Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Sita GenitoUrinary System > Lecture 8: Inguinal Canal and Spermatic Cord > Flashcards

Lecture 8: Inguinal Canal and Spermatic Cord Flashcards

1
Q

What are the 9x layers of the abdominal wall?

A
  1. Skin
  2. Camper’s Fatty Superficial fascia
  3. Scarpa’s Membranous Superficial fascia
  4. External oblique
  5. Internal Oblique
  6. Transversus Abdominus
  7. Transversalis Fascia
  8. Extraperitoneal Fascia
  9. Partial Perotineum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Key Pelvic Landmarks

A 
ASIS: termination of illiac spine
AIIS
Pectineal Line
Pubic Tubercle, Crest (posterior medial) and Symphysis (Linea Alba)
Inguinal Ligament
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinical relevance of Pubic Tubercle

A

Can palpate

Useful if want to diagnose hernia’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Relationship b/w Pubic Crest and Tubercle

A

Pubic Crest is PosterioMedial to Pubic Tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

3x Key Pelvic Ligaments

A
  1. Inguinal Ligament
  2. Pectineal Ligament
  3. Lacunar Ligament
    Function of Pelvic ligaments: Attach suture during Inguinal hernia repairs. Will hold as all 3x are strong and robust ligaments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Inguinal Ligament

A

ASIS to Pubic Tubercle

Rolled free edge of External Oblique Aponeurosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pectineal Ligament

A

Pectineal line to Pubic bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lacunar Ligament

A

connects Inguinal and Pectineal Ligament
- sweeps horizontally onto pubic bones
- essentially a continuation of Inguinal ligament
Clinical: Sharp edges which thing scan get trapped against

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Inguinal canal

A

Canal through which Pelvic Inguinal Ligament passes through (Lower part of the abdominal wall)
Oblique passage –> helps prevent herniation (of abdominal contents)
Superficial Inguinal Ring Deep Inguinal Ring (4 cm in adults) (runs superficial –> deep)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Inguinal Canal in Males and Females

A

Male Inguinal Canal: Has Spermatic cord carries structures too/from abdomen testes 2. Illioinguinal nerve alongside (in canal not in cord)
Female Inguinal Canal: 1. (Uterine) Round Ligament from pelvis Labia majora 2. Ilioinguinal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ilioinguinal nerve

A

Contained in Inguinal Canal in both males and female
Males: In Inguinal canal, Ontop (not inside) Spermatic Cord
- DOES NOT “travel through” inguinal canal technically –> Misses DIR and instead Pierces Internal Oblique Roof (of the canal) –> runs outside spermatic cord –> Exits at SIR
- therefore does not go through DIR
- Provides sensation around pubic region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Superficial Inguinal Ring

A

Aponeurosis of External Oblique –> Triangular Shaped
SuperioLateral to Pubic Tubercle
Crura= Margins –> Medial and Lateral Crus –> create the spermatic cords’ (within male inguinal canal) External Spermatic Fascia
- Sometimes contains Transverse fibres for support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Deep Inguinal Ring

A

Transversalis Fascia Oval opening
Location:
1. Lateral to Inferior Epigastic artery.
2. Just past Mid-Inguinal Point (1.5- 2cm superior) –> 1/2 Way b/w ASIS and Pubic Symphsis
Creates Internal Spermatic Fascia of male Spermatic Cord –> Round Ligament in females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Transversus Abdominus and Internal Oblique

A

Located b/w Superficial and Deep Inguinal Ring
1. Transversus Abdominus: Doesnt contribute to spermatic fascia
2. Internal Oblique: Creates Cremasteric Muscle
- part of spermatic cord. comes of the scrotum
- helps draw testes towards body
Combined: Transversus Abdominus + Internal Oblique –> combine to form a CONJOINT TENDON
- on Pubic CREST / Pectineal Line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Borders of the Inguinal Canal

A 
Anterior Wall: (Deep I. R)
1. External Oblique aponeurosis
2. Internal Oblique Lateral 1/3
Floor (ligaments for solidarity --> used for suturing herniation)
1. Inguinal ligament (rolled free edge of ext. oblique aponeurosis)
2. Lacunar Ligament
Roof: 
1. Internal Oblique
2. Transversus Abdominus
Posterior Wall: (Superficial I. R)
1. Transversalis Fascia
2. Conjoint Ligament (medial 1/3)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Draw Inguinal Canal diagram

A

**

17
Q

Hesselback’s (Inguinal) Triangle

A

Sides:

  1. Inferior Epigastric Artery
  2. Inguinal Ligament
  3. Rectus Abdominus (lateral border)
    - Site of Direct Hernia (pushing through abdominal wall)
    - Deep Inguinal ring located superiolateral
    - Associated with weak anterior wall of Superficial Inguinal Ring
18
Q

