Pelvis & Perineum

Question 1

what are the levator ani muscles?

Answer 1

• puboanalis
• pubococcygeus
• iliococcygeus

Question 2

describe the course of the inguinal canal

Answer 2

• defect in external oblique aponeurosis (superficial inguinal ring)
  arches over:
• internal oblique
• transversalis abdominis
• defect in transversalis fascia (deep inguinal ring)

Question 3

what are the borders of the inguinal canal?

Answer 3

anterior:
- external oblique aponeurosis
- (anterolateral) internal oblique
posterior:
- transversalis fascia
- (posteromedial) medial fibres of aponeuroses of internal oblique and transversus abdominis 
roof:
- transversalis fascia 
- arching fibres of internal oblique and transversus abdominis 
floor:
- inguinal ligament

Question 4

what is the inguinal ligament?

Answer 4

rolled-up lower border of the external oblique aponeurosis

Question 5

what are the contents of the spermatic cord in females?

Answer 5

• round ligament of uterus
• ilioinguinal nerve
• genital branch of genitofemoral nerve

Question 6

what are the contents of the spermatic cord in males?

Answer 6

3 nerves, 3 arteries, 3 fascial layers, 4 others

nerves:
- ilioinguinal
- genital branch of genitofemoral
- sympathetic nerve fibres
arteries:
- testicular
- cremasteric
- artery to vas deferens
fascial layers:
- external spermatic 
- cremasteric muscle and fascia 
- internal spermatic 
others:
- pampiniform venous plexus
- lymphatics
- vas deferens
- processus vaginalis

Question 7

what do the fascial layers in the male spermatic cord derive form?

Answer 7

external: external oblique
cremasteric: internal oblique
internal: transversalis fascia

Question 8

what is an indirect inguinal hernia?

Answer 8

intra-abdominal contents are forced through the deep inguinal ring and into the inguinal canal
- may be forced through to come out of the superficial ring and into the scrotum/follow the round ligament and into the labia majora

Question 9

what is a direct inguinal hernia?

Answer 9

intra-abdominal contents forced directly through posterior wall of inguinal canal (weak transversalis fascia) and through the superficial ring

• do not pass through deep ring