Inguinal Region/Spermatic Cord Flashcards
layers over testes
- superficial/dartos fascia
- external spermatic fascia
- cremaster muscle and fascia
- internal spermatic fascia
- parietal layer tunica vaginalis
- epididymis
- testis covered by visceral layer
inguinal ligament
made from aponeurosis of external oblique
ASIS to pubic tubercule
conjoint tendon
from aponeuroses of internal oblique and TA
attaches to linguinal
inguinal canal
passageway for spermatic cord and round ligament in abdominal wall
floor of canal is ligament
order of testes passage
transversalis fascia
transversus abdominus (TA)
internal oblique
external oblique
arches
under the 3 muscles:
TA
internal oblique
external oblique
rings
deep: in transversalis fascia ENTER canal
superficial: external oblique EXIT to scrotum
rings
location
deep: 1/2 way b/t ASIS and pubic tubercule
superficial: medial to pubic tubercule
transversalis fascia
becomes
deep ring
internal spermatic fascia (deepest of the 4 fascia layers)
transversus abdominis
becomes
nothing
just arches over canal to conjoint tendon
internal oblique
becomes
cremaster muscle and fascia (3rd layer of fascia)
cremaster raises testes based on temp
external oblique
becomes
external spermatic fascia (2nd layer)
superficial ring
arterial supply
testicular arteries
off aorta
venous return
pampiniform plexus
right drains into IVC
left drains into left renal canal
cremaster vessels from inferior epigastric vasculature too?
anterior cutaneous branch iliohypogastric
skin of canal
L1
genital branch genitofemoral
cremaster muscle
L1-2
anterior scrotal branch iliolinguinal
inside canal?
L1
spermatic cord contents
vas deferens (+ art and vein)
genital branch-genitofemoral
external and internal spermatic fascia
cremaster muscle/art/vein
vestige processus vaginalis, tunica vaginalis
testicular plexus
testicular artery
testicular vein/pampiniform plexus
muscles
inguinal region
pyramidalis
cremaster
dartos
pyramidalis
tenses linea alba
subcostal T12
not important
dartos muscle
shrivels testes when cold to hold heat
from scarpa’s fasica
gubernaculum
ligamentous primordia attaches developing testis/ovary and scrotal/labial folds
marks site of future inguinal canal
inguinal canal formation
7th week- parietal peritoneum projects out into processus vaginalis to make pocket thru body wall
9th month- pocket/procesus vaginalis seals
next to gubernaculum
peritoneum
becomes
tunica vaginalis
camper’s fascia
becomes
nothing in spermatic cord
layers in labia majora
external fascia
cremasteric muscle and fascia
internal fascia
round ligament
labia major same as scrotum
round lig from gubernaculum
inguinal canal in females
formation
upper gubernaculum > ovarian ligament
lower gubernaculumm > round ligament
8th week start > 15th week end
hernia
protrusion of tissue or organ thru weakness or opening in layers normally contained in
hernia
causes
erect posture
inc intra-ab pressure (constipation, birth, coughing)
processus vaginalis not sealing
muscular deficiency
tissue abnormality
common hernias
direct inguinal
indirect inguinal
femoral
direct hernias
thru weaking in hasselbach triange
thru body wall
parallel to cord never within
unilateral bc acquired somehow
hasselbach triangle borders
inferior epigastric superior
rectus abdominus medial
inguinal ligament lateral/inferior
indirect hernia
congenital
thru deep ring
within cord
bilateral presentation
femoral hernia
thru femoral ring
more common in older women
hydrocele
clinical correlate
build up of fluid
can go away on it’s own
less dangerous
can be associated w/ hernias
hematocele
clinical correlate
filled with blood
more dangerous
spermatocele
clinical correlate
epididymis cyst
build up of sperm and assoc fluids
feels hard so mistaken for cancer
common
