Inguinal Region Flashcards
Lacunar Ligament
Medial extension of the inguinal ligament which attaches to the pectineal line; its sharp edge form the femoral ring
Inguinal Ligament
Lower border of the E.O. aponeurosis; extends from the ASIS to the pubic tubercle
Pectineal Ligament
Thickening of the periosteum that is continuous w/ the lacunar ligament at the pectineal line of the pubis
Conjoint tendon
Fused aponeuroses of I.O. and transversus abdominis mucles
Hesselbach’s Triangle
Weakness in the abdominal wall vulnerable to a direct inguinal hernia; found in the medial inguinal fossa
Deep Inguinal Ring
Found lateral to the inferior epigastric vessels in the lateral inguinal fossa; spermatic cord protrudes thru the transverasalis fascia
Superficial Inguinal Ring
Formed by the medial and lateral crus (attached to the pubic symphysis and tubercle) and the pubic crest; technically an evagination of the E.O. aponeurosis
Anterior Wall of the Inguinal Canal
E.O. aponeurosis and I.O. aponeurosis (lateral 1/3)
Posterior Wall of the Inguinal Canal
Transversalis fascia and conjoint tendon (medial 1/3)
Roof of Inguinal Canal
I.O. muscle and aponeurosis and transversus abdominis aponeurosis
Also arching muscle fibers
Floor of Inguinal Canal
Ingiuinal and lacunar (medial 1/3) ligament
Structures transmitted thru the inguinal canal
Male=Spermatic Cord
Female= Round ligament of the uterus
Both= llioinguinal nerve and gential branch of the genitofemoral nerve
*llioinguinal nerve pierces canal laterally at the transversus abdominis and exits thru the superficial ring
Processus vaginalis
Evagination of peritoneum into the ventral abdominal wall that is independent of testes descent; after obliteration, persists as the tunica vaginalis on the testes
Gubernaculum
Condense band of mesenchyme that connects the developing gonad to the labioscrotal swellings; becomes the fibrous cord connecting the testest to the scrotum or the round ligament of the uterus
Testes descent
Gonads develop at L1 and descend thru the inguinal canal picking up layers of fascia as they travel the the processus vaginalis via the gubernaculum
*Cavity of the tunica vaginalis originates from the peritoneum
Camper’s Fascia in scrotum
Dartos muscle
Scarpa’s Fascia in scrotum
Colle’s Fascia
-membranous layer of superficial fascia
E.O. aponeurosis in scrotum
External Spermatic Fascia
I.O. muscle and aponeurosis in scrotum
Cremaster muscle and fascia
Transversus abdominis muscle in scrotum
NO CONTRIBUTION
Transversalis fascia in scrotum
Internal spermatic fascia
Extraperitoneal fat in scrotum
Loose CT
Parietal Peritoneum in scrotum
Tunica vaginalis (obliterated processus vaginalis)
Dartos muscle
Contracts in response to cold and reduces the surface area of the scrotum
*Stabilizes testis temperature
Tunica albuginea
Outer capsule surrounding the testis
Site of sperm production
Seminiferous tubules
Spermatic Cord Layers and Components
Layers: External spermatic fascia
Cremasteric fascia
Internal spermatic fascia
Components: Testicular artery
Ductus deferens and artery
Pampiniform plexus (converges as testicular vein)
Genital branch of genitofemoral nerve
Cremasteric artery
Autonomic nerve plexus
Indirect Inguinal Hernia
- Neck of hernia passes thru deep inguinal ring in lateral inguinal fossa
- Enters lateral to inferior epigastric vessels
- Cause is from incomplete obliteration of the processus vaginalis
- covering consists of peritoneum
- More common hernia
Direct Inguinal Hernia
- Neck of hernia passes directly thru inguinal fossa in Hesselbach’s triangle
- Enters medial to inferior epigastric vessels
- Never extends to scrotum
- Caused by weak posterior wall of inguinal canal
Femoral Hernia
Occurs thru the femoral ring and lies inferolaterally to the pubic tubercle
- Dangerous to repair due to possible presence of corona mortis and constriction by tough ligaments
- Common in women
Cryptochordism
Incomplete testes descent such that one of both testes remain in the body cavity or inguinal canal
Cremasteric Reflex
Reflex contraction of the cremaster muscle due to stroking of the medial thigh
Ilioinguinal N.-sensory to inner thigh
Genital Branch of genitofemoral N.- Motor to cremaster
Peritoneal recess infection
Occurs more commonly in women due to communication of Fallopian tubes and peritoneal cavity
