Inguinal Region Flashcards
The inguinal region extends between ___ and ___
ASIS and the pubic tubercle
The aponeurosis of external oblique forms:
- Inguinal ligament
- Lacunar ligament
- Superficial inguinal ring
The myopectineal orifice is in what region?
Inguinal region
Where is the inguinal ligament?
Inferior border of aponeurosis of external oblique between ASIS and pubic tubercle
What is the lacunar ligament?
Deeper fibers of inguinal ligament that pass posteriorly attaching to the superior pubic ramus
What is the superficial inguinal ring?
Opening in the aponeurosis of external oblique= exit of inguinal canal
Opens inferomedially in lower part of anterior abdominal wall, superolateral to pubic tubercle
The superficial inguinal ring is created by what three points of attachment?
- Lateral crus attaches to pubic tubercle
- Medial crus attaches to pubic crest
- Intercrural fibers connect the two
What is the inguinal canal?
~4cm long, obliquely oriented, tubular passage parallel to inguinal ligament
What are the entrance and exit of the inguinal canal called?
Entrance: deep inguinal ring
Exit: superficial inguinal ring
What is the deep inguinal ring?
Entrance of inguinal canal: evagination in transversalis fascia lateral to inferior epigastric artery
What is the anterior wall of the inguinal canal?
Aponeurosis of external oblique
What is the posterior wall of the inguinal canal?
Transversalis fascia and conjoint tendon (inguinal falx)
What is the roof of the inguinal canal?
Arching fibers of aponeurosis of internal oblique and transversus abdominis; medially, medial crus of aponeurosis of external oblique
What is the floor of the inguinal canal?
Iliopubic tracts, inguinal ligament, and lacunar ligament
The inguinal canal is a passageway for which structures?
- Ilioinguinal nerve
- Spermatic cord in males
- Round ligament of the uterus in females
Where do testes and ovaries develop?
In the superior lumbar region of the posterior abdominal wall
What is gubernaculum? Where is it in males?
A fibrous CT cord connecting testes to anterolateral abdominal wall at the deep inguinal ring
What is gubernaculum? Where is it in females?
A fibrous CT cord connecting ovaries and uterus to labia majora
What ligament connects the ovary to the uterus?
Ovarian ligament
What ligament connects the uterus to the anterior abdominal wall?
Round ligament of the uterus
Where is processus vaginalis?
What is its function in males and females?
Passes through the inguinal canal and carries muscular and fascial layers with it into the primordial scrotum in males and labia majora in females
In the development of females, what does gubernaculum become?
Ovarian ligament and round ligament of the uterus
With menopause, what happens to the round ligament of the uterus?
It shrinks
A direct inguinal hernia is also called…
acquired
An indirect inguinal hernia is also called…
congenital
Which type of inguinal hernia is most common?
Indirect/congenital
What is the typical cause of a direct/acquired inguinal hernia?
Weakening of muscular wall
A direct/acquired inguinal hernia is a protusion of… through…
protrusion of parietal peritoneum and possibly abdominal contents through anterior abdominal wall in inguinal area
Where are direct/acquired inguinal hernias in relation to inferior epigastric vessels?
Medial
What are potential sites for direct/acquired inguinal hernia?
Medial inguinal fossae
Where are indirect/congenital inguinal hernias in relation to inferior epigastric vessels?
Lateral
What are potential sites for indirect/congenital inguinal hernia?
Lateral inguinal fossae and deep inguinal ring
Indirect/congenital hernia is a protusion of… through… into…
protrusion of parietal peritoneum and sometimes abdominal contents through deep inguinal ring into the inguinal canal and possibly scrotum/ labia majora
The spermatic cord extends from… to …
from deep inguinal ring to the posterior border of the testis in the scrotum
List 8 contents of the spermatic cord
- 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)
The coverings of the spermatic cord are derived from…
anterior abdominal wall tissues
spermatic cord
Dartos fascia and muscle are continuous with…
scarpa’s fascia in scrotum
spermatic cord
What type of muscle is dartos muscle?
Smooth muscle
spermatic cord
External spermatic fascia is derived from what tissue?
External oblique
spermatic cord
Cremasteric fascia and cremaster muscle are derived from what tissue?
Internal oblique
spermatic cord
Innervation of cremasteric fascia and muscle
Genital branch of genitofemoral nerve (L1, L2)
spermatic cord
What type of muscle is cremaster muscle?
Striated muscle
spermatic cord
Internal spermatic fascia is derived from what tissue?
Transversalis fascia
Name the coverings of the spermatic cord from superficial to deep
- Dartos muscle/fascia
- External spermatic fascia
- Cremaster muscle
- Cremasteric fascia
- Internal spermatic fascia
- Vestige of processus vaginalis
What does the scrotum develop from?
Lumbosacral swellings
The internal division of the scrotum is called ___
The externally visible division is called ___
internal division: septum
external division: scrotal raphe
In the scrotum, what is the dartos fascia continuous with?
Scarpa’s fascia
What is the dartos muscle in the scrotum?
What is its function?
Smooth muscle attached to overlying skin; functions as thermoregulation
What ligament is found in the scrotum?
Scrotal ligament
What structure is a closed peritoneal sac covering the testis?
Visceral layer of tunica vaginalis
What structure is an internal spermatic fascia lining the scrotum?
Parietal layer of tunica vaginalis
What is the tough outer surface found deep to visceral tunica vaginalis in the testis?
Tunica albuginea
The tunica albuginea in the testis forms a thickened ridge posteriorly. What is this called?
Mediastinum of the testis
What is the function of the testes?
Production of spermatozoa and testosterone
Innervation of testes
Autonomic nerves arise from testicular plexus of nerves
What is included in the testicular plexus of nerves?
- Vagal parasympathetic fibers
- Visceral afferent fibers
- Sympathetic fibers from spinal level T7
The testicular artery is a branch of…
abdominal aorta
Describe the path of the testicular artery
Passes through the inguinal canal to spermatic cord
The right and left testicular veins are formed from the convergence of…
pampiniform plexus of veins
Pampiniform plexus of veins is involved in what function?
Thermoregulation
Where does the right testicular vein drain?
Into the IVC
Where does the left testicular vein drain?
Into the left renal vein
Lymphatic drainage of the testes follows testicular vessels to…
lumbar and preaortic lymph nodes
Where does lymph from scrotum drain?
Into superficial inguinal nodes
Where is the epididymis?
Along posterior border of testes
Where is the head of the epididymis?
Superior expanded part
Where is the tail of the epididymis?
Continues to ductus (vas) deferens
An indirect hernia that has herniated all the way into the scrotum will pass through…
Deep inguinal ring, inguinal canal, superficial inguinal ring
