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MGA Exam 3 > Inguinal Region > Flashcards

Inguinal Region Flashcards

1
Q

Inguinal canal is formed by

A

Relocation of testis during development

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2
Q

Where does the inguinal canal start? (2)

A

Intraabdominally on the deep aspect of the abdominal wall where the spermatic cord passes through a hiatus in the transversalis fascia

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3
Q

The hiatus in the transversalis fascia is called

A

The deep or inguinal ring

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4
Q

Where does the inguinal canal end?

A

On the superficial aspect of the abdominal wall musculature at the superficial/external inguinal ring

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5
Q

Anterior boundary of the inguinal canal (2)

A

External oblique aponeurosis and internal oblique muscle laterally

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6
Q

Posterior boundary of the inguinal canal (2)

A

Fusion of transversalis fascia and transversus abdoiminis muscle

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7
Q

Superior boundary of the inguinal canal (3)

A

Arch formed by fibers of the internal oblique muscle and the transversus abdominis muscle and aponeurosis

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8
Q

Inferior boundary of the inguinal canal (2)

A

Formed by the inguinal ligament and lacunar ligament

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9
Q

Inguinal ligament is comprised of

A

Inferior fibers of the external oblique aponeurosis

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10
Q

Inguinal ligament stretches from

A

Anterior superior iliac spine to pubic tubercle

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11
Q

What forms the inferior floor of the inguinal canal?

A

Inguinal ligament

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12
Q

What is the lacunar ligament?

A

Triangular fanning out of the inguinal ligament as it joins the pubic tubercle

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13
Q

The lateral edge of the lacunar ligament forms

A

The medial border of the femoral canal

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14
Q

What is the pectineal ligament?

A

The lateral portion of the lacunar ligament that is fused to the periosteum of the pubic tubercle

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15
Q

The pectineal ligament may include fibers from (4)

A

Transversus abdominis

Iliopubic tract

Internal oblique

Rectus abdominis

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16
Q

What is the iliopubic tract?

A

An aponeurotic band that begins at the anterior suprior iliac spine and inserts into the pectineal ligament from above

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17
Q

Where does the iliopubic tract form? (3)

A

The deep side of the inferior margin of the transversus abdominis and transversalis fascia

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18
Q

What is the on the superficial side of the iliopubic tract?

A

Inguinal ligament

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19
Q

What connects the iliopubic tract to the inguinal ligament?

A

Shelving edge

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20
Q

The iliopubic tract helps form (2)

A

The inferior margin of the internal inguinal ring as it courses medially

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21
Q

The iliopubic tract continues as (2)

A

The anterior and medial border of the femoral canal

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22
Q

The conjoined tendon is (3)

A

The fusion of the inferior fibers of the internal oblique and transversus abdominis aponeurosis at the point where they insert on the pubic tubercle

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23
Q

What is the purpose of the internal ring? (2)

A

It is the enterance to the inguinal canal for the spermatic cord (round ligament) and genital branch of the genitofemoral nerve

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24
Q

Where is the internal ring located? (3)

A

Superior to the middle of the inguinal ligament

Lateral to the inferior epigastric artery

Inferior border: iliopubic tract

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25
Q

The internal ring starts as (3)

A

an envagination in the transversalis fascia that forms and opening which the vas deferens (round ligament) passes to enter the inguinal canal

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26
Q

Transversalis fascia continues into the inguinal canal to form

A

The internal fasica

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27
Q

What is the purpose of the external ring? (3)

A

It is the exit for the spermatic cord, genitofemoral nerve, and ilioinguinal nerve from the inguinal canal

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28
Q

The external ring splits to form

A

the lateral and medial crus

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29
Q

What are the lateral and medial crus?

A

portion of the external oblique aponeurosis that forms the lateral and medial margins of the superficial ring respectively

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30
Q

Where is the external ring located? (2)

A

Superior and lateral to the pubic tubercle

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31
Q

What does the lateral crus attach to?

A

The pubic tubercle

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32
Q

What does the medial crus attach to?

