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HS Exam 2 > Inguinal Region > Flashcards

Inguinal Region Flashcards

1
Q

what is the difference between direct and indirect hernias

A

direct enters inguinal canal via posterior wall through haseslbach’s triangle due to weakened conjoint tendon
indirect enters inguinal canal via deep inguinal ring outside haseselbach’s triangle due to patent process vaginalis

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2
Q

is there an inguinal canal in females

A

yes

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3
Q

why is the cremater reflex tested

A

to test that the iliogenital and iliofemoral nerves are working

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4
Q

how do layers of the spermatic cord relate to the layers of the anterior abdominal wall

A

skin is the same as the skin of the abdominal wall
campers and scarpas fascia fuse to form the darts- fat lost from campers fascia
external spermatic fascia comes from the external obliques
cremaster muscle comes from internal oblique
internal spermatic fascia comes from transversus abdominis

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5
Q

what is the difference between the deep and superficial inguinal rings

A

superficial inguinal ring- formed by the external oblique

deep inguinal ring- formed by transversus abdominis

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6
Q

what is the origin of tunica vaginalis in the testis?

A

process vaginalis disappears, but stays to form the layers around the testis

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7
Q

what is the origin of the tunica vaginalis in females

A

no tunica vaginalis, the process vaginalis regresses in females
if it doesn’t forms the canal of nuck

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8
Q

what are clinical implications of the gubernaculum

A

guides the testis into the scrotum

if it doesn’t develop fully testis does not descend fully

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9
Q

what does the gubernaculum become in the male

A

lower part connects the testis to the scrotum

upper part degenerates

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10
Q

what does the gubernaculum become in the female

A

round ligament of uterus and round ligament of ovary

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11
Q

where do the testis travel during development

A

through the inguinal canal

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12
Q

what happens if the wall of the inguinal canal is weakened

A

hernia

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13
Q

what is a hernia

A

visceral protrusion beyond normal boundaries

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14
Q

what level do gonads develop at and in what space

A

T12 in retroperitoneal space

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15
Q

what is in the spermatic cord

A

nerves
vessels
lymphatics
ductus deferens

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16
Q

describe week 6 of testis development

A

testis in retroperitoneal space with caudal ligament attached to the skin in the scrotal swelling

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17
Q

what becomes the gobernaculum ligament

A

caudal ligament

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18
Q

describe week 10 of development

A

testis travels anteriorly in subserous fascia, taking the nerves, vessels and lymphatics with it from T12

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19
Q

describe 7 month development

A

process vaginalis forms
testis moves into the deep inguinal canal taking wall layers with it
exit through superficial ring
testis pushes into the processes vaginalis which forms the parietal and visceral layers and cavity of tunica vaginalis

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20
Q

describe testis at birth

A

testis is in scrotum surrounded by tunica vaginalis and the process vaginalis is closed off

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21
Q

what is the role of the gobernaculum

A

guides the testis into scrotum

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22
Q

what happens if the gobernaculum is incompletely formed

A

incomplete testis descent

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23
Q

what is cryptorchidism

A

undescended testis- usually in the inguinal canal

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24
Q

what are consequences of undescended testes

A

decreased fertility

increased risk of testicular cancer

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25
Q

what part of the process vaginalis remains

A

tunica vaginalis- lining testes and the cavity

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26
Q

what is patent process vaginalis

A

failure of close, leaving a communication between the peritoneal cavity and the scrotum
can lead to an indirect hernia

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27
Q

what is a hydrocele

A

fluid filled sac in the spermatic cord from a weird closing of the process vaginalis

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28
Q

how is a hydrocele distinguished from an undescended testis

A

light- hydroceles let light through

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29
Q

what does the gubernaculum become in females and where is it attached

A

round ligament of uterus
attached to the labia major distally and ovary proximally
middle is attached to the uterus

30
Q

round ligament of the uterus

A

gobernaculum between the uterus and labia majora

31
Q

round ligament of the ovary

A

gobernaculum between the uterus and ovary

32
Q

what is significant about the lymphatics associated with the round ligament in females

A

acts as a communication between the uterus and labia major so cancer cells from the uterus can migrate inferior and result in enlarged superficial inguinal lymph nodes