Spermatic Cord

A

Collection of structures, within male Inguinal canal, DIR (deep inguinal ring) testes
3x concentric layers of fascia. all derived from Anterior abdominal wall
- layers are continuous w. scrotum
- pushes through abdominal wall –> 3x concentric continuous layers (take a tubular sheath from each layer)
Spermatic Cord arises from Processus Vaginalis (a Peritoneal Diverticulum)
- Peritoneal (inner most abdominal layer) out-pouching pinches off –> forms closed sac –> remnant is newly named Tunica vaginalis

19
Q

Layers of the Spermatic Cord

A
  1. External Oblique (SIR) –> External Spermatic Fascia
  2. Internal Oblique –> Cremaster Muscle
  3. Transversus Abdominus (NO COVERING - hooks around)
  4. Transversalis Fascia (DIR) –> Internal Spermatic Fascia
20
Q

Scrotal Remnant

A

Innermost layer of abdominal cavity being pushed downwards by descending spermatic cord (Peritineum) –> eventually pinches off and forms a closed sac remnant structure –> Tunica Vaginalis

21
Q

Contents of the Spermatic Cord

A

3x Layers:

  1. 3x Arteries: a) Testicular (L2) b) Vas deferens/Deferential c) Cremasteric
  2. 3x Nerves: a) Genital branch of Gentiofemoral (L1&2) b) Sympathetic nerves (from testicular plexus) c) Illioinguinal nerve L1 (within canal, ontop of cord)
  3. 3x Other structures: a) vas deferens b) Lympahtics c) Tunica vaginalis
  4. 1x Venous plexuses: Pampiniform plexus (runs entire way down plexus)
22
Q

Why are the Testes external?

A

Testes external so can be relatively colder than body temp –> VENOUS PLEXUS heat exchange/dissipation –> optimum enviro. for sperm production

23
Q

Testicular Artery

A

Abdominal aorta La

Supplied Testes and Epididymis

24
Q

Vas deferens

A

Muscular duct

Transport spermatozoa from Epididymis Urethra

25
Q

Artery of vas deferens

A

Accompanies Vas Deferens

IMPORTANT to be considered in order to avoid damaged during VASECTOMY

26
Q

Pampiniform Plexus

A

Temperature regulation

Forms a single vein in DIR

27
Q

Genital branch of Gentiofemoral nerve

A

Motor and sensory
Innervates:
1. Cremasteric Muscle
2. Skin of the Scrotum –> Therefore gentiofemoral nerve is located b/w External Spermatic Fascia + Cremasteric Muscle

28
Q

Lymphatics in scrotal area

A

Drain to Para-aortic nodes in L2

- this is the origin of testicular arteries

29
Q

Testicular Torsion

A

spermatic cord twists around –> cuts off blood supply –> ischaemia
Surgical emergency in 6 hours

30
Q

Symptoms of Testicular Torsion

A

Acute and severe testicular pain (L1-2) –> Loin-Groin (referred to groin + lower abdomen)
- similar symptoms to similar pathologies in anatomical region (epididimytis)
Absent/Decreased cremasteric reflex
Nausea/ Vomitting
Redness/Pyrexia (inflammation)

31
Q

Is there any predisposition to suffering from testicular torsion/decreased cremasteric reflex?

A

Pubinaculum is involved in testicular descent to scrotum –> Anchors testes to the floor of the scrotum
However: Some people are less anchored –> relatively freer to move –> greater risk of testicular torsion

32
Q

Normal Cremasteric reflex

A

(Juvenile)

  1. Stroke Superiomedial thigh –>
  2. Stimulation of sensory fibres of:
    a) Femoral branch of genitofemoral nerve (L1-2)
    b) Illioinguinal nerve (L1-2)
  3. Stimulation of motor fibres of: Genital branch of gentiofemoral nerve (which innervates cremasteric muscle and skin of scrotum)
  4. Contraction of Cremasteric muscle –> on Ipsilasteral (same) side –> Testes raised
33
Q

Cremasteric reflex if testicular torsion has occured

A

Cremasteric muscle isnt present
Confirming Occurance of testicular torsion:
- Superiomedial stroking stimulation of reflex isnt Infallible (Note: cremasteric reflex absence doesnt guarantee testicular torsion, and vice versa)
- Ultrasound confirmation shows lack of blood flow –> very reliable
Note: Testicular Torsion decreases blood Flow > doesnt occur in Epididimytis (therefore US can distinguish b/w the two)
6 hour window of opportunity –> after this chance of saving testis decreases significantly

Sita GenitoUrinary System (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions