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Anatomy > Quiz 4 - Inguinal Region > Flashcards

Quiz 4 - Inguinal Region Flashcards

1
Q

inferior margin of the aponeurosis of the external oblique muscle extends from the ASIS to the ______

A
  • pubic tubercle

- is folded under upon itself and thickened to create the inguinal ligament

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2
Q

inguinal canal

A
  • created in the anterior abdominal wall in the fetal descent of the testis from the posterior abdominal wall into the scrotum
  • in males, the spermatic cord lies in this canal
  • in females, the ligamentum teres lies in this canal
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3
Q

what forms the inguinal canal?

A
  • inferior portion: inguinal ligament
  • superior portion: arching fibers of internal and transversus abdominis muscles
  • anterior wall: external oblique aponeurosis
  • posterior wall: transversalis fascia and the conjoint tendon (from int. oblique and trans. abdominis)
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4
Q

deep inguinal ring

A
  • the internal (deep) opening of the inguinal canal

- thru the transversalis fascia

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5
Q

superficial (external) inguinal ring

A
  • external opening of the inguinal canal; lies superior to the inguinal ligament
  • thru the aponeurosis of the external oblique muscle
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6
Q

spermatic cord

A
  • results from the descent of the testis into the scrotum dragging with it its blood supply, nerves, lymphatics, and vas deferens
  • 3 layers of the abdominal wall are “pushed out” in front of the descending testis and thereby form the fascial coverings of the spermatic cord
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7
Q

fascial coverings of spermatic cord

A
  • external oblique –> external spermatic fascia
  • internal oblique –> cremasteric muscle and fascia
  • transversalis fascia –> internal spermatic fascia
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8
Q

inguinal region (groin)

A
  • junction of the lower abdomen and the upper, medial thigh
  • abdominal wall is weaker here compared to other areas
  • common site for herniation of peritoneum and abdominal contents
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9
Q

inguinal ligament

A
  • formed by the thickened inferior margin of the external oblique aponeurosis
  • extends from the anterior superior iliac spine (ASIS) to the pubic tubercle (both palpable structures)
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10
Q

major structures within the spermatic cord

A
  1. vas (ductus) deferens
  2. testicular artery
  3. artery of the vas
  4. pampiniform plexus of veins
  5. processus vaginalis (obliterated peritoneum) at its center

-also, nerves and lymphatics

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11
Q

pampniform plexus

A
  • surrounds the testicular artery

- serves as an important counter-current thermo-regulatory function

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12
Q

hernias

A
  • protrusions of structures thru tissues that normally contain them
  • in the abdominal wall, the most common hernias are in the umbilical region (around the bellybutton) thru poorly healed surgical incisions and in the inguinal region
  • there must be a protrusion of the parietal peritoneum forming a sac which may or may not contain some intra-abdominal viscera
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13
Q

inguinal hernias

A

-either “direct” or “indirect,” depending on whether they originate medial or lateral to the inferior epigastric vessels

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14
Q

direct hernias

A

-protrude thru the inguinal (Hesselbach’s) triangle (medial to the inferior epigastric vessels) and is located alongside (not within) the spermatic cord.

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15
Q

indirect hernias

A

-pass thru the internal (deep) inguinal rings and therefore must reside within the spermatic cord coverings

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16
Q

as the testis descends into the scrotum…

A

…it becomes enveloped in the various tissues that it encounters as it pushes thru the abdominal wall

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17
Q

first layer of the abdominal wall that the testis meets as it descends into the scrotum

A

-the transversalis fascia, which is pushes out in front of itself thereby forming the innermost layer of the testis and the spermatic cord, called the internal spermatic fascia

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18
Q

second layer of the abdominal wall that the testis meets as it descends into the scrotum

A
  • internal oblique muscle

- some of its muscle fibers will be carried along to become the cremaster muscle fibers and its fascia

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19
Q

third layer of the abdominal wall that the testis meets as it descends into the scrotum

A

-external oblique aponeurosis, which will become the most superficial fascial layer of the spermatic cord, the external spermatic fascia

20
Q

does the transversus abdominis contribute to the fascial coverings of the spermatic cord?

A

-no because it originates in part from the lateral 1/3 of the inguinal ligaments, so the testis (which descend at the midpoint of the inguinal ligament) “miss” it entirely.

21
Q

inguinal triangle

A

bordered by the lateral edge of the rectus abdominis (semilunar line), inferior epigastric vessels, and the inguinal ligament

-one of two common sites for herniation; the other is the deep ring

22
Q

how do the inferior epigastric vessels reach and ascend along the posterior surface of the rectus abdominis muscle?

