalis fascia

71
Q

the cremaster muscle is continuous with what

A

internal oblique

72
Q

the external spermatic fascia is continuous with what

A

external oblique aponeurosis

73
Q

what is the equivalent of the spermatic cord in females

A

round ligament of uterus

74
Q

what nerve runs within the round ligament

A

genital branch of genitofemoral nerve

75
Q

what is the vas deferens

A

cord-like muscular duct which transports spermatozoa from the epididymis to the urethra

76
Q

where does the testicular artery come from

A

L2 branch of aorta

77
Q

what does the testicular artery supply

A

testes and epididymis

78
Q

describe the venous drainage of the testes

A

pampiniform plexus from the border of the testis forms a single vein at the level of the deep inguinal ring

79
Q

at what level is a single testicular vein formed from the pampiniform plexus

A

at/near level of deep inguinal ring

80
Q

where does lymph from testes drain

A

para-aortic nodes at root of testicular artery

81
Q

describe the autonomic nerves in the spermatic cord

A

sympathetic on artery from renal or aortic plexuses

82
Q

contents of the spermatic cord

A 
vas deferens
testicular artery
pampiniform plexus
autonomic nerves
lymph vessels
cremasteric artery
artery of vas deferens
genital branch of genitofemoral nerve
83
Q

where does the cremasteric artery come from and go

A

from inferior epigastric artery

to cremaster fascia

84
Q

where does the artery of the vas deferens come from

A

inferior vesical

85
Q

what nerve supplies the cremaster muscle

A

genital branch of genitofemoral nerve

86
Q

the genitofemoral nerve and artery to the cremaster muscle/fascia layer lie where

A

between cremasteric muscle and internal fascial layers

87
Q

the artery of the vas deferens lies where in the cord

A

deep

88
Q

why do the testes lie outside the body

A

sperm cannot develop at core body temperature

89
Q

what is the scrotum

A

outpouching of skin of abdominal wall

90
Q

what does the scrotum contain

A

testes
epididymis
lower end of spermatic cords

91
Q

describe the fascial coverings of the scrotum

A

superficial fascia continuous with abdominal wall but fat replaced by smooth muscle

92
Q

what is the smooth muscle of the scrotum called

A

dartos

93
Q

what is scarpa’s fascia called in the perineal region

A

Colles’ fascia

94
Q

where does Scarpa’s (colles’) fascia attach

A

perineal body and membrane and the ischiopubic rami

95
Q

what fascial layer has the muscle fibres of dartos muscle

A

camper’s

96
Q

what is the function of the cremaster muscle layer

A

moves scrotum and testes upwards towards the body wall for warmth and protection

97
Q

what is the layer closest to the testis itself

A

tunica vaginalis - small closed sac that is all that is remaining of the embryological processus vaginalis

98
Q

what are the 3 layers of the spermatic cord

A

external spermatic fascia
cremasteric fascia
internal spermatic fascia

99
Q

the external spermatic fascia is derived from

A

external oblique aponeurosis

100
Q

the cremaster fascia is derived from

A

internal oblique

101
Q

the internal spermatic fascia is derived from

A

transversalis fascia

102
Q

why is there no fascial contribution from transversus abdominis

A

processus vaginalis passes under this layer instead of through

103
Q

where are the testes formed

A

abdominal region

104
Q

what is the name of the embryological pathway that the testes follow to the scrotum

A

gabernaculum

105
Q

describe the embryological pathway that the testes follow to the scrotum

A

descend through abdomen to inguinal region through inguinal canal and into pouch of abdominal wall skin that forms the scrotum

106
Q

why does the same not happen to ovaries in females

A

ova can develop at core body temperature so ovaries don’t need to move away from pelvic cavity, sperm cannot

107
Q

when do the testes move through inguinal canal

A

7th-8th month

108
Q

how is the gabernaculum formed

A

mesenchyme cells condense to form gabernaculum through the inguinal canal to the labio-scrotal swelling

109
Q

where is the gabernaculum in females

A

stuck to uterus

110
Q

what is the name of the fascial band that extends through the inguinal canal to the labia majora

A

round ligament

111
Q

what is the implication of the round ligament on lymphatic drainage

A

potential for lymph drainage to superficial inguinal nodes from the area of the uterus to which the round ligament attaches

112
Q

function of the testes

A

create sperm

113
Q

where is sperm made in testes

A

seminiferous tubules

114
Q

each seminal vesicle lobule contains how many seminiferous tubules

A

1-3

115
Q

what surrounds the seminal vesicle lobules and forms septa

A

tubica albuginea

116
Q

sperm goes from the lobules to

A

rete testis

117
Q

sperm goes from the rete testis to the epididymis via

A

efferent ductules

118
Q

the testis are _ degrees cooler than the abdomen

A

3

119
Q

how is temperature of testes controlled

A

dartos
cremaster
heat exchange between artery and veins

120
Q

where is sperm stored and matured

A

epididymis

121
Q

sperm goes from the epididymis to…

A

leave testes via the vas deferens

122
Q

what is the path of the vas deferens

A

passes through the spermatic cord and into the pelvic cavity where it joins with the duct of the seminal vesicle to form the ejaculatory duct (one each side) within the prostate gland

123
Q

how is the ejaculatory duct formed

A

vas deferens joins with duct of seminal vesicle to form ejaculatory duct in the prostate gland (one each side)

124
Q

lymph from the testis and epididymis drain to

A

para-aortic nodes at root of testicular artery (L2)

125
Q

lymph from scrotal wall and fascia drain to

A

superficial inguinal nodes

BMSC Regional Gross Anatomy 1 (30 decks)

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