33
Q

what happens to the process vaginalis in females

A

regresses

34
Q

what is the canal of nuck

A

failure of the process vaginalis to regress in females

results in abcess and indirect hernia potential

35
Q

what are the 3 muscles layers involved in the formation of the inguinal canal

A

external oblique
internal oblique
transversus abdominis

36
Q

what is the inguinal ligament

A

thickened inferior edge of the external oblique going from the anterior superior ishial spine to the pubic tubercle

37
Q

what is the lacunar ligament

A

triangular ligament next to the pubis

forms medial floor of inguinal canal

38
Q

what is the pectinal ligament

A

ligament below the lacunar ligament, on top of the pectinate muscle, right up next to the bone

39
Q

what is the conjoint tendon

A

internal oblique + transverses abdominis

strenghten posterior wall of inguinal canal

40
Q

what forms the deep inguinal ring

A

transversalis abdominis lateral to inferior epigastric vessels

41
Q

where does the conjoint tendon move when it weakens

A

medially

42
Q

where is an indirect inguinal herina

A

bowel comes out lateral to inferior epigastric vessels

43
Q

where is a direct inguinal hernia

A

bowel enters inguinal canal medial to inferior epigastric vessels

44
Q

what forms the roof of the inguinal canal

A

transversus abdominis and the internal oblique muscles

45
Q

what forms the posterior boarder of the inguinal canal

A

trasversali fascia and conjoint tendon (transversus and interal)

46
Q

what forms the anterior wall of the inguinal canal

A

external oblique

47
Q

what forms the floor of the inguinal canal

A

inguinal ligament and the lacunar ligament (both from external oblique)

48
Q

what is in the male inguinal canal

A 
ductus deferens
testicular artery and vein
sympathetic innervation
ilioinguinal nerve
genitofemoral nerve
49
Q

what is in the female inguinal canal

A

round ligament of the uterus

ilioinguinal nerve

50
Q

what contributes to the spermatic cord

A

internal spermatic fascia- transversalis fascia
cremaster muscle- internal oblique
external spermatic fascia- external oblique

51
Q

what is a vasectomy

A

surgical disruption in the ductus deferens as a form of birth control

52
Q

what is testicular torsion

A

spermatic cord twisting resulting in loss of blood supply to the testis

53
Q

what is the cremaster reflex and what does it test

A

scratch medial thigh (iliofemoral nerve) to make the cremaster muscle contract (genitofemoral nerve)

54
Q

what i varicocele

A

varicosities in the pampinform plexus of the scrotum due to obstruction of the left renal vein affecting the testicular vein

55
Q

what is a hydrocele

A

fluid filled process vaginalis remant

56
Q

what does a patent process vaginalis cause

A

indirect inguinal hernia in men, canal of nuck in females

57
Q

what is a canal of nuck

A

patent process vaginalis in female

58
Q

what is a hematocele

A

accumulation of blood in the tunica vaginalis

59
Q

which hernia enters hesselbach’s triangle

A

direct- bowel enters scrotum due to weakening of conjoint tendon which strengthens the posterior wall of the inguinal canal

60
Q

where is a indirect hernia palpable

A

on the tip of the finger

61
Q

where is a direct hernia palpable

A

side of finger

62
Q

what causes an indirect inguinal hernia

A

congenital latency of process vaginalis

63
Q

describe a indirect inguinal hernia

A

bowel enters deep inguinal ring outside hasselbach’s triangle

64
Q

describe a direct inguinal hernia

A

bowel enters posterior wall of inguinal canal inside hasselbach’s triangle

65
Q

what are the boarders of hasselbach’s triangle

A

inferior epigastric vessels
inguinal ligament
lateral rectus sheath

66
Q

what is seen on inspection with hernia preseent

A

buldge in inguinal region

67
Q

what is felt on palpation with hernia

A

pain/discomfort

eversion of skin with finger- feel buldge

68
Q

what is heard on auscultation of a hernia

A

bowel sounds

69
Q

what type of hernia is more common in females

A

femoral

70
Q

which type of inguinal hernia is more common

A

indirect

HS Exam 2 (24 decks)

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