Inguinal Region Flashcards
With the exception of this abdominal wall, the abdominal wall layers are involved during the descent of the gonads? Which layer is not?
transversus abdominis
Under the arcuate line, there is not posterior rectus sheath but rather, what lines the posterior aspect of the recuts abdominis muscle?
the transversalis fascia and parietal peritoneum are posterior to the muscle
the lack of the posterior recutus sheath inferior to the arcuate line is anatomically important because?
it allows for the inferior epigastric vessels to access/supply the rectus abdominis muscle and provide collateral circulation to the trunk muscle
testes originally develop where?
along the posterior abdominal wall
Why do testes leave the pelvis and travel through the abdominal wall into the scrotum?
the temperature is lower and compatible with spermatogenesis
what ligamentous structure attaches to both the superior and inferior poles of the developing testes?
gubernaculum
which part of the gubernaculum dengerates?
The superior part of the gubernaculum
which part of the gubernaculum will guide the testis along its descent through the anterior abdominal wall
inferior part of the gubernaculum
what is the testis supplied by as it is developing along the posterior abdominal wall? what is that artery a branch of?
the testicular artery
this is a branch of the abdominal aorta
transversalis fascia is a layer of? what is its function?
connective tissue
it binds the parietal peritoneum and is subserous fascia to the transverses abdomens muscle
the processus vaginalis is formed by
the evagination of the parietal peritoneum from the lower abdominal wall toward the skin of the scrotum
what does the processus do as it grows inferiorly?
push the abdominal wall layers ahead of itself
due to the processus pushing layers of the abdominal walls ahead of itself, what layers are also evaginated?
parietal peritoneum
transversalis fascia
internal oblique
external oblique
why does the transversus abdominis not partake in the descent of the testis?
because the inferior edge of the transversus abdominis muscle is slightly above the level where the processus vaginalis and testis descend
Where are the testis originally located in the posterior abdominal wall?
between the parietal peritoneum and the transversalis fascia
the process of descent creates a canal through the abdominal wall called?
the inguinal canal
where does the inguinal canal begin internally?
at the deep inguinal ring
At the deep inguinal ring the transversalis fascia evaginates what?
around the processus vaginalis and testis
the inguinal canal ends externally at? where what evaginates?
the superficial inguinal ring, where the external oblique evaginates
the inguinal canal contains?
bundled vessels, nerves and ducts of the testis- the spermatic cord
After the descent, the processus vaginalis degenerates proximally, but persists in the scrotum as?
the tunica vaginalis
what is a celomic (serous) sac that covers the anterior and lateral aspects of the testis and head of the epididymis
tunica vaginalis
the tunica vaginalis has what two layers? where do they come from?
a visceral and parietal layer.
both layers come from the parietal peritoneum of the processus vaginalis
what happens once the processus vaginalis degenerates proximally?
there is no longer a pathway/connection between the parietal peritoneum of the abdomen and the tunica vaginalis in the scrotum
what can occur if the processus vaginalis only partially degenerates or doesn’t degenerate at all?
an indirect inguinal hernia can occur
in the descent of the ovary. the gubernaculum extends?
from the ovary to the skin of the labium majus
the labium majus is equivalent to?
the scrotum
what supplies the ovary when it is attached to the posterior abdominal wall? What is it a branch of?
the ovarian artery
a branch of the abdominal aorta
the evagination of the abdominal layers in the descent of the ovaries is toward?
the labium majus
there is no tunica vaginalis in women after the descent is complete and the processus vaginalis collapses and degenerates. True or false?
true
During the descent of the ovary, why is the process arrested within the pelvis?
the gubernaculum gets trapped within the lateral wall of the expanding uterus
as the gubernaculum becomes tethered to the uterus, what happens to the ovary
it reaches its final destination in the pelvis
the ovary does not travel through the inguinal canal, true or false?
true
What does the gubernaculum remain as in people with testes? what is the function?
scrotal/testicular ligament
the function is to tether the testis to the scrotal skin
what does the gubernaculum persists as in people with ovaries?