A

Pubic crest

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33
Q

What helps prevent the crua from opening? (2)

A

Intercrural fibers from the superficial layer of the deep fascia overlying the external oblique muscle

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34
Q

What is the gubernaculum? (3)

A

Fibrous tract connecting the testis to the anterolateral abdominal wall at the site of the deep ring of the inguinal canal

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35
Q

In females, the gubernaculum connects (3)

A

the ovary and uterus to the developing labium majus

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36
Q

In females, the gubernaculum becomes (2)

A

The ovarian and round ligaments

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37
Q

What is the processus vaginalis? (3)

A

A pertinoneal diverticulum that crosses the developing inguinal canal carrying the muscular and fascial layers of the anterolateral abdominal wall into the scrotum

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38
Q

Embryology- testis develop in the (3)

A

extraperitoneal connective tissue in the superior lumbar region of the posterior abdominal wall

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39
Q

Embryology- what happens to the processus vaginalis

A

It crosses crosses the developing inguinal ring carrying the muscular and fascial layers of the anterolateral abdominal wall before it as it enters the scrotum

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40
Q

Embryology- what happens as the testis enter the scrotum?

A

they are covered by the musculofascial extensions of the anterolateral abdominal wall

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41
Q

Embryology- the distal part of the processus vaginalis forms the

A

Tunica vaginalis

42
Q

In females, ovaries develop (2)

A

in superior lumbar region of the posterior abdominal wall and migrate to the lateral abdominal wall in the pelvis

43
Q

In females, the gubernaculum is (3)

A

a fibrous cord connecting the ovary and the primordial uterus to the developing labium majus

44
Q

The ovarian ligament connects

A

The ovary and uterus

45
Q

The round ligament connects

A

The uterus and labium majus

46
Q

In females, which ligament passes through the inguinal region?

A

Round ligament

47
Q

In females, the inguinal canal is ___, compared to males

48
Q

What are the nerves of the inguinal region? (4)

A

Ilioinguinal

Iliohypogastric

Genitofemoral

Lateral femoral cutaneous

49
Q

Function of the spermatic cord

A

Suspends the testis in the scrotum

50
Q

The spermatic cord contains (8)

A

Vas deferenes

vas deferens artery and vein

cremasteric artery and vein

testicular artery and vein

pampiniform venous plexus

genital branch of genitofemoral nerve

sympathetic nerves

lymphatic vessels

51
Q

What are the 3 fascial layers that envelope the spermatic cord?

A

External

Cremasteric

Internal

52
Q

The external fascial layer of the spermatic cord is formed from

A

The external oblique aponeurosis

53
Q

The cremasteric fascial layer of the spermatic cord is formed from

A

superficial and deep surfaces of the internal oblique muscles

54
Q

The internal fascial layer of the spermatic cord is formed from

A

Transversalis fascia

55
Q

The testicular artery supplies

A

Testis and epididymis

56
Q

Testicular artery arises from

57
Q

Vas deferens artery arises from

A

Inferior vesical artery

58
Q

Cremasteric artery arises from

A

Inferior epigastric artery

59
Q

What is the pampiniform plexus?

A

A VENOUS network formed by 12 veins

60
Q

What is the function of the pampiniform plexus?

A

Drains into the right or left testicular veins

61
Q

The pampiniform plexus runs in the

A

Spermatic cord

62
Q

What are the main arteries and veins of the spermatic cord? (4)

A

Testicular artery

Vas deferens artery

Cremasteric artery

Pampiniform plexus

63
Q

Descend of the testis occurs ___ the peritoneum

A

Beneath/behind

64
Q

The abdominal skin of the abdominal wall (i.e. Scarpa’s fascia) becomes the ___ in the testis

A

Scrotal skin with tunica dartos (dartos muscle of the scrotum)

65
Q

The superficial fascia of the abdominal wall/external abdominal oblique becomes the ___ in the testis

A

External spermatic fascia

66
Q

The external oblique muscle of the abdominal wall becomes the ___ in the testis

A

IT HAS NO COUNTERPART

67
Q

The transversalis fasica of the abdominal wall becomes the ___ in the testis

A

Internal spermatic fascia

68
Q

The peritoneum of the abdominal wall becomes the ___ in the testis

A

Tunica vaginalis

69
Q

Inguinal hernias are caused by

A

A failure of the processus vaginalis to close

70
Q

What is the superior/lateral border of Hesselbach’s triangle?