A

-they must penetrate the transversalis fascia of the posterior rectal sheath inferior to the arcuate line

23
Q

testes and ovaries begin their development where?

A
  • near the posterior abdominal wall
  • the testis descends from this position into the scrotum, passing thru the abdominal wall as it does so.
  • the ovary descends from the posterior abdominal wall into the pelvis
24
Q

testicular arteries

A
  • arise directly from the aorta in the superior portion of the posterior abdominal cavity (site of the embryonic origin of the testes)
  • are “dragged” into the scrotum as the testes descend
25
Q

descent of the testes

A
  • occurs posterior to the peritoneal cavity of which the processus vaginalis is an outpouching
  • testes do NOT enter the processus vaginalis, but travel posterior to it
26
Q

proximal portion of the processus vaginalis normally obliterates, leaving ___

A
  • the distal portion to become the tunica vaginalis

- the testis partially invaginates into the tunica vaginalis from posterior (fist in balloon)

27
Q

the posterior layer of the tunica partially covers the testis as the ____ tunica vaginalis

A

visceral

28
Q

the anterolateral layer of the tunica vaginalis becomes the ____ tunica vaginalis

A

parietal

29
Q

there (is/is not) usually some fluid between the visceral and parietal layers of the tunica vaginalis

A

IS

30
Q

what do you need for healthy production of spermatozoa?

A
  • the ambient temp of the testis must be lower than core body temp
  • some of the core body heat carried in the testicular artery is transferred to the surrounding pampniform plexus of veins, and ascends, never reaching the testis
31
Q

what else plays a role in the thermo-regulation of the testis?

A
  • cremasteric skeletal muscle in the spermatic cord and smooth muscle fibers in the dartos fascia of the scrotum
  • by contracting or relaxing they control the distance of the testes from the inguinal region and thereby help regulate the temperature
32
Q

the testes reside in the scrotum and are covered by what?

A

-a thick fibrous layer called the tunica albuginea

33
Q

testes are surrounded by which two layers of residual processus vaginalis (except on its posterior aspect)?

A

-the parietal and visceral layers of the tunica vaginalis

34
Q

seminiferous tubules of the testes drain thru the ___

A
  • straight tubules to the rete testis
  • then the efferent ductules into the convoluted epididymis, which is situated on the posterior surface of the testis and which transports the spermatozoa to the vas deferens
35
Q

testes originate in the embryo from ___

A

intermediate mesoderm in the posterior abdominal wall near the kidneys

-so, their arterial supply descends with them from the aorta into the scrotum, and the venous return is back to that same area

36
Q

lymphatic drainage of testis differs how from that of the scrotal skin?

A
  • lymphatics of testes drain into lateral (lumbar) and pre-aortic lymph nodes near the origin of the testicular vessels
  • scrotal lymphatics drain into superficial inguinal lymph nodes
37
Q

hydrocele

A
  • abnormal accumulation of fluid between the parietal and visceral layers of the tunica vaginalis
  • thought to develop when there is an imbalance between the secretion and reabsorption of fluid from the tunica vaginalis
  • typically are asymptomatic, but pain/pressure will increase with size
  • if left untreated, can get up to several L in size.
  • at birth or infancy are associated with a patent processus vaginalis
38
Q

visceral layer of tunica vaginalis is applied directly to ___

A

the fibrous capsule of the testis (tunica albuginea)

39
Q

contents of the spermatic cord

A
  • testicular artery
  • pampniform plexus of veins
  • ductus deference
  • branches of the genitofemoral nerve, to supply the cremaster muscule
40
Q

greater omentum

A
  • first thing you notice when you open the abdominal cavity
  • fatty fold of peritoneum which drapes inferiorly from the greater curvature of the stomach
  • lies anterior to the transverse colon and much of the small intestine
41
Q

what is visible when the greater omentum is elevated

A

-the transverse colon on the posterior surface of the omentum

42
Q

small intestine attached to the posterior wall of the abdominal cavity by a _____

A
  • mesentery (double layer of visceral peritoneum).

- allows the small intestine to be quite mobile

43
Q

transversalis fascia –> ___ (in spermatic cord)

A

internal spermatic fascia

44
Q

transversus abdominis –> ___ (in spermatic cord)

A

missed (bypassed)

45
Q

internal oblique –> ___ (in spermatic cord)

A

cremaster muscle

46
Q

external oblique –> ___ (in spermatic cord)

A

external spermatic fascia

Anatomy (13 decks)

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