Inguinal Region Flashcards

1
Q

The inguinal region extends between ___ and ___

A

ASIS and the pubic tubercle

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2
Q

The aponeurosis of external oblique forms:

A
  • Inguinal ligament
  • Lacunar ligament
  • Superficial inguinal ring
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3
Q

The myopectineal orifice is in what region?

A

Inguinal region

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4
Q

Where is the inguinal ligament?

A

Inferior border of aponeurosis of external oblique between ASIS and pubic tubercle

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5
Q

What is the lacunar ligament?

A

Deeper fibers of inguinal ligament that pass posteriorly attaching to the superior pubic ramus

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6
Q

What is the superficial inguinal ring?

A

Opening in the aponeurosis of external oblique= exit of inguinal canal
Opens inferomedially in lower part of anterior abdominal wall, superolateral to pubic tubercle

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7
Q

The superficial inguinal ring is created by what three points of attachment?

A
  • Lateral crus attaches to pubic tubercle
  • Medial crus attaches to pubic crest
  • Intercrural fibers connect the two
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8
Q

What is the inguinal canal?

A

~4cm long, obliquely oriented, tubular passage parallel to inguinal ligament

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9
Q

What are the entrance and exit of the inguinal canal called?

A

Entrance: deep inguinal ring
Exit: superficial inguinal ring

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10
Q

What is the deep inguinal ring?

A

Entrance of inguinal canal: evagination in transversalis fascia lateral to inferior epigastric artery

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11
Q

What is the anterior wall of the inguinal canal?

A

Aponeurosis of external oblique

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12
Q

What is the posterior wall of the inguinal canal?

A

Transversalis fascia and conjoint tendon (inguinal falx)

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13
Q

What is the roof of the inguinal canal?

A

Arching fibers of aponeurosis of internal oblique and transversus abdominis; medially, medial crus of aponeurosis of external oblique

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14
Q

What is the floor of the inguinal canal?

A

Iliopubic tracts, inguinal ligament, and lacunar ligament

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15
Q

The inguinal canal is a passageway for which structures?

A
  • Ilioinguinal nerve
  • Spermatic cord in males
  • Round ligament of the uterus in females
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16
Q

Where do testes and ovaries develop?

A

In the superior lumbar region of the posterior abdominal wall

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17
Q

What is gubernaculum? Where is it in males?

A

A fibrous CT cord connecting testes to anterolateral abdominal wall at the deep inguinal ring

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18
Q

What is gubernaculum? Where is it in females?

A

A fibrous CT cord connecting ovaries and uterus to labia majora

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19
Q

What ligament connects the ovary to the uterus?

A

Ovarian ligament

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20
Q

What ligament connects the uterus to the anterior abdominal wall?

A

Round ligament of the uterus

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21
Q

Where is processus vaginalis?
What is its function in males and females?

A

Passes through the inguinal canal and carries muscular and fascial layers with it into the primordial scrotum in males and labia majora in females

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22
Q

In the development of females, what does gubernaculum become?

A

Ovarian ligament and round ligament of the uterus

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23
Q

With menopause, what happens to the round ligament of the uterus?

A

It shrinks

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24
Q

A direct inguinal hernia is also called…

A

acquired

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25
Q

An indirect inguinal hernia is also called…

A

congenital

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26
Q

Which type of inguinal hernia is most common?

A

Indirect/congenital

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27
Q

What is the typical cause of a direct/acquired inguinal hernia?

A

Weakening of muscular wall

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28
Q

A direct/acquired inguinal hernia is a protusion of… through…

A

protrusion of parietal peritoneum and possibly abdominal contents through anterior abdominal wall in inguinal area

29
Q

Where are direct/acquired inguinal hernias in relation to inferior epigastric vessels?

A

Medial

30
Q

What are potential sites for direct/acquired inguinal hernia?

A

Medial inguinal fossae

31
Q

Where are indirect/congenital inguinal hernias in relation to inferior epigastric vessels?

A

Lateral

32
Q

What are potential sites for indirect/congenital inguinal hernia?