A

Inferior epigastrics

71
Q

What is the meidal border of Hesselbach’s triangle?

A

Lateral edge of the rectus abdominis muscle

72
Q

What is the inferior border of Hesselbach’s triangle?

A

Inguinal ligament

73
Q

What is the Triangle of pain?

A

It is a space bordered by the iliopubic tract and gonadal vessels

74
Q

What does the triangle of pain contain? (3)

A

Lateral femoral cutaneous nerve

Femoral branch of the genitofemoral nerve

Femoral nerve

75
Q

What is the triangle of doom?

A

A space bordered by the vas deferens and spermatic cord vessels

76
Q

The triangle of doom contains (4)

A

external iliacs

deep circumflex iliac vein

femoral nerve

genital branch of genitofemoral nerve

77
Q

What is the circle of death? (4)

A

A vascular anastomosis between the obturator and the external iliac vascular systems that passes over Cooper’s pectineal ligament and posterior to the lacunar ligament

78
Q

Direct vs. indirect hernia

A

Any hernia that occurs inside Hesselbach’s triangle is a direct hernia

Any hernia that occurs on the lateral side of the triangle is an indirect hernia

79
Q

What is Scarpa’s Triangle/the Femoral triangle?

A

Subfascial space that appears as a triangular depression inferior to the inguinal ligament when the thigh is flexed, abducted, and laterally rotated.

80
Q

What is the superior border of Scarpa’s/the Femoral Triangle?

A

Inginal ligament

81
Q

What is the medial border of Scarpa’s/the Femoral Triangle?

A

Lateral border of the adductor longus

82
Q

What is the lateral border of Scarpa’s/the Femoral Triangle?

A

Medial border of the Sartorius muscle

83
Q

What is the floor of Scarpa’s/the Femoral Triangle?

A

Pectinous and adductor longus muslces medially

Iliopsoas muscles laterally

84
Q

What is the roof of Scarpa’s/the Femoral Triangle?

A

Fascia lata

85
Q

What structures are contained within the femoral triangle? (6)

A

Femoral nerve + terminal branches

Femoral sheath which contains:

  • Femoral artery
  • Femoral vein
  • Deep inguinal lymph nodes
86
Q

What are the borders of the subinguinal hiatus superiorly and inferiorly? (1+3)

A

Superior: inguinal ligament

Inferior: iliopubic eminance, body, and pubic tubercle

87
Q

What are the 3 compartments of the subinguial hiatus? (3)

A

Lacuna musculonervosa

Lacuna vasorum

Lacuna lymphatica

88
Q

The lacuna musculonervosa contains

A

The femoral nerve and the iliopsoas muscle

89
Q

The lacuna vasorum contains

A

femoral artery and vein

90
Q

The lacuna lymphatica is a common site of

A

Herniation

91
Q

The cremaster muscle is a derivative of

A

The internal abdominal oblique

92
Q

In the subinguinal hiatus, what divides the subinguinal hiatus into the lacuna visorum and the lacuna musculorum?

A

Subinguinal hiatus

93
Q

The external abdominal oblique fascia becomes the ___ in the testis

A

External spermatic fascia

94
Q

The transversalis fascia in the abdominal wall becomes __ in the testis

A

The internal spermatic fascia

95
Q

The transversus abdominis muscle in the abdominal wall becomes ___ in the testis

96
Q

The external abdominal oblique fascia in the abdominal wall becomes the ___ in the testis

A

External spermatic fascia

97
Q

The right gonadal vein drains into the ___

The left gonadal vein drains into the ___

A

Right = IVC

Left = renal vein

98
Q

From lateral to medial, what is located in the femoral sheath? (5)

A

Lateral femoral cutaneous nerve

Femoral artery

Femoral vein

Nodes/fat of the femoral canal/ring

Lacunar ligament

99
Q

What is located superiorly to the femoral sheath?

A

Inguinal ligament/inguinal canal (superficial ring)

100
Q

Femoral hernias occur

A

Below the inguinal ligament

101
Q

Cloquet’s hernia occurs between

A

The pectineus msucle and its aponeurosis and behind the femoral vessels

102
Q

Be’clard’s hernia occurs

A

Through the saphenous ring

MGA Exam 3 (8 decks)

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