Part II. Inguinal Region, spermatic cord, scrotum pg 40-44 Flashcards

1
Q

The region between ASIS and pubic tubercle?

A

Inguinal region

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2
Q

Oblique, inferomedially oriented passage along lower anterolateral abdominal wall that is 4cm long, parallel and superior to the inguinal ligament?

A

Inguinal canal

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3
Q

What does the inguinal canal contain?

A
  • spermatic cord in males
  • round ligament in females
  • blood vessels, lymphatics and ilioinguinal nerve
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4
Q

Structure that is about 1cm superior to middle portion of Inguinal Ligament, lateral to Inferior Epigastric A and inferior to Transversus Abdominis M.

A

Deep (Internal) Inguinal Ring

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5
Q

What is the Internal location of evaginated Transversalis Fascia?

A

Deep (Internal) Inguinal Ring

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6
Q

Slit-like opening in inferomedial portion of External Oblique Aponeurosis that is located superolateral to Pubic Tubercle

A

Superficial (External) Inguinal Ring

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7
Q

Lateral margins of superficial inguinal ring are called ______.

A

crura

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8
Q

The lateral crus of the superficial inguinal ligament attaches to ________.

A

Pubic tubercle

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9
Q

The medial crus of the superficial inguinal ligament attaches to ________.

A

Pubic crest

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10
Q

What spans between the 2 crura of the superficial inguinal ring to prevent separation?

A

Intercrural fibers

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11
Q

Anterior wall of inguinal canal

A

External Oblique aponeurosis

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12
Q

Posterior wall of inguinal canal

A

Transversalis Fascia - Reinforced by conjoint tendon

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13
Q

Roof of inguinal canal

A

Internal Oblique and Transversus Abdominis muscle/aponeuroses

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14
Q

Floor of inguinal canal

A

Inguinal L (i.e., rolled aponeurosis of External Oblique M)

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15
Q

Where do testes develop?

A

Testes develop in transversalis fascia of posterior abdominal wall, attached to anterior abdominal wall (at site of deep ring) by gubernaculum, which persists as scrotal ligament

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16
Q

What is the peritoneal diverticulum traversing the inguinal canal carrying muscular/fascial layers that will form around the spermatic cord and testis?

A

Processus vaginalis

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17
Q

The distal secular portion of the processes vaginalis will persist as __________.

A

parietal/visceral Tunica Vaginalis

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18
Q

What is the spermatic cord?

A

A structure that contains structures passing to/from testis. It begins at deep ring, passes through inguinal canal and superficial ring, ends at testis

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19
Q

What fascial layer of the spermatic cord is derived from evaginated External Oblique aponeurosis and investing fascia?

A

External Spermatic fascia

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20
Q

What fascial layer of the spermatic cord is derived from evaginated Internal Oblique investing fascia?

A

Cremasteric fascia

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21
Q

The cremaster muscle is derived from what?

A

from evaginated Internal Oblique M

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22
Q

What fascial layer of the spermatic cord is derived from evaginated Transversalis Fascia?

A

Internal Spermatic fascia

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23
Q

What is the function of the cremaster muscle?

A

Raises/lowers testis in scrotum in response to temperature to help maintain optimal temperature to support spermatogenesis

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24
Q

How is the cremaster muscle innervated?

A

Genital branch of Genitofemoral N (L1, L2)

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25
Q

What are the constituents of the spermatic cord?

A
  • ductus deferens (Vas Deferens)
  • testicular artery
  • ductus deferens artery
  • cremaster artery
  • pempiniform venous plexus
  • autonomic nerve fibers
  • genital branch of genitofemoral nerve
  • lymphatics
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26
Q

What is the function of the Ductus Deferens (Vas Deferens)?

A

Conveys sperm from Tail of Epididymis to Ejaculatory Duct

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27
Q

What artery supplies the testis and epididymus?

A

Testicular artery

28
Q

Where does the testicular artery branch from?

A

Abdominal Aorta just inferior to Renal A

29
Q

The testicular artery is initially located retroperitoneally. How does it get into the spermatic cord?

A

it crosses Ureter and External Iliac A, the enters inguinal canal at Deep Inguinal Ring and exits at Superficial Inguinal Ring

30
Q

Where does the ductus deferens artery branch from and what does it supply?

A

Branches from Inferior Vesical Artery and supplies the ductus deferens

31
Q

Where does the cremaster artery branch from and what does it supply?

A

Branches from Inferior Epigastric Artery to supply cremaster muscle

32
Q

What is the Extensive venous network formed by 8 to 12 individual veins that is located anterior to Ductus Deferens and surrounding Testicular Artery?

A

Pampiniform Venous Plexus

33
Q

Other than return of blood, what other function does the Pampiniform Venous Plexus have?

A

Because it surrounds the testicular artery, it contributes to thermoregulation by cooling the artery and its incoming blood for optimal spermatogenesis

34
Q

The right Pampiniform Venous Plexus converges with the right _________ and then drains to __________.

