Lecture 2: Inguinal Canal Flashcards

1
Q

Where is the inguinal ligament found?

A

ASIS to pubic tubercle

-base of the inguinal canal

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2
Q

What makes up the conjoint tendon?

A

Aponeurosis of internal oblique muscle and transversus abdominis muscle inserting into pubis

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3
Q

Describe the superficial ring.

A

External opening of inguinal canal within the aponeurosis of external oblique muscle

  • Spermatic cord or round ligament exits from here
  • closer to pubis (exit for inguinal canal)
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4
Q

What crural fibers make up superficial ring?

A

Medial crus
Lateral crus
Intercrural fibers

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5
Q

Describe the lacunar ligament.

A

Ligament between pubic rami and inguinal ligament

-helps attach inguinal ligament to pbus

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6
Q

Describe the pectineal ligament.

A

Fibers from lacunar ligament running along pectin pubis

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7
Q

Where is the femoral ring found?

A

Lateral to lacunar ligament

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8
Q

Describe the deep ring.

A

Entrance to inguinal canal

-beginning of invagination of peritoneum into the transversalis fascia

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9
Q

What makes up the roof of the inguinal canal?

A

Transversalis fascia
Aponeurosis of transverse abdominis muscle
Aponeurosis of internal oblique muscle

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10
Q

What makes up the anterior wall of the inguinal canal?

A

Aponeurosis of external oblique muscle

Internal oblique muscle

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11
Q

What makes up posterior wall of the inguinal canal?

A

Transversalis fascia

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12
Q

What makes up the foor of the inguinal canal?

A

Inguinal Ligament

Lacunar Ligament

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13
Q

What is the iliopubic tract a thickening of?

A

Transversalis fascia

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14
Q

Where is the genitofemoral nerve found?

A

L1 and L2

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15
Q

What is the motor and sensory function of the genitofemoral nerve?

A

Motor: Cremasteric muscle
Sensory: small part of medial thigh and scrotal/labial fascia

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16
Q

Where are gonads formed?

A

near T10 axial level

17
Q

What attaches gonads to future scrotal swellings?

A

Gubernaculum

18
Q

During testicular descent, there is an outpocketing of the peritoneal cavity into the future scrotum. What is this called?
What is remnant called?

A

Processus vaginalis

Tunica vaginalis: evagination of peritoneal cavity and remains of processus vaginalis around testes

19
Q

What are cryptorchid testis?

Patients with cryptorchid testis have an increased risk of developing what?

A

Undescended testes

-increased risk of developing testicular cancer

20
Q

What abdominal layers undergo testicular migration?

What do they become?

A

1) Skin
2) Scarpa’s fascia –> Dartos fascia
3) External abdominal oblique muscle –> External spermatic fascia
4) Internal abdominal oblique muscle –> Cremasteric muscle
5) Transversalis fascia —> Internal spermatic fascia
6) Peritoneum —> parietal and visceral tunica vaginalis

21
Q

Which abdominal layer does not undergo testicuar migration?

A

Transversus abdominis muscle

22
Q

What innervates external spermatic fascia?

A

Sympathetic NS

23
Q

What innervates cremasteric muscle?

A

Genital Branch of Genitofemoral nerve

24
Q

What structures are found in the spermatic cord?

A

Vas deferens
Testicular artery and veins (Pampiniform Plexus)
Gonadal nerves
Gonadal lymphatics

25
What is a testicular varicocele?
Enlargement of veins in scrotum | -varicosities of pampiniform plexus
26
Describe persistent processus vaginalis.
Patent connection between tunica vaginalis and abdomen
27
What is a hydrocele?
Peritoneal serous fluid accumulation within tunica vaginalis
28
What is a hematocele?
Accumulation of blood in tunica vaginalis
29
In females, describe what happens to the gubernaculum.
1) Attaches to developing uterus | 2) Forms ovarian ligament and round ligament of uterus
30
What does the round ligament of the uterus enter and exit?
Enters deep inguinal ring | Exits superficial inguinal ring, attaching to labial swellings
31
What structures are found in the female inguinal canal?
- Round ligament of uterus - Ilioinguinal nerve - Genitofemoral nerve (genital branch)
32
What are the boundaries of Inguinal (Hesselbach's) Triangle?
Medial: lateral border of the rectus abdominis muscle (linea semilunaris) Lateral: inferior epigastric vessels Inferior: inguinal ligament
33
Describe a direct hernia.
Hernia found in Hesselbach's Triangle - medial to inferior epigastric artery - exits superficial ring
34
Describe an indirect hernia.
Hernia enters scrotum - lateral to inferior epigastric artery - enters deep ring - exits superficial ring
35
Describe a femoral hernia.
Hernia below inguinal ligament | -more common in women