A

Lateral inguinal fossae and deep inguinal ring

33
Q

Indirect/congenital hernia is a protusion of… through… into…

A

protrusion of parietal peritoneum and sometimes abdominal contents through deep inguinal ring into the inguinal canal and possibly scrotum/ labia majora

34
Q

The spermatic cord extends from… to …

A

from deep inguinal ring to the posterior border of the testis in the scrotum

35
Q

List 8 contents of the spermatic cord

A
  • Ductus (vas) deferens
  • Artery of ductus deferens
  • Testicular artery
  • Cremasteric artery
  • Pampiniform plexus of veins (converge as testicular veins)
  • Sympathetic nerve fibers
  • Lymphatic vessels
  • Genital branch of the genitofemoral nerve (supplies cremaster muscle)
36
Q

The coverings of the spermatic cord are derived from…

A

anterior abdominal wall tissues

37
Q

spermatic cord

Dartos fascia and muscle are continuous with…

A

scarpa’s fascia in scrotum

38
Q

spermatic cord

What type of muscle is dartos muscle?

A

Smooth muscle

39
Q

spermatic cord

External spermatic fascia is derived from what tissue?

A

External oblique

40
Q

spermatic cord

Cremasteric fascia and cremaster muscle are derived from what tissue?

A

Internal oblique

41
Q

spermatic cord

Innervation of cremasteric fascia and muscle

A

Genital branch of genitofemoral nerve (L1, L2)

42
Q

spermatic cord

What type of muscle is cremaster muscle?

A

Striated muscle

43
Q

spermatic cord

Internal spermatic fascia is derived from what tissue?

A

Transversalis fascia

44
Q

Name the coverings of the spermatic cord from superficial to deep

A
  • Dartos muscle/fascia
  • External spermatic fascia
  • Cremaster muscle
  • Cremasteric fascia
  • Internal spermatic fascia
  • Vestige of processus vaginalis
45
Q

What does the scrotum develop from?

A

Lumbosacral swellings

46
Q

The internal division of the scrotum is called ___
The externally visible division is called ___

A

internal division: septum
external division: scrotal raphe

47
Q

In the scrotum, what is the dartos fascia continuous with?

A

Scarpa’s fascia

48
Q

What is the dartos muscle in the scrotum?
What is its function?

A

Smooth muscle attached to overlying skin; functions as thermoregulation

49
Q

What ligament is found in the scrotum?

A

Scrotal ligament

50
Q

What structure is a closed peritoneal sac covering the testis?

A

Visceral layer of tunica vaginalis

51
Q

What structure is an internal spermatic fascia lining the scrotum?

A

Parietal layer of tunica vaginalis

52
Q

What is the tough outer surface found deep to visceral tunica vaginalis in the testis?

A

Tunica albuginea

53
Q

The tunica albuginea in the testis forms a thickened ridge posteriorly. What is this called?

A

Mediastinum of the testis

54
Q

What is the function of the testes?

A

Production of spermatozoa and testosterone

55
Q

Innervation of testes

A

Autonomic nerves arise from testicular plexus of nerves

56
Q

What is included in the testicular plexus of nerves?

A
  • Vagal parasympathetic fibers
  • Visceral afferent fibers
  • Sympathetic fibers from spinal level T7
57
Q

The testicular artery is a branch of…

A

abdominal aorta

58
Q

Describe the path of the testicular artery

A

Passes through the inguinal canal to spermatic cord

59
Q

The right and left testicular veins are formed from the convergence of…

A

pampiniform plexus of veins

60
Q

Pampiniform plexus of veins is involved in what function?

A

Thermoregulation

61
Q

Where does the right testicular vein drain?

A

Into the IVC

62
Q

Where does the left testicular vein drain?

A

Into the left renal vein

63
Q

Lymphatic drainage of the testes follows testicular vessels to…

A

lumbar and preaortic lymph nodes

64
Q

Where does lymph from scrotum drain?

A

Into superficial inguinal nodes

65
Q

Where is the epididymis?

A

Along posterior border of testes

66
Q

Where is the head of the epididymis?

A

Superior expanded part

67
Q

Where is the tail of the epididymis?

A

Continues to ductus (vas) deferens

68
Q

An indirect hernia that has herniated all the way into the scrotum will pass through…

A

Deep inguinal ring, inguinal canal, superficial inguinal ring