A

Testicular vein: inferior vena cava

35
Q

The left Pampiniform Venous Plexus converges with the left _________ and then drains to __________.

A

Testicular vein: left renal vein

36
Q

There is sympathetic innervation to what structures in the spermatic cord?

A
  • Testicular A and Ductus Deferens
37
Q

What are the VPRs that contribute to sympathetic innervation of the Testicular Artery and Ductus Deferens? What kind of fibers do they contain?

A

VPRs of T10-T11 that contain both efferent (vasomotor) and visceral afferent (pain)

38
Q

There is parasympathetic innervation to what structure in the spermatic cord? What cranial nerve carries these fibers?

A
  • Ductus Deferens

- vagus nerve

39
Q

What is the effect of sympathetic stimulation to the ductus deferens?

A

Stimulates contraction in ductus deferens during emission

40
Q

What is the effect of parasympathetic stimulation to the ductus deferens?

A

Relax ductus deferens after emission

41
Q

The lymphatics that drain the testis, epididymis and associated structures will drain to which nodes?

A

Lumbar lymph nodes

Note: Scrotum lymphatic drainage goes to Superficial Inguinal lymph nodes

42
Q

What is the fascia of the scrotum and what is it continuous with?

A

Dartos fascia

  • Continuation of Scarpa’s fascia in anterolateral abdominal wall
  • Continuation of Colles fascia in perineum
43
Q

Dartos fascia divides their stratum internally into right and left compartments by extending inward at __________ to from the __________.

A

scrotal raphe : scrotal septum

44
Q

What is the smooth muscle attached to the skin of the scrotum and what is it’s function?

A

Dartos muscle which contracts when cold to wrinkle scrotal skin & assist Cremaster mm. (reduces heat loss)

45
Q

What arteries supply the scrotum?

A

Anterior and posterior scrotal artery

46
Q

Anterior scrotal artery branches from where?

A

Deep External Pudendal A (from Femoral A)

47
Q

Posterior scrotal artery branches from where?

A

Perineal A (from Internal Pudendal A)

48
Q

Where do lymphatics from the scrotum drain to?

A

Superficial Inguinal lymph nodes

NOTE: testes drain to Lumbar lymph nodes

49
Q

What innervates anterolateral surface of the scrotum?

A

Genitofemoral nerve (L1,L2)

50
Q

What innervates anterior surface of the scrotum?

A

Anterior scrotal nerve which is a branch of ilioinguinal nerve (L1)

51
Q

What innervates the posterior surface of the scrotum?

A

Posterior scrotal nerve which branches from Perineal N (from Pudendal N, S2-S4)

52
Q

What innervates the inferior surface of the scrotum?

A

Posterior femoral cutaneous nerve (S2,S3)

53
Q

Which fascial layer of the testis is a continuation of the external oblique aponeurosis and investing fascia, and is also continuous with the same layer in the spermatic cord?

A

External spermatic fascia

-Forms outer tunic of trilaminar sac surrounding testis

54
Q

Which fascial layer of the testis is a continuation of the internal oblique investing fascia, and is also continuous with the same layer in the spermatic cord?

A

Cremasteric fascia

- Forms middle tunic of trilaminar sac surrounding testis

55
Q

Which fascial layer of the testis is a continuation of the transversalis fascia, and is also continuous with the same layer in the spermatic cord?

A

Internal spermatic fascia

- Forms inner tunic of trilaminar sac surrounding testis

56
Q

What is the pouch of serous membrane that covers the testes and is derived from the Processus Vaginalis of the peritoneum, which in the fetus precedes the descent of the testes from the abdomen into the scrotum.?

A

Tunica vaginalis

57
Q

The parietal layer of the tunica vaginalis fuses to internal surface of ________.

A

Internal Spermatic fascia

58
Q

The visceral layer of the tunica vaginalis fuses to external surface of ________, _________, and inferior _________.

A

testis, epididymis; inferior vas deferens

59
Q

The space between the parietal and visceral layers of the tunica vaginalis is filled with what?

A

Serous fluid

60
Q

What is the epididymis?

A

Very tightly convoluted duct on posterior surface of testis where spermatozoa are stored and undergo maturation prior to emission

61
Q

The diameter of the epididymis decreases from _______ (superiorly) to ______ (inferiorly).

A

head : tail

62
Q

What is the epididymis covered by?

A

Visceral Tunica Vaginalis

63
Q

How is the epididymis connected to testis?

A

by several microscopic efferent ductules

64
Q

What is the testis?

A

Ovoid organ suspended in scrotum by spermatic cord

65
Q

Which testis is usually suspended more inferiorly in the scrotum by the spermatic cord?

A

Left testis

66
Q

The capsule of the testis is _________ and it is covered by __________.

A

tunica albuginea : Visceral Tunica Vaginalis