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GIGU Exam 1 > Inguinal Region > Flashcards

Inguinal Region Flashcards

1
Q

What is the inguinal ligament?

A

The rolled under inferior border of the EOM aponeurosis

Attached to ASIS and pubic tubercle

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2
Q

What is the conjoint tendon (inguinal falx)?

A

Combined aponeurosis of inferior/medial margins of IOM and TA muscle inserting onto pubis

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3
Q

What is the superficial ring?

A

External opening within aponeurosis for spermatic cord (male) or round ligament of uterus (female) to exit from the inguinal canal

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4
Q

What are the three types of crural fibers of the inguinal region?

A

Medial crus, lateral crus and inter crural fibers

Medial and lateral are boundaries for the superficial ring

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5
Q

What is the lacunar ligament?

A

Ligament between pubic rami and inguinal ligament

Anchors inguinal ligament to pubis

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6
Q

What is the pectineal ligament?

A

Continuation of fibers from lacunar ligament running along the pectin pubis (used in hernia repairs)

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7
Q

What is the femoral canal (subinguinal space)?

A

Lies immediately lateral to lacunar ligament

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8
Q

What is the deep ring?

A

Entrance to inguinal canal and beginning of the invagination of peritoneum into transversalis fascia
Superior to inguinal ligament and lateral to inferior epigastric A

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9
Q

What passes through the deep ring?

A

Vas deferens and gonadal vessels/nerves in males and round ligament in females

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10
Q

What nerves are near the inguinal ligament, canal and ring?

A

Iliohypogastric nerve, ilioinguinal nerve and genitofemoral nerve

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11
Q

Describe the Iliohypogastric nerve

A

L1
Motor to abdominal muscles (IO and TA)
Sensory to skin above pubis (hypogastric region)

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12
Q

Describe the ilioinguinal nerve

A

L1
Traverses inguinal canal, exits superficial ring lateral to cord
Motor to IO and TA muscles
Sensory to skin over upper/medial thigh and skin to root of penis/clitoris and anterior scrotum/labia

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13
Q

Describe the genital branch of the genitofemoral nerve

A

L1-2
Motor to cremasteric muscle
Sensory to small part of medial thigh and scrotal/labia fascia

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14
Q

What are the borders of the inguinal (Hasselbach’s) triangle?

A

Inferior epigastric vessels (lateral umbilical ligament), inguinal ligament and the lateral edge of the RA

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15
Q

What is the clinical significances of the inguinal triangle?

A

An area of abdominal weakness

Direct hernia can occur inferior to conjoint tendon and medial to lateral umbilical ligament

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16
Q

What is the iliopubic tract?

A

Thickened transversalis fascia running posterior to inguinal ligament
Reinforces floor of inguinal canal

17
Q

What is a direct hernia?

A

Medial to inferior epigastric A

Peritoneum/transversalis fascia alongside the spermatic cord (exit superficial ring)

18
Q

What is an indirect hernia?

A

Enters deep ring

Periosteum within spermatic cord

19
Q

What is a femoral hernia?

A

Below inguinal ligament
More common in women
40% present as emergencies with incarceration or strangulation

20
Q

Where do gonads form?

A

Near T10 axial level

21
Q

Gonads are connected to future scrotal swellings by what structure?

A

Gubernaculum

22
Q

What are cryptorchid testes?

A

Undescended testis

Increase risk of developing testicular cancer

23
Q

What is the processus vaginalis?

A

Evagination of peritoneal cavity

Communication usually closes within 1st year postnatally

24
Q

Describe testicular descent

A

Descent along with an out-pocketing of peritoneal cavity (processus vaginalis) into future scrotum carrying vessels and nerves with them (future suspensory ligament)
Connection to peritoneum closed; tunica vaginalis represents the remains of processus vaginalis around testes
Layers of abdominal wall carried as spermatic cord develops such as transversalis fascia, internal and external oblique muscles

25
Q

Describe the spermatic cord layers

A

As gonad herniates out along with its blood supply and vas deferens it carries layers of abdominal wall with it forming the spermatic cord
-Transversalis fascia: internal spermatic fascia
-Internal oblique: makes cremasteric muscle
-External oblique: external spermatic fascia
Site of abdominal wall weakness

26
Q

What are the contents of the spermatic cord?

A

Vas deferens (ductus deferens), testicular A and veins (pampiniform plexus), gonadal nerves and lymphatics

27
Q

What is a persistent processus vaginalis?

A

Patent connection between tunica vaginalis and abdomen

28
Q

What is hydrocele?

A

Peritoneal fluid accumulation within tunica vaginalis
More common in babies
In adults, inflammation or injury in the scrotum, testis or epididymis
Communicating and non-communicating types
Detected with transillumination

29
Q

What is hematocele?

A

Accumulation of blood in tunica vaginalis

30
Q

Describe lymph drainage of the testes and scrotum

A

From scrotum drains into superficial inguinal nodes and eventually travel into iliac and lumbar LNs
Testes drain into lumbar and pre-aortic LNs

31
Q

Describe ovarian descent

A

Begins descending but gubernaculum becomes attached to developing uterus
Gubernaculum forms ovarian ligament and round ligament of the uterus
Round ligament of the uterus enters deep ring and exits superficial ring attaching to labial swellings

32
Q

Describe the female inguinal canal

A 
Deep and superficial rings 
Medial/lateral crus
Lacunar/pectineal ligaments 
Conjoint tendon (inguinal falx) 
Scrotal/labia relationship
33
Q

What are the contents of the female inguinal canal?

A

Round ligament of uterus, ilioinguinal nerve and genitofemoral nerve (genital branch)

34
Q

The inferior epigastric A runs anterior to what?

A

Posterior rectus sheath

35
Q

What is the median umbilical fold?

A

Due to obliterated urachus

36
Q

What is the medial umbilical fold?

A

Due to obliterated umbilical A

37
Q

What is the lateral umbilical fold?

A

Fold due to inferior epigastric A

GIGU Exam 1 (19 decks)

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