the round ligament of the ovary/ ovarian ligament and the round ligament of the uterus
what was the first layer encountered by the processus vaginalis?
transversalis fascia
evagination of the transversalis fascia
internal spermatic fascia
the sight where the transversalis fasia evaginated is called? where does it lie in relation to the epigastric vessels?
the deep inguinal ring
lateral to the inferior epigastric vessels
what enters the inguinal ring?
vas deferens and testicular vessels or the round ligament of the uterus
as the processus vaginalis descends further, it encounters the internal abdominal oblique. This evagination becomes?
the cremaster muscle
what is the function of the cremaster?
it helps to regulate the temperature of the testis by contracting to pull the testis up
due to the the external oblique ending more laterally, the descent only effects what?
the aponeurosis of the external oblique muscle
fibers of the aponeurosis of the external oblique form lateral and medial crura that flank the?
superficial inguinal ring
the external oblique evaginates to form?
the external spermatic fascia
when descent is complete, in men what cord exits the superficial inguinal ring
spermatic cord
in people with ovaries, what travels through the inguinal canal
round ligament of the uterus
Because an ovary does not pass through the inguinal canal, what is not as evident?
the evagination of the abdominal wall at the superficial inguinal ring
name the inferior margin of the external oblique aponeurosis
inguinal ligament
name the evagination of the peritoneum that grows into the labium majus/scrotum
processus vaginalis
where is the primitive gonad located relative to the peritoneum?
primarily retroperitoneal
a general term used to describe a situation when an organ or part of an organ introduces through an opening where it doesn’t belong?
Hernia
occurs because of a weakening of the abdominal wall?
direct inguinal hernia
the inguinal triangle is bounded by
the inferior epigastric vessels laterally, the lateral edge of the rectus abdominis medially, and the inguinal ligament inferiorly
aponeuroses of the transversus abdominis and the internal oblique makes the
conjoint tendon
weak spot within the inguinal triangle, where is it and why is it weak?
region lateral to the conjoint tendon and medial to the inferior epigastric artery.
weak because it consists only of parietal peritoneum, transversalis fascia and external oblique aponeurosis
if the conjoint tendon is quite narrow?
there will be a large weak spot
if the conjoint tendon is wide
the weak spot will be smaller
when the internal oblique and the transversus abdominis muscles contract
the weak spot is reduced
a direct inguinal hernia will usually involve the protrusion of
peritoneal fat or the small intestine
as a direct hernia enlarges, it protrudes through?
the superficial inguinal ring because that is the only weak spot in the aponeurosis of the external abdominal oblique
if the herniated bowel emerges through the superficial ring it will be covered by what layers?
layers of the peritoneum, transversalis fascia and external spermatic fascia
hernia that is a result of a congenital defect
indirect inguinal hernia
because the deep inguinal ring lies just lateral to the inferior epigastric vessels and lateral to the inguinal triangle it is called an indirect inguinal hernia
because it traverses the body wall in an indirect or oblique fashion
both types of inguinal hernias would protrude though the superficial inguinal ring if the hernia became large enough, true or false
true
the inguinal ligament spans
from the anterior superior iliac spine to the pubis
As the inguinal ligament approaches the pubic tubercle, some is fibers curve, what is this called?
lacunar ligament
along the superior ramus of the pubis the inguinal ligament continue to become
the pectineal ligament
the femoral artery, vein and lymphatics pass through this region, they are invested by an extension of transversals fascia that forms
the femoral sheath
the femoral sheath has what three compartments, where are thy located and what is their function?
femoral canal- most medial and contains lymphatic vessels which drains the inguinal nodes
femoral vein- intermediate
drains the lower limb
femoral artery- most lateral functions to supply the lower body with blood
because lymphatic vessels in the femoral canal are so small and delicate, they do not fill their allotted space thus
the femoral canal is a weak spot
all hernias in the groin involve a bulge in the?
parietal peritoneum
an indirect hernia could extend?
all the way to the scrotum and would be within the tunica vaginalis and surrounded by fascial layers of the sprmatic cord
